台灣地區嬰兒出生體重與妊娠週數分佈之長期變化趨勢

Long-term Secular Trends in Birth Weight and Gestational Age Among Live Births in Taiwan

10.6288/TJPH2003-22-05-12

李佩珍(Pei-Chen Lee)；郭素珍(Su-Chen Kuo)；鄧森文(Sen-Wen Teng)；呂宗學(Tsung-Hsueh Lu)；李中一(Chung-Yi Li)

妊娠週數 ； 出生體重 ； 早產 ； 低出生體重 ； 出生登記 ； gestational age ； birth weight ； pre-term birth ； low birth weight ； birth registry

台灣公共衛生雜誌

22卷5期（2003 / 10 / 01）

376 - 385

繁體中文

Objectives: To analyze the calendar-year specific distributions of birth weight and gestational age among live births in Taiwan for the years 1982, 1987, 1992, and 1997. Methods: After excluding implausible gestational age and birth weight, we calculated calendar or birth characteristics specific means and standard deviations of gestational age and birth weight. We also estimated the calendar-year specific rates of low birth infants (＜2500 grams) and pre-term birth (＜37 completed gestational weeks). Certain infant and maternal characteristics suspected of being associated with birth weight or gestational age were also calculated. We finally draw a gestation specific birth weight curve for the years 1982 and 1997, respectively. Results: The mean birth weight decreased by 3.2% (105 grams) between 1982 and 1997, and the rate of low birth weight of infant increased by 33.3%. The gestational weeks also reduced by 2.3% (0.9 weeks) and the rate of pre-term birth increased dramatically by 230% (2.6%-6.3%). Triplets or higher births showed the most reduction in both birth weight (16.8%) and gestational age (8.5%). Between the study period, the sex ratio and birth order distribution showed little variation whereas the proportion of mothers aged 35 or more and that of multiple births increased substantially by 3.8 and 13 times, respectively. Conclusions: The reduction of health care services and completeness of birth weight and gestation during the study period is possibly related to improvement in both health care services and completeness of birth registration. An increase in multiple births and a higher survival rate of very pre-term birth (＜34 weeks) might also contribute to the reduction of birth weight in recent years.

Objectives: To analyze the calendar-year specific distributions of birth weight and gestational age among live births in Taiwan for the years 1982, 1987, 1992, and 1997. Methods: After excluding implausible gestational age and birth weight, we calculated calendar or birth characteristics specific means and standard deviations of gestational age and birth weight. We also estimated the calendar-year specific rates of low birth infants (＜2500 grams) and pre-term birth (＜37 completed gestational weeks). Certain infant and maternal characteristics suspected of being associated with birth weight or gestational age were also calculated. We finally draw a gestation specific birth weight curve for the years 1982 and 1997, respectively. Results: The mean birth weight decreased by 3.2% (105 grams) between 1982 and 1997, and the rate of low birth weight of infant increased by 33.3%. The gestational weeks also reduced by 2.3% (0.9 weeks) and the rate of pre-term birth increased dramatically by 230% (2.6%-6.3%). Triplets or higher births showed the most reduction in both birth weight (16.8%) and gestational age (8.5%). Between the study period, the sex ratio and birth order distribution showed little variation whereas the proportion of mothers aged 35 or more and that of multiple births increased substantially by 3.8 and 13 times, respectively. Conclusions: The reduction of health care services and completeness of birth weight and gestation during the study period is possibly related to improvement in both health care services and completeness of birth registration. An increase in multiple births and a higher survival rate of very pre-term birth (＜34 weeks) might also contribute to the reduction of birth weight in recent years.

1. Alexander, G. R., De Caunes, F., Hulsey, T. C., Tompkins, M. E., Allen, M.(1992).Validity of Postnatal Assessments of Gestational Age: A Comparison of the Method of Ballard et al. and Early Ultrasonography.Am J Obstet Gynecol,166
2. Alexander, G. R., Tompkins, M. E., Cornely, D. A.(1990).Gestational Age Reporting and Preterm Delivery.Public Health Rep,105
3. Arbuckle, T. E., Wilkins, R., Sherman, G. J.(1993).Birth Weight Percentiles by Gestational Age in Canada.Obstet Gynecol,81
4. Blondel, B., Kogan, M. D., Alexander, G. R.(2002).The Impact of the Increasing Number of Multiple Births on the Rates of Pretermbirth and Low Birthweight: An International Study.Am J Public Health,92
5. Branum, A. M., Schoendorf, K. C.(2002).Changing Patterns of Low Birthweight and Preterm Birth in the United States, 1981-1998.Paediatr Perinat Epidemiol,16
6. Daltveit, A. K., Vollset, S. E., Skjaerven, R., Irgens, L. M.(1999).Impact of Multiple Births and Elective Deliveries on the Trends in Low Birthweight in Norway, 1967-1995.Am J Epidemiol,149
7. Emery, 3rd E. S., Eaton, A., Grether, J. K., Nelson, K. B.(1997).Assessment of Gestational Age Using Birth Certificate Data Compared with Medicalrecord Data.Paediatr Perinat Epidemiol,11
8. Gardosi, J., Vanner, T., Francis, A.(1997).Gestational Age and Induction of Labour for Prolonged Pregnancy.Br J Obstet Gynaecol,104
9. Golding, J.(1991).Reproductive and Perinatal Epidemiology.New York:CRC Press.
10. Hsieh, T. T., Hsu, J. J., Chen, C. J.(1991).Analysis of Birth Weight and Gestational Age in Taiwan.J Formosan Med Assoc,90
11. Jenicek, M.(1995).Epidemiology - The Logic of Modern Medicine.EPIMED International.
12. Joseph, K. S., Demissie, K., Kramer, M. S.(2002).Obstetric Intervention, Stillbirth, and Preterm Birth.Semin Perinatol,26
13. Joseph, K. S., Kramer, M. S.(1997).Recent Trends in Infant Mortality Rates and Proportions of Low-Birth-Weight Livebirths in Canada.CMAJ,157
14. Joseph, K. S., Kramer, M. S., Marcoux, S.(1998).Determinants of Preterm Birth Rates in Canada from 1981 through 1983 and from 1992 through 1994.N Engl J Med,339
15. Kaminski, M., Goujard, J., Rumeau-Rouquette, C.(1973).Prediction of Low Birth Weight and Prematurity by a Multiple Regression Analysis with Maternal Characteristics Known Since the Beginning of the Pregnancy.Int J Epidemiol,2
16. Kramer, M.(1997).Preventing Preterm Birth: Are We Making Any Progress?.Yale J Biol Med,70
17. Kramer, M. S., Morin, I., Yang, H.(2002).Why are Babies Getting Bigger? Temporal Trends in Fetal Growth and Its Determinants.J Pediatr,141
18. Mongelli, M., Gardosi, J.(1997).Birth Weight, Prematurity and Accuracy of Gestational Age.Int J Gynaecol Obstet,56
19. Silva, A. A., Barbieri, M. A., Gomes, U. A., Bettiol, H.(1998).Trends in Low Birth Weight: A Comparison of Two Birth Cohorts Separated by A 15-Year Interval in Ribeirao Preto, Brazil.Bull World Health Organ,76
20. Stein, Z. A., Susser, M.(1984).Intrauterine Growth Retardation: Epidemiological Issues and Public Health Significance.Semin Perinatol,8
21. Tough, S. C., Newburn-Cook, C., Johnston, D. W., Svenson, L. W., Rose, S., Belik, J.(2002).Delayed Childbearing and Its Impact on Population Rate Changes in Lower Birthweight, Multiple Birth, and Preterm Delivery.Pediatrics,109
22. Valero, C., Villalbi, J. R., Borrell, C., Nebot, M.(1996).Inequalities in Health at Birth: Barcelona, 1990-1991.Aten Primaria,17
23. Vintzileos, A. M., Ananth, C. V., Smulian, J. C., Scorza, W. E., Knuppel, R. A.(2002).The Impact of Prenatal Care in the United States on Preterm Births in the Presence and Absence of Antenatal High-Risk Conditions.Am J Obstet Gynecol,187
24. Wong, D. L.(1997).Whaley and Wong's Essentials of Pediatric Nursing.Saint Louis, MO:Mosby-Year Book Inc..
25. 何黎星(2002)。台中，中山大學醫學研究所。
26. 林金定 Lin, Jin-Ding、 陳麗美 Chen, Lih-Mei(1995)。台灣地區低出生體重兒之發生率及其危險因子之研究。公共衛生 Public Health Quarterly，1
27. 陳德人(1992)。新生兒出生體重分佈、新生兒死亡與新生兒醫療。中華民國新生兒科醫學會會刊，7
28. 陳麗美 Chen, Lih-Mei(1997)。台灣地區嬰兒死亡率、新生兒死亡率、週產期死亡率之流行病學調查台灣地區嬰兒死亡率、新生兒死亡率、週產期死亡率之流行病學調查,台北:行政院衛生署。
29. 劉桂霞 Liu, Kuei-Hsia、 李鴻森 Lee, Hong-Shen(1999)。懷孕週數與低出生體重及極低出生體重嬰兒盛行率之研究。中山醫學雜誌 The Chung Shan Medical Journal，10

1. 戴汝妤、邱冠斌、邱冠舜(2005)。台北市立婦幼綜合醫院低體重新生兒發生原因之研究。中華行政學報，2，153-175。
2. 賴金滿,孫海倫(2019)。育有接受早期療育早產兒之父母對偶親職參與之研究。若瑟醫護雜誌，13(1)，7-22。
3. 廖建彰、廖宗志、詹婉瑜、林俊龍、宋鴻樟(2006)。外籍新娘本地婦女的低出生體嬰兒比較。臺灣家庭醫學雜誌，16(4)，226-236。
4. 劉錦添、陳妍蒨、張景福(2013)。父母親失業對新生兒體重的影響。經濟論文，41(2)，183-213。
5. 羅紀琼、管中閔、王心妙(2006)。產婦個人特質與妊娠狀況對新生兒體重的影響。臺灣公共衛生雜誌，25(6)，474-481。
6. 邱冠斌(2008)。新竹市外籍配偶與低體重新生兒之相關性研究—以民國九十三年爲例。中華行政學報，5，123-142。
7. 吳嘉苓(2011)。編排風險：多胚胎孕育的多重社會科技網絡。台灣社會學，22，111-156。