湖北省新生儿低出生体重空间格局及影响因素分析

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摘要目的描述2016年湖北省各乡镇街道尺度低出生体重发生率的空间格局及影响因素,为湖北省各地开展相关的疾病干预、医疗资源布局及制定区域差异化政策提供科学依据。方法基于地区生育特征变量、社会经济变量和自然环境变量,以混合层级区划方法为基础,进行低出生体重发生率疾病制图;运用最小二乘法和地理加权回归相结合,以及地理探测器方法,分析低出生体重的影响因素。结果区划后985个新区域低出生体重发生率Moran′s I的指数为0.31,具有一定的空间自相关性。小于胎龄儿占比、高龄产妇占比、非单胎占比、海拔和归一化植被指数在普通最小二乘法回归与地理加权回归,以及地理探测器结果中均为显著变量。大部分地区,小于胎龄儿占比、非单胎占比和海拔与低出生体重发生率呈正相关;归一化植被指数在鄂中与鄂东地区与低出生体重发生率呈负相关,在鄂北与鄂西大部分地区与低出生体重发生率呈正相关。高龄产妇占比在地理探测器结果中与低出生体重发生率呈正相关,与最小二乘法回归和地理加权回归结果相反。此外,二胎占比在普通最小二乘法回归与地理加权回归中为显著变量,该变量与低出生体重发生率呈负相关关系;城乡居民人均可支配收入比在地理探测器中为显著变量,与低出生体重发生率呈“U型”关系。结论湖北省低出生体重发生率热点区域在西部平原-山地过渡区呈条带状分布,在武汉市及周围地区呈团状分布。就影响因素而言,胎龄、胎数、胎次、海拔和归一化植被指数对新生儿低出生体重的影响较大。各变量在不同地区对低出生体重发生率的影响作用不同;生育特征变量对新生儿低出生体重的影响大于自然环境变量,社会经济变量的作用较小。个别变量在两种方法中的结果具有较大差异,需进一步研究探讨。

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	王颖霜
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	杨淼

关键词 ：低出生体重, 空间格局, 影响因素, 湖北省

Abstract：Objective This study aims to describe the spatial pattern of low birth weight incidence rate at the township/street level in Hubei Province in 2016 and to analyze its influencing factors, so as to provide scientific evidence for conducting relevant disease intervention, allocating healthcare resources and making policies in different regions in Hubei Province. Methods Based on the variables of regional characteristics on fertility, socioeconomic status and physical environment, the Mixed Level Regionalization(MLR) is used to map the incidence rate of low birth weight, and the Ordinary Least Squares(OLS) combined with Geographical Weighting Regression(GWR) and Geo-detector are used to analyze the influencing factors of low birth weight. Results After regionalization, 985 new areas are obtained, and Moran′s I of low birth weight rate in the new areas is 0.31, which confirms spatial autocorrelation existing for the low birth weight incidence rate among the spatial units. The proportion of small gestational age, advanced maternal age and non-single birth, altitude and Normalized Difference Vegetation Index(NDVI) are significant variables identified by the OLS and GWR models, as well as the Geo-detector. The proportion of small gestational age, non-single birth and altitude are positively correlated with the incidence rate of low birth weight in most areas. NDVI is negatively correlated with low birth weight in the central and eastern Hubei, and positively correlated with low birth weight in northern and most of western Hubei. The proportion of advanced maternal age is positively correlated with the incidence rate of low birth weight identified by the Geo-detector, which is contrary to the results of OLS and GWR models. In addition, the proportion of second birth is a significant variable in OLS and GWR models, which is negatively correlated with the incidence rate of low birth weight. The per capita disposable income ratio of urban and rural residents is a significant variable identified by the Geo-detector, and showed an ‘U′-shaped relationship with the incidence rate of low birth weight. Conclusion The results show that the hot spots of low birth weight in Hubei Province are distributed in strips in the western plain-mountainous transition zone and in clusters in Wuhan and its surrounding areas. As far as influencing factors are concerned, gestational age, number of births, parity, altitude and NDVI have significant influence on the low birth weight of newborns. Different variables have different effects on the incidence rate of low birth weight in different regions. Fertility characteristic variables have a greater impact on low birth weight than natural environment variables, while socio-economic variables have less effect. Several variables show different impacts on the incidence rate of low birth weight in the two methods, which needs further study and discussion.

Key words： low birth weight spatial pattern influencing factors Hubei Province

收稿日期: 2021-05-31

ZTFLH:

R17

基金资助:国家自然科学基金面上项目(41671497)

通讯作者: 程杨(chengyang@bnu.edu.cn)

引用本文:

王颖霜, 程杨, 冯玲, 王少帅, 杨淼. 湖北省新生儿低出生体重空间格局及影响因素分析[J]. 中国生育健康杂志, 2023, 34(1): 35-46. WANG Yingshuang, CHENG Yang, FENG Ling, WANG Shaoshuai, YANG Miao. Analysis of spatial pattern and influencing factors of newborn low birth weight in Hubei Province. Chinese Journal of Reproductive Health, 2023, 34(1): 35-46.

链接本文:

http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2023/V34/I1/35

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