Smith R M, Smith P A, McKinnon M, Gracey M
Miln Walker and Associates Pty Ltd, Belair, South Australia.
Aust N Z J Public Health. 2000 Apr;24(2):124-35. doi: 10.1111/j.1467-842x.2000.tb00132.x.
To improve, by culturally appropriate means, birthweights and growth of children up to three years of age over 14 months in five Aboriginal communities in north-western Australia.
Frequent individual nutritional assessment of infants and children with counselling of mothers and carers and of pregnant women and the introduction of the Aboriginal-controlled Strong Women, Strong Babies, Strong Culture maternal support program. Outcomes compared with those in the same communities for the five years preceding intervention.
By international standards, pre-intervention birthweights of full-term infants (37-42 weeks) were only moderately depressed and recovered to exceed standard weight-for-age within two weeks of birth. Growth of full-term infants slowed abruptly after six months. Prevalence and duration of breastfeeding were very high. Prevailing low average birthweight was chiefly attributable to a prevalence of pre-term birth approaching 20%. Intervention was not accompanied by any change in full-term birth weight but was associated with increased weight gain after six months. From 12 to 36 months growth rose by 30 g per month (p = 0.001). Average birthweights of pre-term infants were < 2,500 g and average weight-for-age did not improve during intervention.
Both low birthweight and a disproportionate part of intransigent failure to grow by Aboriginal infants were associated with pre-term birth. Depressed average growth of full-term infants appeared to respond to nutritional counselling accompanied by a community support program.
Investigation of the causes of the exceptionally high rate of Aboriginal pre-term birth in the region is urgently required.
通过采用符合文化习俗的方法，在澳大利亚西北部的五个原住民社区，使14个月内三岁以下儿童的出生体重和生长状况得到改善。
对婴儿和儿童进行频繁的个体营养评估，并为母亲、照顾者以及孕妇提供咨询服务，同时引入由原住民管理的“强壮女性、强壮婴儿、强壮文化”孕产妇支持项目。将干预后的结果与干预前五年同一社区的情况进行比较。
按照国际标准，干预前足月婴儿（37 - 42周）的出生体重仅略有降低，且在出生后两周内恢复到超过标准年龄体重。足月婴儿六个月后生长突然放缓。母乳喂养的普及率和持续时间非常高。普遍较低的平均出生体重主要归因于早产患病率接近20%。干预并未伴随足月出生体重的任何变化，但与六个月后体重增加有关。在12至36个月期间，生长速度每月增加30克（p = 0.001）。早产婴儿的平均出生体重<2500克，干预期间平均年龄体重并未改善。
低出生体重以及原住民婴儿生长顽固不发育的不成比例部分均与早产有关。足月婴儿平均生长发育迟缓似乎对营养咨询及社区支持项目有反应。
迫切需要对该地区原住民早产率异常高的原因进行调查。
