Torres-Arreola Laura P, Constantino-Casas Patricia, Flores-Hernández Sergio, Villa-Barragán Juan Pablo, Rendón-Macías Enrique
Health Services and Epidemiologic Research Unit, National Medical Centre Century XXI, Mexican Institute of Social Security, Mexico.
BMC Public Health. 2005 Mar 3;5:20. doi: 10.1186/1471-2458-5-20.
Low birth weight (LBW) is a public health problem linked to lack of equity in populations. Despite efforts to decrease the proportion of newborns with LBW, success has been quite limited. In recent years, studies focused on explaining how social factors influence this problem have shown that populations with greater inequities have a greater proportion of newborns with LBW.
The objective was to describe socioeconomic factors related to LBW adjusted by demographic, reproductive and health services variables in Mexico City. A case-control study was carried out in three hospitals with gynaecological and obstetrics services in Mexico City during the first half of 1996. During the recruiting period all children with LBW (cases), defined as newborns weighing <2500 grams, were matched with children born on the same day to control for time of birth. Upon arrival at the hospital for delivery, women were interviewed to determine if they met our inclusion criteria. Women with a history of chronic conditions and those with twin or multiple pregnancies were excluded. Variables with clinical and statistical significance were included in a multivariate model (logistic regression).
We found that low socioeconomic level was the most important risk factor for LBW and was independent of other factors, including those related to reproduction and nutrition, smoking, morbidity during pregnancy, accessibility to health services and prenatal care (OR 2.68; 95% CI 1.19, 6.03).
We found that socioeconomic factors are relevant to LBW. However further research should be done in different population groups as well as developing precise ways of measuring socioeconomic factors and their role in reproductive health.
低出生体重是一个与人群中缺乏公平性相关的公共卫生问题。尽管一直在努力降低低出生体重新生儿的比例，但成效相当有限。近年来，专注于解释社会因素如何影响这一问题的研究表明，不平等程度较高的人群中低出生体重新生儿的比例更大。
目的是描述墨西哥城经人口统计学、生殖和卫生服务变量调整后的与低出生体重相关的社会经济因素。1996年上半年，在墨西哥城三家设有妇产科服务的医院开展了一项病例对照研究。在招募期间，所有低出生体重儿童（病例），即体重<2500克的新生儿，与同一天出生的儿童进行匹配，以控制出生时间。在产妇入院分娩时，对其进行访谈以确定是否符合纳入标准。有慢性病病史的妇女以及怀有双胞胎或多胞胎的妇女被排除。具有临床和统计学意义的变量被纳入多变量模型（逻辑回归）。
我们发现社会经济水平低是低出生体重最重要的风险因素，且独立于其他因素，包括与生殖和营养、吸烟、孕期发病率、获得卫生服务和产前护理相关的因素（比值比2.68；95%置信区间1.19，6.03）。
我们发现社会经济因素与低出生体重相关。然而，应在不同人群中开展进一步研究，并开发精确测量社会经济因素及其在生殖健康中作用的方法。
