Bisai Samiran, Mahalanabis Dilip, Sen Amitava, Bose Kaushik, Datta Nandini
Department of Anthropology, Vidyasagar University, Midnapore 721 102, West Bengal, India.
Ann Hum Biol. 2007 Jan-Feb;34(1):91-101. doi: 10.1080/03014460601080728.
The study examined to what degree maternal early second trimester pregnancy weight is useful and efficient in predicting birth outcome of Bengalee women.
The cross-sectional retrospective study was conducted in a government general hospital in South Kolkata, India. This hospital serves the needs of people belonging to lower and lower middle class socio-economic groups. Data were collected by one-to-one interview for confirmation of age, history of last menstrual period (LMP) including medical disorders. Mother's weight was recorded at 14-18 weeks of pregnancy from the history of LMP. Birth weight was measured within 24h of delivery and gestational age was assessed by Ballard's method using newborn physical and neurological maturity scoring. Of the 331 Bengalees, 295 mother-baby pairs met the recruitment criteria and were included in this study.
Mean +/- SD maternal early second trimester pregnancy weight and birth weight were 45.9+/-7.0kg and 2612+/-371g, respectively. The difference in mean weight (3.74kg) between mothers who delivered low birth weight (LBW) and normal birth weight (NBW) babies was statistically significant (t = 4.497, p < 0.001). Overall, the prevalence of LBW was nearly 34%. A higher incidence of LBW and lower mean birth weight was observed in first quartile or low weight (< or =40 kg) mothers. The rate of LBW decreased (chi2 =14.47, p<0.01) and mean birth weight increased significantly with increasing maternal weight (F=9.218, p<0.001). Risk ratio (RR) for LBW, intrauterine growth retardation (IUGR) and preterm birth in low weight (first quartile or <40.0 kg) mothers were 2.72 (95% confidence interval (CI): 1.45-5.10), 3.54 (95% CI: 1.17-10.74) and 1.97 (95% CI: 0.56-6.90), respectively, compared with heavier (>50.0kg) mothers. Finally, the present data showed that the maternal weight of <46.0 kg is the best cut-off for detecting LBW with 66% sensitivity and 75% negative predictive power.
The findings suggest a positive association between maternal early second trimester pregnancy weight and birth outcome. The present study provided an efficient cut-off point for detecting LBW. Antenatal caregivers in health institutions and community health workers in the field can use this cut-off value for screening pregnant women at early second trimester.
本研究旨在探讨孕中期早期孕妇体重在预测孟加拉裔女性分娩结局方面的有效性和实用性。
本横断面回顾性研究在印度加尔各答南部的一家政府综合医院进行。该医院服务于社会经济地位较低和中下阶层的人群。通过一对一访谈收集数据，以确认年龄、末次月经（LMP）史，包括疾病史。根据LMP史记录孕妇在妊娠14 - 18周时的体重。出生体重在分娩后24小时内测量，胎龄通过巴拉德法评估，采用新生儿身体和神经成熟度评分。在331名孟加拉裔女性中，295对母婴符合纳入标准并被纳入本研究。
孕中期早期孕妇平均体重±标准差为45.9±7.0kg，出生体重为2612±371g。分娩低出生体重（LBW）婴儿的母亲与分娩正常出生体重（NBW）婴儿的母亲之间的平均体重差异（3.74kg）具有统计学意义（t = 4.497，p < 0.001）。总体而言，LBW的患病率接近34%。在第一四分位数或体重较低（≤40kg）的母亲中，LBW的发生率较高，平均出生体重较低。随着孕妇体重增加，LBW的发生率下降（χ² = 14.47，p < 0.01），平均出生体重显著增加（F = 9.218，p < 0.001）。体重较低（第一四分位数或<40.0kg）的母亲发生LBW、胎儿宫内生长受限（IUGR）和早产的风险比（RR）分别为2.72（95%置信区间（CI）：1.45 - 5.10）、3.54（95% CI：1.17 - 10.74）和1.97（95% CI：0.56 - 6.90），与体重较重（>50.0kg）的母亲相比。最后，目前的数据表明，孕妇体重<46.0kg是检测LBW的最佳临界值，灵敏度为66%，阴性预测值为75%。
研究结果表明孕中期早期孕妇体重与分娩结局之间存在正相关。本研究为检测LBW提供了一个有效的临界值。医疗机构的产前护理人员和现场社区卫生工作者可利用此临界值在孕中期早期对孕妇进行筛查。
