Nahar Shamsun, Mascie-Taylor C G N, Begum Housne Ara
National Institute for Preventive and Social Medicine, Mohakhali, Dhaka 1212, Bangladesh.
Public Health Nutr. 2007 Sep;10(9):965-70. doi: 10.1017/S1368980007217975.
To determine whether maternal anthropometry predicted birth weight, and if so, to identify which cut-offs provided the best prediction of low birth weight (LBW) in a field situation.
Community-based longitudinal study.
A rural union of Bhaluka Upazila, Mymensingh, located 110 km north-west of Dhaka, the capital of Bangladesh.
A total of 1104 normotensive, non-smoking pregnant women who attended community nutrition centres were studied from first presentation at the centre until delivery of their child.
Most of the pregnant mothers were between 20 and 34 years of age. Over one-third of the women were nulliparous, while 12.8% were multiparous (parity >/= 4). Most (93%) mothers registered between the 3rd and 5th month of pregnancy. The frequency of LBW ( < 2500 g) was 17%. Polynomial regression analyses showed that the best predictors of birth weight (based on adjusted R2 values) were in general weight at registration and weight at month 9, with adjusted R2 ranging from 2.5% to nearly 20%. Sequential regression analyses with height and weight showed that there was a significant effect of height after removing the weight variables, and adjusted R2 increased in all analyses. Weight and height at registration month continued to be the best predictors of LBW. Sensitivity and specificity curves were drawn for each registration month, body mass index and different weight gain groups, and using different weight and height combinations. The results showed that, for registration month 3-5, a combination of weight ( </= 45 kg) and height ( </= 150 cm) gave the highest sensitivity, which was 50%. However, maternal weight </= 43 kg in pregnancy month 3-5 alone gave the highest sensitivity of 80%.
The best predictor of birth weight as a continuous variable was maternal weight at registration, each 1 kg increase in weight at registration being associated with an increase in birth weight of about 260 g. Maternal weight </= 43 kg in pregnancy month 3-5 alone gave the highest sensitivity of 80%. A combination of initial weight and height of the mother was not as good a predictor of LBW as weight alone.
确定孕产妇人体测量指标是否能预测出生体重，若能，则确定在实际情况下哪些临界值对低出生体重（LBW）具有最佳预测效果。
基于社区的纵向研究。
位于孟加拉国首都达卡西北110公里处的迈门辛希县巴卢卡乡的一个农村联合体。
共有1104名血压正常、不吸烟的孕妇参与研究，她们从首次到社区营养中心就诊直至分娩期间都在接受观察。
大多数孕妇年龄在20至34岁之间。超过三分之一的女性为初产妇，而12.8%为经产妇（产次≥4）。大多数（93%）母亲在怀孕第3至5个月进行了登记。低出生体重（<2500克）的发生率为17%。多项式回归分析表明，出生体重的最佳预测指标（基于调整后的R²值）通常是登记时的体重和第9个月的体重，调整后的R²范围从2.5%到近20%。对身高和体重进行的逐步回归分析表明，在去除体重变量后，身高有显著影响，且在所有分析中调整后的R²均有所增加。登记月份的体重和身高仍然是低出生体重的最佳预测指标。针对每个登记月份、体重指数和不同体重增加组，并使用不同的体重和身高组合绘制了敏感性和特异性曲线。结果表明，对于第3至5个月的登记情况，体重（≤45千克）和身高（≤150厘米）的组合具有最高敏感性，为50%。然而，仅怀孕第3至5个月时母亲体重≤43千克的敏感性最高，为80%。
作为连续变量的出生体重的最佳预测指标是登记时的孕产妇体重，登记时体重每增加1千克，出生体重约增加260克。仅怀孕第3至5个月时母亲体重≤43千克的敏感性最高，为80%。母亲的初始体重和身高组合对低出生体重的预测效果不如单独的体重。
