Khatun Selina, Rahman Mahmudur
Institute of Epidemiology Disease Control and Research, Dhaka, Bangladesh.
J Biosoc Sci. 2008 May;40(3):321-37. doi: 10.1017/S0021932007002532. Epub 2007 Nov 16.
Four hundred and sixty-five pregnant women and their newborn babies were studied at a maternal and child health training institute in Dhaka, Bangladesh, between July 2002 and June 2003 with the objective of (1) examining the relationship between birth weight and maternal factors, and, if there was a dose-response relationship between quality of antenatal care and birth weight, (2) predicting the number of antenatal visits required for women with different significant characteristics to reduce the incidence of low-birth-weight babies. The study revealed that 23.2% of the babies were of low birth weight according to the WHO cut-off point of <2500 g. Mean birth weight was 2674.19+/-425.31 g. A low birth weight was more common in younger (<20 years) and older (> or =30 years) mothers, the low-income group and those with little or no education. The mean birth weight of the babies increased with an increase in quality of antenatal care. The babies of the mothers who had 6+ antenatal visits were found to be 727.26 g heavier than those who had 1-3 visits and 325.88 g heavier than those who had 4-5 visits. No significant relationship was found between number of conception, birth-to-conception interval, BMI at first visit, sex of the newborn and birth weight. Further, from multiple regression analysis (stepwise), it was revealed that number of antenatal visits, educational level of the mother and per capita yearly income had independent effects on birth weight after controlling the effect of each variable. Using multiple regression analysis, the estimated number of antenatal visits required to reduce the incidence of low-birth-weight babies for women with no education and below-average per capita income status was 6; the number required for women with no education and above-average per capita income status was 5; and that for women with education and with any category of income status was 4 visits. So there is a need to stratify women according to their income and educational status so that, along with other measures, the required number of antenatal visits can be estimated beforehand to reduce the incidence of low-birth-weight babies.
2002年7月至2003年6月期间，在孟加拉国达卡的一家妇幼保健培训机构对465名孕妇及其新生儿进行了研究，目的是：（1）研究出生体重与母亲因素之间的关系，以及产前护理质量与出生体重之间是否存在剂量反应关系；（2）预测具有不同显著特征的妇女为降低低体重儿发生率所需的产前检查次数。研究显示，根据世界卫生组织<2500克的临界值，23.2%的婴儿为低体重儿。平均出生体重为2674.19±425.31克。低体重儿在年轻（<20岁）和年长（≥30岁）母亲、低收入群体以及受教育程度低或未受过教育的母亲中更为常见。随着产前护理质量的提高，婴儿的平均出生体重增加。发现进行6次及以上产前检查的母亲所生的婴儿比进行1 - 3次产前检查的母亲所生的婴儿重727.26克，比进行4 - 5次产前检查的母亲所生的婴儿重325.88克。未发现受孕次数、受孕间隔、首次就诊时的体重指数、新生儿性别与出生体重之间存在显著关系。此外，多元回归分析（逐步法）显示，在控制每个变量的影响后，产前检查次数、母亲的教育水平和人均年收入对出生体重有独立影响。使用多元回归分析，对于未受过教育且人均收入低于平均水平的妇女，为降低低体重儿发生率所需的产前检查次数估计为6次；对于未受过教育且人均收入高于平均水平的妇女，所需次数为5次；对于受过教育且处于任何收入水平的妇女，所需次数为4次。因此，有必要根据妇女的收入和教育状况进行分层，以便与其他措施一起，预先估计所需的产前检查次数，以降低低体重儿的发生率。
