Siza J E
National Institute for Medical Research, Mwanza Research Centre, P.O. Box 1462, Mwanza, Tanzania.
Tanzan J Health Res. 2008 Jan;10(1):1-8. doi: 10.4314/thrb.v10i1.14334.
According to the World Health Organization low birth weight (LBW) babies are those born with less than 2500g. A descriptive retrospective cross - sectional study using existing data from a one-year (2001) block of birth registers of 3464 pregnant women was done at Kilimanjaro Christian Medical Centre in Moshi, Tanzania. The objective was to determine factors associated with LBW and their contribution to the problem. Out of 648 pregnant women who were tested for HIV infection 59 (9.1%) were positive for the infection. Twelve (20.3%) of HIV positive women gave birth to LBW neonates. HIV positive women were twice more likely to give birth to LBW infants than HIV negative ones (chi2 = 6.7; P < 0.01; OR = 2.4; 1.1, 5.1). Mothers without formal education were 4 times more likely to give birth to LBW neonates than those who had attained higher education (OR = 3.6; 2.2, 5.9). There was a linear decrease in low birth weights of newborns as fraternal educational level increased (chi2 for linear trend = 42.7; P < 0.01). There was no statistically significant difference among parents' occupations regarding LBW of their newborns. Unmarried mothers were more likely to give birth to LBW neonates as compared to their married counterparts (OR = 1.65; 1.2, 2.2) and the difference was statistically significant (chi2 = 13.0, P < 0.01). Hypertension, pre-eclampsia and eclampsia disease complex had the highest prevalence (46.67%) and population attributable fraction of low birth weight (PAF = 25.2%; CI = 22.0-27.6). Bleeding and schistosomiasis had the same prevalence (33.33%) of LBW babies. Other complications and diseases which contributed to high prevalence of LBW included anaemia (25%), thromboembolic diseases (20%), tuberculosis (17%) and malaria (14.8%). Prevalence of LBW was high in women with premature rupture of membrane (38%), placenta previa (17%) and abruption of placenta (15.5%). LBW was strongly associated with gestational age below 37 weeks (OR = 2; CI = 1.5, 2.8) contributing to 42% of LBW deliveries in the study population (PAF = 42.4%: 25, 55). Pregnant women with malnutrition (BMI < 18) gave the highest proportions 17% of LBW children followed by underweight (BMI; 18-22) who gave 15.5% of LBW neonates. There was a statistical significant difference between the proportions of LBW infants from mothers who did not receive antenatal care (28.6%) and those who attended for the services (13.8%) (chi2 = 8.8; P = 0.01). There is need of increasing promotion of reproductive health services in relation to safe motherhood at community level in order to reduce risk factors of LBW.
根据世界卫生组织的定义，低体重出生（LBW）婴儿是指出生时体重低于2500克的婴儿。在坦桑尼亚莫希的乞力马扎罗基督教医疗中心，利用2001年为期一年的3464名孕妇的出生登记现有数据进行了一项描述性回顾性横断面研究。目的是确定与低体重出生相关的因素及其对该问题的影响。在648名接受艾滋病毒感染检测的孕妇中，59名（9.1%）感染呈阳性。12名（20.3%）艾滋病毒呈阳性的妇女产下了低体重出生的新生儿。艾滋病毒呈阳性的妇女产下低体重出生婴儿的可能性是艾滋病毒呈阴性妇女的两倍（卡方=6.7；P<0.01；比值比=2.4；1.1，5.1）。未受过正规教育的母亲产下低体重出生新生儿的可能性是受过高等教育母亲的4倍（比值比=3.6；2.2，5.9）。随着父母教育水平的提高，新生儿低体重出生情况呈线性下降（线性趋势卡方=42.7；P<0.01）。关于新生儿低体重出生情况，父母职业之间没有统计学上的显著差异。与已婚母亲相比，未婚母亲产下低体重出生新生儿的可能性更大（比值比=1.65；1.2，2.2），且差异具有统计学显著性（卡方=13.0，P<0.01）。高血压、先兆子痫和子痫疾病综合征的患病率最高（46.67%），低体重出生的人群归因分数（PAF=25.2%；可信区间=22.0-27.6）。出血和血吸虫病导致低体重出生婴儿的患病率相同（33.33%）。导致低体重出生高患病率的其他并发症和疾病包括贫血（25%）、血栓栓塞性疾病（20%）、结核病（17%）和疟疾（14.8%）。胎膜早破（38%）、前置胎盘（17%）和胎盘早剥（15.5%）的妇女中低体重出生的患病率较高。低体重出生与孕周低于37周密切相关（比值比=2；可信区间=1.5，2.8），在研究人群中导致42%的低体重出生分娩（PAF=42.4%：25，55）。营养不良（体重指数<18）的孕妇产下低体重出生儿童的比例最高，为17%，其次是体重过轻（体重指数；18-22）的孕妇，产下低体重出生新生儿的比例为15.5%。未接受产前护理的母亲所生低体重出生婴儿的比例（28.6%）与接受产前护理服务的母亲所生低体重出生婴儿的比例（13.8%）之间存在统计学显著差异（卡方=8.8；P=0.01）。有必要在社区层面加强与安全孕产相关的生殖健康服务推广，以降低低体重出生的风险因素。
