Khanal Vishnu, Sauer Kay, Karkee Rajendra, Zhao Yun
School of Public Health, Curtin University, Perth, Australia.
BMC Pregnancy Childbirth. 2014 Jan 18;14:32. doi: 10.1186/1471-2393-14-32.
The global Low Birth Weight (LBW) rate is reported to be 15.5% with more than 95% of these LBW infants being from developing countries. LBW is a major factor associated with neonatal deaths in developing countries. The determinants of low birth weight in Nepal have rarely been studied. This study aimed to identify the factors associated with small size at birth among under-five children.
Data from the 2011 Nepal Demographic and Health Survey (NDHS) were used. The association between small size at birth and explanatory variables were analysed using Chi-square tests (χ2) followed by logistic regression. Complex Sample Analysis was used to adjust for study design and sampling.
A total of 5240 mother- singleton under five child pairs were included in the analysis, of which 936 (16.0%) children were reported as small size at birth. Of 1922 infants whose birth weight was recorded, 235 (11.5%) infants had low birth weight (<2500 grams). The mean birth weight was 3030 grams (standard deviation: 648.249 grams).The mothers who had no antenatal visits were more likely (odds ratio (OR) 1.315; 95% confidence interval (CI) (1.042-1.661)) to have small size infants than those who had attended four or more antenatal visits. Mothers who lived in the Far-western development region were more likely to have (OR 1.698; 95% CI (1.228-2.349)) small size infants as compared to mothers from the Eastern development region. Female infants were more likely (OR 1.530; 95% CI (1.245-1.880)) to be at risk of being small than males.
One in every six infants was reported to be small at birth. Attendance of antenatal care programs appeared to have a significant impact on birth size. Adequate antenatal care visits combined with counselling and nutritional supplementation should be a focus to reduce adverse birth outcomes such as small size at birth, especially in the geographically and economically disadvantaged areas such as Far-western region of Nepal.
据报道，全球低体重出生率为15.5%，其中超过95%的低体重婴儿来自发展中国家。低体重是发展中国家新生儿死亡的主要相关因素。尼泊尔低出生体重的决定因素鲜有研究。本研究旨在确定五岁以下儿童中与出生时体型小相关的因素。
使用2011年尼泊尔人口与健康调查（NDHS）的数据。采用卡方检验（χ2）分析出生时体型小与解释变量之间的关联，随后进行逻辑回归分析。采用复杂样本分析来调整研究设计和抽样。
共有5240对五岁以下母亲与单胎子女被纳入分析，其中936名（16.0%）儿童被报告出生时体型小。在1922名记录了出生体重的婴儿中，235名（11.5%）婴儿出生体重低（<2500克）。平均出生体重为3030克（标准差：648.249克）。未进行产前检查的母亲生出体型小的婴儿的可能性更大（优势比（OR）为1.315；95%置信区间（CI）为（1.042 - 1.661）），而进行过四次或更多次产前检查的母亲则不然。与东部发展地区的母亲相比，居住在远西发展地区的母亲生出体型小的婴儿的可能性更大（OR为1.698；95%CI为（1.228 - 2.349））。女婴比男婴更有可能（OR为1.530；95%CI为（1.245 - 1.880））体型小。
据报告，每六名婴儿中就有一名出生时体型小。参加产前保健项目似乎对出生时的体型有显著影响。应重点关注充分的产前检查，并结合咨询和营养补充，以减少不良出生结局，如出生时体型小，特别是在尼泊尔远西地区等地理和经济条件不利的地区。
