Nkwabong E, Kamgnia Nounemi N, Sando Z, Mbu R E, Mbede J
Department of Obstetrics & Gynecology, Central Maternity/Faculty of Medicine and Biomedical Sciences, Yaoundé, Cameroon.
Faculty of Medicine and Biomedical Sciences, Yaoundé, Cameroon.
Placenta. 2015 Feb;36(2):138-41. doi: 10.1016/j.placenta.2014.12.005. Epub 2014 Dec 19.
Low birth weight (LBW) is associated with increased neonatal morbidity and mortality. Hence, this condition should be well studied. The aims of this study were to identify the risk factors for term born LBW, as well as the placental histopathological lesions observed.
This case control study was carried out in the University Teaching Hospital and the Central Maternity, both of Yaoundé, Cameroon, from November 1st, 2013 to April 30th, 2014. Maternal medical records and placentas of term born (≥37 completed weeks) LBW (<2500 g at birth) or normal weight (3000-3500 g) were compared. The main variables recorded included maternal age and parity, maternal height, complications that occurred during pregnancy, maternal pre-gestational body mass index, the number of antenatal visits, the sex and birth weight of the newborn, the umbilical cord length, the placental weight and placental histology. Data were analyzed using Epi info 3.5.4. Fisher exact test, t-test and logistic regression were used for comparison. P < 0.05 was considered statistically significant.
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A total of 30 cases of LBW and the same number of controls were examined. Significant risk factors for LBW were primiparity (aOR 14.0, 95%CI 2.1-92.7), hypertensive diseases of pregnancy (aOR 18.1, 95%CI 1.02-322.5) and <4 antenatal visits (aOR 9.5, 95%CI 1.3-67.5). Significant placental lesions were placental infarction (aOR 19.5, 95%CI 2.9-130.1) and chronic villitis (aOR 35.9, 95%CI 1.2-1034.3). Our study showed that primiparous women, those with pregnancy-induced hypertensive diseases and those with <4 antenatal visits were more at risk for LBW. Significant placental lesions observed among LBW were placental infarcts and chronic villitis. Since LBW has the tendency to recur, and given that some causes such as placental infarcts are preventable, we recommend that a histological examination of the placenta should always be carried out in cases of LBW.
低出生体重与新生儿发病率和死亡率的增加相关。因此，应对这种情况进行充分研究。本研究的目的是确定足月儿低出生体重的危险因素以及观察到的胎盘组织病理学病变。
本病例对照研究于2013年11月1日至2014年4月30日在喀麦隆雅温得的大学教学医院和中央妇产医院进行。比较了足月儿（≥37足周）低出生体重（出生时<2500g）或正常体重（3000 - 3500g）的产妇病历和胎盘。记录的主要变量包括产妇年龄和产次、产妇身高、孕期发生的并发症、孕前体重指数、产前检查次数、新生儿性别和出生体重、脐带长度、胎盘重量和胎盘组织学。使用Epi info 3.5.4软件进行数据分析。采用Fisher精确检验、t检验和逻辑回归进行比较。P < 0.05被认为具有统计学意义。
共检查了30例低出生体重病例和相同数量的对照。低出生体重的显著危险因素是初产（调整后比值比14.0，95%可信区间2.1 - 92.7）、妊娠高血压疾病（调整后比值比18.1，95%可信区间1.02 - 322.5）和产前检查次数<4次（调整后比值比9.5，95%可信区间1.3 - 67.5）。显著的胎盘病变是胎盘梗死（调整后比值比19.5，95%可信区间2.9 - 130.1）和慢性绒毛炎（调整后比值比35.9，95%可信区间1.2 - 1034.3）。我们的研究表明，初产妇、患有妊娠高血压疾病的妇女以及产前检查次数<4次的妇女发生低出生体重的风险更高。在低出生体重儿中观察到的显著胎盘病变是胎盘梗死和慢性绒毛炎。由于低出生体重有复发的倾向，而且鉴于一些原因如胎盘梗死是可预防的，我们建议对于低出生体重病例应始终进行胎盘组织学检查。
