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尼泊尔一家三级医院足月低出生体重及其决定因素:一项病例对照研究。

Low birth weight at term and its determinants in a tertiary hospital of Nepal: a case-control study.

作者信息

Sharma Sudesh Raj, Giri Smith, Timalsina Utsav, Bhandari Sanjiv Sudarshan, Basyal Bikash, Wagle Kusum, Shrestha Laxman

机构信息

Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal.

The University of Tennessee Health Science Center, Memphis, United States of America.

出版信息

PLoS One. 2015 Apr 8;10(4):e0123962. doi: 10.1371/journal.pone.0123962. eCollection 2015.

Abstract

Birth weight of a child is an important indicator of its vulnerability for childhood illness and chances of survival. A large number of infant deaths can be averted by appropriate management of low birth weight babies and prevention of factors associated with low birth weight. The prevalence of low birth weight babies in Nepal is estimated to be about 12-32%.Our study aimed at identifying major determinants of low birth weight among term babies in Nepal. A hospital-based retrospective case control study was conducted in maternity ward of Tribhuvan University Teaching Hospital from February to July 2011. A total of 155 LBW babies and 310 controls were included in the study. Mothers admitted to maternity ward during the study period were interviewed, medical records were assessed and anthropometric measurements were done. Risk factors, broadly classified into proximal and distal factors, were assessed for any association with birth of low-birth weight babies. Regression analysis revealed that a history of premature delivery (adjusted odds ratio; aOR5.24, CI 1.05-26.28), hard physical work during pregnancy (aOR1.48, CI 0.97-2.26), younger age of mother (aOR1.98, CI 1.15-3.41), mothers with haemoglobin level less than 11gm/dl (aOR0.51, CI0.24-1.07) and lack of consumption of nutritious food during pregnancy (aOR1.99, CI 1.28-3.10) were significantly associated with the birth of LBW babies. These factors should be addressed with appropriate measures so as to decrease the prevalence of low birth weight among term babies in Nepal.

摘要

儿童出生体重是其患儿童期疾病易感性和生存几率的一项重要指标。通过对低出生体重儿进行恰当管理以及预防与低出生体重相关的因素,可避免大量婴儿死亡。据估计,尼泊尔低出生体重儿的患病率约为12%至32%。我们的研究旨在确定尼泊尔足月儿中低出生体重的主要决定因素。2011年2月至7月,在特里布万大学教学医院的产科病房开展了一项基于医院的回顾性病例对照研究。该研究共纳入了155名低出生体重儿和310名对照。对研究期间入住产科病房的母亲进行了访谈,评估了病历并进行了人体测量。对大致分为近端因素和远端因素的风险因素与低出生体重儿出生之间的关联进行了评估。回归分析显示,早产史(调整优势比;aOR 5.24,可信区间1.05 - 26.28)、孕期从事繁重体力劳动(aOR 1.48,可信区间0.97 - 2.26)、母亲年龄较小(aOR 1.98,可信区间1.15 - 3.41)、血红蛋白水平低于11克/分升的母亲(aOR 0.51,可信区间0.24 - 1.07)以及孕期未摄入营养食品(aOR 1.99,可信区间1.28 - 3.10)与低出生体重儿的出生显著相关。应采取适当措施处理这些因素,以降低尼泊尔足月儿中低出生体重的患病率。

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