Yaya Sanni, Bishwajit Ghose, Ekholuenetale Michael, Shah Vaibhav
Faculty of Social Sciences, School of International Development and Global Studies, University of Ottawa , Ottawa, ON , Canada.
School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , China.
Front Public Health. 2017 Mar 6;5:35. doi: 10.3389/fpubh.2017.00035. eCollection 2017.
Globally, low birth weight (LBW) remains a leading cause of neonatal and infant mortality and poses significant challenges toward the progress of achieving infant mortality-related goals. Experience from developed countries shows that two major causes of LBW (premature delivery and intrauterine growth restriction) can be averted to a great extent by adequate utilization of maternal health-care services, during pregnancy. In this study, we attempt to measure the prevalence of LBW in Zimbabwe and explore the association between adequate utilization of prenatal care (PNC) services and LBW in Zimbabwe. We also explore other possible associations with LBW.
This study was based on nationally representative, cross-sectional data from Multiple Indicator Cluster Survey round 5, conducted in 2014. Participants included 3,221 mothers from both rural and urban areas. The participants were selected regardless of their current pregnancy status. Sample characteristics were presented using descriptive statistics. Association between utilization status of ANC and LBW was measured by chi-square (bivariate) test and logistic regression methods.
Prevalence of LBW was 12.8%. There was 11% reduction in the odds of having LBW babies for participants from urban area when compared with rural area (AOR = 0.897; 95% CI = 0.707-1.138). When compared to women with higher education, those having primary/below primary and secondary level qualification had higher odds of experiencing LBW babies by 73 and 56%, respectively. Participants who had less than four PNC/ANC visits had 34% higher odds (AOR = 1.340; 95% CI = 1.065-1.685) than those with at least four visits, and those who had given birth more than once, had 38% lower odds (AOR = 0.620; 95% CI = 0.493-0.780) of giving birth to LBW babies when compared to those who had given birth only once.
The findings of this study have programmatic and policy implications for low-resource nations and suggest that promoting access to ANC services especially in the rural areas is likely to reduce prevalence of LBW in Zimbabwe. This is important as LBW babies consume lot of health resources and not only in terms of hospitalization but also in terms of outpatient and physician visits during the first year of their life.
在全球范围内,低出生体重仍是新生儿和婴儿死亡的主要原因,对实现与婴儿死亡率相关目标的进展构成重大挑战。发达国家的经验表明,低出生体重的两个主要原因(早产和宫内生长受限)在很大程度上可以通过孕期充分利用孕产妇保健服务来避免。在本研究中,我们试图测量津巴布韦低出生体重的患病率,并探讨产前保健(PNC)服务的充分利用与津巴布韦低出生体重之间的关联。我们还探讨了与低出生体重其他可能的关联。
本研究基于2014年进行的多指标类集调查第5轮具有全国代表性的横断面数据。参与者包括来自农村和城市地区的3221名母亲。参与者的选择不考虑其当前的怀孕状况。使用描述性统计呈现样本特征。通过卡方(双变量)检验和逻辑回归方法测量产前保健利用状况与低出生体重之间的关联。
低出生体重的患病率为12.8%。与农村地区的参与者相比,城市地区的参与者生出低出生体重婴儿的几率降低了11%(调整后比值比[AOR]=0.897;95%置信区间[CI]=0.707 - 1.138)。与受过高等教育的女性相比,小学及以下学历和初中学历的女性生出低出生体重婴儿的几率分别高出73%和56%。产前保健/孕期检查次数少于4次的参与者生出低出生体重婴儿的几率比至少进行4次检查的参与者高出34%(AOR = 1.340;95% CI = 1.065 - 1.685),与只生育过一次的女性相比,生育过不止一次的女性生出低出生体重婴儿的几率低38%(AOR = 0.620;95% CI = 0.493 - 0.780)。
本研究结果对资源匮乏国家具有规划和政策意义,并表明促进产前保健服务的可及性,尤其是在农村地区,可能会降低津巴布韦低出生体重的患病率。这一点很重要,因为低出生体重婴儿不仅在住院方面,而且在其生命的第一年进行门诊和看医生方面都消耗大量卫生资源。