Mengesha Hayelom Gebrekirstos, Wuneh Alem Desta, Weldearegawi Berhe, Selvakumar Divya L
College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia.
School of Public Health, Mekelle University, Mekelle, Ethiopia.
BMC Pediatr. 2017 Jun 12;17(1):144. doi: 10.1186/s12887-017-0901-1.
Infant birth weight, which is classified into low birth weight, normal birth weight and macrosomia, is associated with short and long-term health consequences, such as neonatal mortality and chronic disease in life. Macrosomia and low birth weight are double burden problems in developing counties, such as Ethiopia, but the paucity of evidence has made it difficult to assess the extent of this situation. As a result there has been inconsistency in the reported prevalence of low birth weight and macrosomia in Ethiopia. This study aimed to determine the incidence and predictors of low birth weight and macrosomia in Tigray, Northern Ethiopia.
We conducted a cross-sectional survey among a cohort of 1152 neonates delivered in Tigray Region at randomly selected hospitals between April and July 2014. We used the birth weight category described previously as an outcome variable. Data were collected using structured questionnaire by midwives. We entered and analyzed data using STATA™ Version 11.0. Data were described using a frequency, percentage, relative risk ratio, and 95% confidence interval. Multinomial logistic regression was conducted to identify independent predictors of low birth weight and macrosomia.
In this study, we found a 10.5% and 6.68% incidence of low birth weight and macrosomia, respectively. Seventy (57.8%) of all low birth weight neonates were term births. The predictors for low birth weight were: early marriage (<18 year) (RRR: 0.59, CI: 0.35-0.97); rural residence (RRR: 0.53, CI: 0.32-0.9); prematurity (RRR: 15.4, CI: 9.18-25.9); no antenatal follow-up (RRR: 6.78, CI: 2.39-19.25); and female sex (RRR: 1.77, CI: 1.13-2.77). Predictors for macrosomia were: female gender (RRR: 0.58, CI: 0.35-0.9); high body mass index (RRR: 5.0, CI: 1.56-16); post-maturity (RRR: 2.23, CI: 1.06-4.6); and no maternal complication (RRR: 0.46, CI: 0.27-0.8).
In this study, we found gestational age and gender of the neonate to be common risk factors for both low birth weight and macrosomia. Strengthening antenatal follow up, prevention of pre and post maturity, controlling body mass index, and improving socioeconomic status of mothers are recommendations to prevent the double burden (low birth weight and macrosomia) and associated short and long-term consequences.
婴儿出生体重分为低出生体重、正常出生体重和巨大儿，与短期和长期健康后果相关，如新生儿死亡率和生活中的慢性病。巨大儿和低出生体重是埃塞俄比亚等发展中国家面临的双重负担问题，但证据匮乏使得难以评估这种情况的严重程度。因此，埃塞俄比亚报告的低出生体重和巨大儿患病率存在不一致。本研究旨在确定埃塞俄比亚北部提格雷地区低出生体重和巨大儿的发生率及预测因素。
2014年4月至7月，我们在提格雷地区随机选择的医院对1152名新生儿进行了横断面调查。我们将先前描述的出生体重类别作为结果变量。数据由助产士使用结构化问卷收集。我们使用STATA™ 11.0版录入和分析数据。数据用频率、百分比、相对风险比和95%置信区间进行描述。进行多项逻辑回归以确定低出生体重和巨大儿的独立预测因素。
在本研究中，我们发现低出生体重和巨大儿的发生率分别为10.5%和6.68%。所有低出生体重新生儿中有70例（57.8%）为足月儿。低出生体重的预测因素为：早婚（<18岁）（相对风险比：0.59，置信区间：0.35 - 0.97）；农村居住（相对风险比：0.53，置信区间：0.32 - 0.9）；早产（相对风险比：15.4，置信区间：9.18 - 25.9）；无产前检查（相对风险比：6.78，置信区间：2.39 - 19.25）；以及女性性别（相对风险比：1.77，置信区间：1.13 - 2.77）。巨大儿的预测因素为：女性性别（相对风险比：0.58，置信区间：0.35 - 0.9）；高体重指数（相对风险比：5.0，置信区间：1.56 - 16）；过期产（相对风险比：2.23，置信区间：1.06 - 4.6）；以及无母体并发症（相对风险比：0.46，置信区间：0.27 - 0.8）。
在本研究中，我们发现新生儿的胎龄和性别是低出生体重和巨大儿的常见危险因素。加强产前检查、预防早产和过期产、控制体重指数以及改善母亲的社会经济地位是预防双重负担（低出生体重和巨大儿）及相关短期和长期后果的建议。
