Neupane Dinesh, Dawson Penny, Houston Robin, Dhakal Liladhar, Sharma Jaganath, Gargi K C, Lagos Christina, Khanal Vishnu, Mishra Shiva Raj, Kallestrup Per
Center for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark.
JSI Research and Training Institute Inc, Kathmandu, Nepal.
BMC Pregnancy Childbirth. 2017 Jul 11;17(1):218. doi: 10.1186/s12884-017-1355-z.
There has been little success in attempts to reduce the proportion of births with low birth weight (LBW). However, deaths associated with LBW may be prevented with extra attention to warmth, feeding, and prevention or early treatment of infections. There are few studies on this in Nepal and in many other developing countries. This is a cohort study to evaluate the risk of deaths among LBW infants who received FCHV follow up visit for home-based care compared to those who did not receive in Rural Nepal.
A cohort study design was used with data from the Morang Innovative Neonatal Intervention (MINI) program in Nepal. Relative Risk (RR) is calculated to compare LBW neonates who received FCHV follow up visit as compared to LBW neonates who did not receive visit.
Out of 51,853 newborn infants recorded in the MINI database, 2229 LBW neonates were included in the analysis. The proportion of deaths among those who received FCHV follow up visit and those who did not receive were 2% (95% CI: 1%; 2%) and 11% (95% CI: 6%; 18%) respectively(P < 0.001). The relative risk of death in LBW infants who received FCHV follow up visit was 84% less as compared to LBW infants who did not receive (RR = 0·16; 95% CI: 0·09, 0·29).
The current study indicates that to save the lives of LBW young infants simple home-based measures implemented through trained health volunteers within the existing government health system may be effective when technically more sophisticated measures such as tertiary health centers, pediatricians, and expensive technology are limited.
降低低出生体重（LBW）儿出生比例的尝试成效甚微。然而，通过格外关注保暖、喂养以及预防或早期治疗感染，与低出生体重相关的死亡是可以预防的。在尼泊尔和许多其他发展中国家，针对这方面的研究很少。这是一项队列研究，旨在评估在尼泊尔农村地区，接受家庭护理的社区健康志愿者（FCHV）随访的低出生体重婴儿与未接受随访的低出生体重婴儿相比的死亡风险。
采用队列研究设计，使用尼泊尔莫朗创新新生儿干预（MINI）项目的数据。计算相对风险（RR），以比较接受FCHV随访的低出生体重新生儿与未接受随访的低出生体重新生儿。
在MINI数据库记录的51,853名新生儿中，2229名低出生体重新生儿被纳入分析。接受FCHV随访的婴儿和未接受随访的婴儿的死亡比例分别为2%（95%CI：1%；2%）和11%（95%CI：6%；18%）（P<0.001）。接受FCHV随访的低出生体重婴儿的死亡相对风险比未接受随访的低出生体重婴儿低84%（RR = 0·16；95%CI：0·09，0·29）。
当前研究表明，在三级医疗中心、儿科医生和昂贵技术等技术上更复杂的措施有限的情况下，通过现有政府卫生系统内训练有素的健康志愿者实施简单的家庭措施，可能有效地挽救低出生体重幼儿的生命。
