Ibal Sub-divisional Hospital, Oku, Northwest Region, Bamenda, Cameroon.
Doctors Without Borders-French Section (MSF-F), Calais, France.
BMC Pregnancy Childbirth. 2018 Jan 15;18(1):30. doi: 10.1186/s12884-018-1663-y.
Low birthweight (LBW) is a major predictor of early neonatal mortality which disproportionately affects low-income countries. WHO recommends regional definitions for LBW to prevent misclassifications and ensure appropriate care of babies with LBW. We conducted this study to define a clinical cut-off for LBW, and to determine the predictors and adverse foetal outcomes of LBW babies in a rural sub-division in Cameroon.
We conducted a retrospective register analysis of 1787 singleton deliveries in two health facilities in the Northwest Region of Cameroon. Records with no birthweight or birthweight less than 1000 g, babies born before arrival, multiple deliveries and deliveries before 28 weeks gestation were excluded from this study. The 10th percentile of birthweights was computed to obtain a statistical cut-off value for the LBW. To assess the clinical significance of the newly defined cut-off value, we compared the prevalence of adverse foetal outcomes between LBW (birthweight <10th percentile) and heavier babies (birthweight ≥10th percentile) in our study population.
The 10th percentile of the birthweights was 2700 g. Preterm delivery was the lone predictor of LBW (aOR = 2.0, 95% CI = 1.3-3.1; p = 0.001). LBW babies were more likely to be stillborn (OR = 9.6; 95% CI = 4.2-21.6; p < 0.001) or asphyxiated at the 5th minute (OR = 2.0; 95% CI = 1.2-3.3; p = 0.006), compared with heavier babies. Also, 6.1% of babies who had a birthweight between 2500 and 2700 g were more likely to be stillborn compared to heavier babies.
This study suggests that the clinical cut-off for LBW in this rural community is 2700 g; with 6.1% of babies born with LBW probably receiving inadequate care as the traditional cut-off value of 2500 g proposed by WHO is still used to define LBW in our setting. Further studies are necessary to define a national cut-off value for harmonisation of LBW definitions in the country to prevent misclassifications and ensure appropriate neonatal care.
低出生体重（LBW）是早期新生儿死亡的主要预测因素， disproportionately 影响低收入国家。世界卫生组织建议对 LBW 进行区域定义，以防止分类错误并确保对 LBW 婴儿进行适当的护理。我们进行了这项研究，以定义 LBW 的临床截止值，并确定喀麦隆农村分区 LBW 婴儿的预测因素和不良胎儿结局。
我们对喀麦隆西北区两家医疗机构的 1787 例单胎分娩进行了回顾性登记分析。本研究排除了无出生体重或出生体重低于 1000 克、出生前到达、多胎分娩和 28 周前分娩的记录。计算出生体重的第 10 百分位数以获得 LBW 的统计截止值。为了评估新定义的截止值的临床意义，我们比较了在我们的研究人群中，LBW（出生体重<第 10 百分位数）和较重婴儿（出生体重≥第 10 百分位数）之间不良胎儿结局的发生率。
出生体重的第 10 百分位数为 2700 克。早产是 LBW 的唯一预测因素（aOR=2.0，95%CI=1.3-3.1；p=0.001）。LBW 婴儿更有可能是死产（OR=9.6；95%CI=4.2-21.6；p<0.001）或在第 5 分钟窒息（OR=2.0；95%CI=1.2-3.3；p=0.006），与较重的婴儿相比。此外，与较重的婴儿相比，出生体重在 2500 克至 2700 克之间的婴儿中，有 6.1%更有可能是死产。
本研究表明，在这个农村社区，LBW 的临床截止值为 2700 克；由于世卫组织提出的传统 2500 克截止值仍用于定义我们环境中的 LBW，因此可能有 6.1%的 LBW 婴儿得不到足够的护理。需要进一步研究以定义国家截止值，以协调该国 LBW 定义，防止分类错误并确保适当的新生儿护理。
