Hoorsan Hayedeh, Alavi Majd Hamid, Chaichian Shahla, Mehdizadehkashi Abolfazl, Hoorsan Roza, Akhlaqghdoust Meisam, Moradi Yousef
Department of Nursing and Midwifery, Islamic Azad University Sanandaj Branch, Sanandaj, Iran.
Shahid Beheshti University of Medical Sciences and Health Services, Tehran, Iran.
Arch Iran Med. 2018 Feb 1;21(2):61-66.
Adverse pregnancy outcome are frequent in developing countries. Pregnancy outcomes are influenced by numerous factors. It seems that maternal anthropometric indices are among the most important factors in this era. The aim of this study was to determine any association between maternal anthropometric characteristics and adverse pregnancy outcomes in Iranian women and provide a predictive model by using factors affecting birth weight (BW) via the pathway analysis.
This study was performed in Alborz province between September 2014 and December 2016. In this cross-sectional study, 1006 pregnant women who had the study criteria were selected from 1500 pregnant women. The data were collected in 2 phases: at their first prenatal visit and during the postpartum period. Demographic data, history of previous pregnancy, fundal height (FH), gestational weight gain (GWG), and abdominal circumference (AC) were recorded. Pathway (path) analysis was used to assess effective factors on pregnancy outcomes.
The mean and standard deviation of participant age at delivery was 25.97 ± 5.71 years. Overall, 4.6% of infants were low BW (LBW) and 5.8% had macrosomia. The final model, with a good fit accounting for 22% of BW variance, indicated that AC and FH (both P < 0.001), and pre-pregnancy body mass index (BMI) (P = 0.01) had positive direct effect on BW, while pre-pregnancy BMI and GWG (both P < 0.001) affected BW indirectly through their effect on FH and AC.
Based on the path analysis model, FH and AC of neonates with the greatest impact on BW, could be predicted by mother's BMI before pregnancy and weight gain during pregnancy. Therefore, close observation during prenatal care can reduce the risk of abnormal BW.
不良妊娠结局在发展中国家很常见。妊娠结局受多种因素影响。在这个时代,孕产妇人体测量指标似乎是最重要的因素之一。本研究的目的是确定伊朗女性孕产妇人体测量特征与不良妊娠结局之间的任何关联,并通过路径分析使用影响出生体重(BW)的因素提供一个预测模型。
本研究于2014年9月至2016年12月在阿尔伯兹省进行。在这项横断面研究中,从1500名孕妇中选取了1006名符合研究标准的孕妇。数据分两个阶段收集:在她们第一次产前检查时和产后期间。记录人口统计学数据、既往妊娠史、宫高(FH)、孕期体重增加(GWG)和腹围(AC)。路径分析用于评估对妊娠结局的有效因素。
分娩时参与者年龄的平均值和标准差为25.97±5.71岁。总体而言,4.6%的婴儿为低出生体重(LBW),5.8%为巨大儿。最终模型拟合良好,解释了22%的BW方差,表明AC和FH(均P<0.001)以及孕前体重指数(BMI)(P = 0.01)对BW有正向直接影响,而孕前BMI和GWG(均P<0.001)通过对FH和AC的影响间接影响BW。
基于路径分析模型,对BW影响最大的新生儿的FH和AC可以通过母亲孕前BMI和孕期体重增加来预测。因此,产前护理期间的密切观察可以降低BW异常的风险。