Nyamasege C K, Kimani-Murage E W, Wanjohi M, Kaindi D W M, Ma E, Fukushige M, Wagatsuma Y
1Graduate School of Comprehensive Human Sciences,University of Tsukuba,Tsukuba,Japan.
2African Population and Health Research Centre,Nairobi,Kenya.
J Dev Orig Health Dis. 2019 Apr;10(2):237-245. doi: 10.1017/S2040174418000715. Epub 2018 Oct 8.
Inadequate knowledge in maternal nutrition is one of the determinants of low birth weight. However, little evidence is available on whether maternal nutrition counselling alone can influence birth weight among women from low socioeconomic households. This study assessed the effect of prenatal maternal nutritional counselling on birth weight and examined the related risk factors. A cluster randomized controlled trial was conducted to assess the effectiveness of home-based maternal nutritional counselling on nutritional outcomes, morbidity, breastfeeding, and infant feeding practices by the African Population and Health Research Center in two urban informal settlements of Nairobi. The intervention group received monthly antenatal and nutritional counselling from trained community health volunteers; meanwhile, the control group received routine antenatal care. A total of 1001 participants were included for analysis. Logistic regression was applied to determine associations between low birth weight and maternal characteristics. A higher prevalence of low birth weight was observed in the control group (6.7%) than in the intervention group (2.5%; P<0.001). Logistic regression identified significant associations between birth weight and intervention group (adjusted odds ratio (AOR)=0.26; 95% confidence interval (CI), 0.10-0.64); maternal height <154.5 cm (AOR=3.33; 95% CI, 1.01-10.96); last antenatal care visits at 1st or 2nd trimesters (AOR=9.48; 95% CI, 3.72-24.15); pre-term delivery (AOR=3.93; 95% CI, 1.93-7.98); maternal mid-upper arm circumference <23 cm (AOR=2.57; 95% CI, 1.15-5.78); and cesarean delivery (AOR=2.27; 95% CI, 1.04-4.94). Nutrition counselling during pregnancy reduced low birth weight and preterm births, which was determined by women of short stature, early stoppage of antenatal visit, and cesarean delivery.
孕产妇营养知识不足是低出生体重的决定因素之一。然而，关于仅通过孕产妇营养咨询能否影响社会经济地位较低家庭妇女的出生体重，几乎没有相关证据。本研究评估了产前孕产妇营养咨询对出生体重的影响，并检查了相关风险因素。非洲人口与健康研究中心在内罗毕的两个城市非正式定居点进行了一项整群随机对照试验，以评估基于家庭的孕产妇营养咨询对营养结局、发病率、母乳喂养和婴儿喂养方式的有效性。干预组接受来自经过培训的社区卫生志愿者的每月一次产前和营养咨询；与此同时，对照组接受常规产前护理。共有1001名参与者纳入分析。应用逻辑回归确定低出生体重与孕产妇特征之间的关联。对照组低出生体重的患病率（6.7%）高于干预组（2.5%；P<0.001）。逻辑回归确定出生体重与干预组之间存在显著关联（调整优势比（AOR）=0.26；95%置信区间（CI），0.10 - 0.64）；孕产妇身高<154.5厘米（AOR = 3.33；95% CI，1.01 - 10.96）；孕早期或孕中期进行最后一次产前检查（AOR = 9.48；95% CI，3.72 - 24.15）；早产（AOR = 3.93；95% CI，1.93 - 7.98）；孕产妇上臂中部周长<二十三厘米（AOR = 2.57；95% CI，1.15 - 5.78）；以及剖宫产（AOR = 2.27；95% CI，1.04 - 4.94）。孕期营养咨询降低了低出生体重和早产率，这是由身材矮小的女性、产前检查提前停止以及剖宫产决定的。
