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产妇产科和社会人口统计学因素对低出生体重的影响:加纳的回顾性横断面研究。

Maternal obstetric and socio-demographic determinants of low birth weight: a retrospective cross-sectional study in Ghana.

机构信息

Department of Nursing, College of Nursing and Midwifery, P. O. Box 10, Nalerigu, Ghana.

Emergency Unit, Sunyani Municipal Hospital, Sunyani, Ghana.

出版信息

Reprod Health. 2019 May 29;16(1):70. doi: 10.1186/s12978-019-0742-5.

Abstract

BACKGROUND

Birth weight is an important predictor of early neonatal mortality, morbidity, and long-term health outcomes. Annually, approximately 20 million babies are born globally with weights less than 2.5kg. In sub-Saharan Africa, the prevalence of LBW is around 13 to 15 percent. In Ghana, 10% of babies born in 2014 were with LBW. The aim of this study was to identify maternal socio-demographic and obstetric risk factors associated with the birth weight of newborns in the Sunyani Municipality of Ghana.

METHODS

This retrospective cross-sectional study analysed data from 931 birth records of all deliveries between January 1 and December 31, 2017, at the Sunyani Municipal Hospital in the Brong-Ahafo Region of Ghana. Univariate and multivariable logistic regression models were fitted to estimate the effect of maternal factors on low birth weight.

RESULTS

We found that the mean age of the participants and the mean gestational age at birth were 27.21(SD = 5.50) years and 37.95(SD = 1.85) weeks respectively. Nearly 10% of the infants born within the study period had birth weights below 2.5kg. The findings revealed that the odds of delivering LBW baby were significantly high (OR 1.77, 95%CI 1.14-2.76) among urban dwellers. However, mothers who attended or completed secondary or higher education were 63% (95% CI 0.20-0.78) less likely to give birth to a LBW baby when compared with uneducated mothers. We found that the odds of LBW significantly decreased with every one-week increase in gestational age (OR 0.67 95%CI 0.59-0.76) and significantly increased with increasing parity (OR 1.43 95%CI 1.21-1.70). Further, the likelihood of delivering LBW baby decreased with every additional ANC visit (OR 0.78 95%CI 0.67-0.90) and with every additional gram of haemoglobin (OR 0.78 95%CI 0.63-0.95).

CONCLUSION

The evidence from this study suggests that maternal educational level, residence, haemoglobin level, parity, number of ANC visits, and gestational age are independent predictors of low birth weight. The current findings add substantially to the growing literature on the influence of maternal socio-demographic and obstetric factors on LBW in resource-constrained settings and provide empirical data for clinical and public health interventions aimed at reducing low birth weight and its associated complications.

摘要

背景

出生体重是预测新生儿早期死亡率、发病率和长期健康结果的重要指标。全球每年约有 2000 万婴儿出生体重低于 2.5 公斤。在撒哈拉以南非洲,LBW 的患病率约为 13%至 15%。在加纳,2014 年出生的婴儿中有 10%为 LBW。本研究旨在确定与加纳 Sunyani 市新生儿出生体重相关的产妇社会人口学和产科危险因素。

方法

本回顾性横断面研究分析了 2017 年 1 月 1 日至 12 月 31 日期间在加纳 Brong-Ahafo 地区 Sunyani 市医院所有分娩的 931 份分娩记录中的数据。使用单变量和多变量逻辑回归模型来估计产妇因素对低出生体重的影响。

结果

我们发现,参与者的平均年龄和出生时的平均胎龄分别为 27.21(SD=5.50)岁和 37.95(SD=1.85)周。在研究期间出生的婴儿中,近 10%的婴儿出生体重低于 2.5 公斤。研究结果表明,城市居民分娩 LBW 婴儿的几率明显较高(OR 1.77,95%CI 1.14-2.76)。然而,与未受过教育的母亲相比,接受过或完成过中等或高等教育的母亲生育 LBW 婴儿的几率低 63%(95%CI 0.20-0.78)。我们发现,胎龄每增加一周,LBW 的几率显著降低(OR 0.67,95%CI 0.59-0.76),而每增加一次生育,LBW 的几率显著增加(OR 1.43,95%CI 1.21-1.70)。此外,每次增加一次 ANC 就诊(OR 0.78,95%CI 0.67-0.90)和每次增加一克血红蛋白(OR 0.78,95%CI 0.63-0.95),LBW 婴儿的分娩几率都会降低。

结论

本研究的证据表明,产妇教育水平、居住地、血红蛋白水平、生育次数、ANC 就诊次数和胎龄是低出生体重的独立预测因素。目前的研究结果为资源有限环境下产妇社会人口学和产科因素对 LBW 的影响提供了重要的文献依据,并为旨在降低低出生体重及其相关并发症的临床和公共卫生干预提供了经验数据。

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