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埃塞俄比亚南部锡达马地区公立医院新生儿低出生体重的决定因素:非匹配病例对照研究

Determinants of Low Birth Weight among Newborns Delivered at Public Hospitals in Sidama Zone, South Ethiopia: Unmatched Case-Control Study.

作者信息

Bekela Muse Bututa, Shimbre Mulugeta Shegaze, Gebabo Teshale Fikadu, Geta Mengesha Boko, Tonga Abayneh Tunje, Zeleke Eshetu Andarge, Sidemo Negussie Boti, Getnet Agegnehu Bante

机构信息

Bona District Hospital, Bona, Sidama Zone, Ethiopia.

College of Medicine and Health Sciences, School of Public Health, Arba Minch University, Ethiopia.

出版信息

J Pregnancy. 2020 Apr 16;2020:4675701. doi: 10.1155/2020/4675701. eCollection 2020.

Abstract

Low birth weight is a global public health problem having various severe and life-threatening health effects. The World Health Organization is working to reduce the prevalence of low birth weight to 30% by the year 2025. Pinpointing the determinants of low birth weight at different scenarios is crucial to reduce the rate of low birth weight in low-income countries which consist of 96.5% of global low birth weight newborns. Thus, the aim of this study was to assess determinants of low birth weight in Sidama Zone public hospitals of South Ethiopia. An institution-based case-control study was conducted from March 1 to May 5, 2019, in Sidama Zone public hospitals. Data were collected from 354 mother-neonate samples with 118 of them having newborns with birth weight < 2500 g (cases) and 236 of them having birth weight ≥ 2500 g (controls) using a pretested, interviewer-administered structured questionnaire and medical record review. The odds of being rural dweller women was 3.51 times higher among cases (low birth weight babies) than among controls (normal birth weight babies) as compared to being urban dweller women (AOR = 3.51, 95% CI (1.91-6.45)). The likelihood of initiating antenatal care late was 3.22 times more among cases than among controls when compared with timely initiation of antenatal care (AOR = 3.22, 95% CI (1.47-7.14)). The probability of having pregnancy-induced hypertension was 4.49 times higher among mothers of the cases than among mothers of the controls as compared to not having pregnancy-induced hypertension (AOR = 4.49, 95% CI (1.94-10.38)). The odds of not taking iron and folic acid during pregnancy was 3.92 times higher among mothers of the cases than mothers of the controls when compared with taking iron and folic acid (AOR = 3.92, 95% CI (1.80-8.50)). The likelihood of having Mid-Upper Arm Circumference (MUAC) < 23 cm was 4.27 times higher among mothers of the cases than among mothers of the controls as compared to having MUAC ≥ 23 cm (AOR = 4.27, 95% CI (2.24-8.12)). The probability of having inadequate dietary diversity was 3.75 times higher among cases than among controls as compared to having adequate dietary diversity (AOR = 3.75, 95% CI (1.64-8.57)). Interventions targeting the aversion of low birth weight should focus on promotion of iron-folic acid supplementation and dietary diversification through timely initiation of antenatal care.

摘要

低出生体重是一个全球性的公共卫生问题,会产生各种严重且危及生命的健康影响。世界卫生组织正在努力到2025年将低出生体重的患病率降低至30%。查明不同情况下低出生体重的决定因素对于降低低收入国家的低出生体重率至关重要,全球96.5%的低出生体重新生儿来自这些国家。因此,本研究的目的是评估埃塞俄比亚南部锡达马地区公立医院低出生体重的决定因素。2019年3月1日至5月5日在锡达马地区公立医院开展了一项基于机构的病例对照研究。使用经过预测试、由访谈员实施的结构化问卷和病历审查,从354对母婴样本中收集数据,其中118对的新生儿出生体重<2500克(病例),236对的新生儿出生体重≥2500克(对照)。与城市居民妇女相比,农村居民妇女成为病例(低出生体重儿)的几率比成为对照(正常出生体重儿)的几率高3.51倍(比值比=3.51,95%置信区间(1.91 - 6.45))。与及时开始产前护理相比,病例中开始产前护理较晚的可能性是对照中的3.22倍(比值比=3.22,95%置信区间(1.47 - 7.14))。与没有妊娠高血压相比,病例母亲患妊娠高血压的概率比对照母亲高4.49倍(比值比=4.49,95%置信区间(1.94 - 10.38))。与服用铁和叶酸相比,病例母亲在孕期未服用铁和叶酸的几率比对照母亲高3.92倍(比值比=3.92,95%置信区间(1.80 - 8.50))。与上臂中段周长(MUAC)≥23厘米相比,病例母亲的MUAC<23厘米的可能性比对照母亲高4.27倍(比值比=4.27,95%置信区间(2.24 - 8.12))。与饮食多样性充足相比,病例中饮食多样性不足的概率比对照高3.75倍(比值比=3.75,95%置信区间(1.64 - 8.57))。针对避免低出生体重的干预措施应侧重于通过及时开始产前护理来促进铁叶酸补充和饮食多样化。

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