Tesfa Desalegn, Tadege Melaku, Digssie Alemayehu, Abebaw Sofonyas
Department of Public Health, College of Health Sciences, Debre Tabor University, Debretabor, Ethiopia.
Arch Public Health. 2020 Sep 29;78:89. doi: 10.1186/s13690-020-00475-2. eCollection 2020.
After prematurity, intrauterine growth restriction (IUGR) is the second leading cause of perinatal mortality. IUGR has significant consequences in fetal, neonatal, and adult life. Currently, Ethiopia lacks information on IUGR's prevalence and its determinants. This study aimed to assess the proportion of IUGR at birth and its associated factors.
A cross-sectional study was carried out among women who give birth in four hospitals of south Gonder zone from November 2018 to February 2019. Multi-stage sampling was applied to select the required samples. IUGR was assessed using a standardized cutoff percentile/mean for each measurement. Data were collected by trained MSc clinical midwives. Bi-variable and multivariable logistic analyses were deployed to identify the association.
A total of 803 maternity women were participating in this study with a response rate of 95%. The proportion of IUGR 23.5% (95% CI: 20.7-26.6), low birth weight 13.3%, small-for- gestational-age 19.7%,and preterm birth 23.16%. Women who was unable to read and write, (AOR; 2.46, 95% CI: 1.02-5.92), total family size ≥7 (AOR; 1.67, 95% CI: 1.04-2.66), maternal mid-upper arm circumference (MUAC) < 23 cm (AOR; 2.10, 95% CI: 1.39-3.01), body mass index (BMI) < 18.5 kg/m (AOR; 2.57, 95% CI: 1.72-3.83), altitude > 3000 m (AOR; 1.89 95% CI: 1.19-3.01), small placental size (< 350 g) (AOR; 2.42, 95% CI: 1.67-3.54) and small-for-gestational-age (AOR; 1.94, 95% CI:1.86-4.52) were the most predictors of IUGR.
IUGR was a major public health concern in this study. Women who were unable to read and write, small-for-gestational-age, maternal BMI < 18.5 kg/m, family size ≥7, maternal MUAC < 23 cm, small placental size, and altitude > 3000 m were found the most predictor variables. Strengthen female education, nutritional intervention before and during pregnancy, and routine maternity care is critical. Further clinical follow-up research is essential which includes maternal, fetal, and placental gens.
除早产外，宫内生长受限（IUGR）是围产期死亡的第二大主要原因。IUGR在胎儿期、新生儿期及成年期都会产生重大影响。目前，埃塞俄比亚缺乏关于IUGR患病率及其决定因素的信息。本研究旨在评估出生时IUGR的比例及其相关因素。
2018年11月至2019年2月，在南贡德尔地区的四家医院对分娩妇女进行了一项横断面研究。采用多阶段抽样来选取所需样本。使用每个测量指标的标准化临界百分位数/均值来评估IUGR。数据由经过培训的临床助产硕士收集。采用双变量和多变量逻辑分析来确定关联。
共有803名产妇参与本研究，应答率为95%。IUGR的比例为23.5%（95%置信区间：20.7 - 26.6），低出生体重为13.3%，小于胎龄儿为19.7%，早产为23.16%。无法读写的女性（调整后比值比[AOR]：2.46，95%置信区间：1.02 - 5.92）、家庭总人口数≥7（AOR：1.67，95%置信区间：1.04 - 2.66）、孕妇上臂中段臂围（MUAC）<23 cm（AOR：2.10，95%置信区间：1.39 - 3.01）、体重指数（BMI）<18.5 kg/m²（AOR：2.57，95%置信区间：1.72 - 3.83）、海拔>3000 m（AOR：1.89，95%置信区间：1.19 - 3.01）、胎盘小（<350 g）（AOR：2.42，95%置信区间：1.67 - 3.54）以及小于胎龄儿（AOR：1.94，95%置信区间：1.86 - 4.52）是IUGR的主要预测因素。
在本研究中，IUGR是一个主要的公共卫生问题。发现无法读写的女性、小于胎龄儿、孕妇BMI<18.5 kg/m²、家庭人口数≥7、孕妇MUAC <23 cm、胎盘小以及海拔>3000 m是最主要的预测变量。加强女性教育、孕期前后的营养干预以及常规产科护理至关重要。进一步开展包括母体、胎儿和胎盘基因的临床随访研究必不可少。
