Discipline of Paediatrics and Child Health, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
Discipline of Occupational and Environmental Health, School of Nursing and Public Health, Howard College Campus, University of KwaZulu-Natal, Room 321, George Campbell Building, Durban, 4041, South Africa.
BMC Pregnancy Childbirth. 2020 Oct 16;20(1):628. doi: 10.1186/s12884-020-03328-6.
Low birthweight (LBW) and preterm birth (PB) remain the leading cause of morbidity and mortality in neonates worldwide. The aim of this study was to identify maternal demographic and antenatal factors associated with PB and LBW among low socio-economic communities.
Pregnant women (n = 1099) were recruited in the first trimester into the Mother and Child in the Environment (MACE) birth cohort in Durban, South Africa. Maternal factors such as demographic information, health status, residential area, occupational, personal and environmental smoking and biomass fuel use were obtained through standardised interviews, while clinical status was obtained in each trimester and antenatal information on HIV status and treatment, syphilis and conditions such as pregnancy induced hypertension, diabetes etc. was extracted from the antenatal assessments. Key outcomes of interest were preterm birth and low birthweight. The latter data was obtained from the clinical assessments performed by midwives at delivery. Logistic regression models identified factors associated with PB and LBW.
Of the 760 live births, 16.4 and 13.5% were preterm and LBW, respectively. Mothers who delivered by caesarean section had an increased odds of having LBW babies (Adjusted odds ratio (AOR): 1.7; 95% CI: 1.1-2.7) and PB (AOR: 1.7, 95% CI: 1.1-2.7) versus normal vaginal deliveries. Mothers > 30 years (AOR: 1.8, 95% CI: 1.1-2.9) and current smokers (AOR: 2.7, 95% CI: 1.3-5.8) had an increased odds of having PB babies. Compared to younger mothers and non-smokers respectively. An effect of PB and LBW was seen among mothers with high BMI (25.0-29.9 kg/m) (PB: AOR: 0.5, 95% CI: 0.3-0.9 and LBW: AOR: 0.5, 0.5, CI: 0.3-0.8), and obese BMI (> 30 kg/m) (PB: AOR: 0.5, 95% CI: 0.3-0.9 and LBW: AOR: 0.4, CI: 0.2-0.7). Maternal HIV (PB AOR: 1.4 and LBW AOR: 1.2) and history of sexually transmitted infections (PB AOR: 2.7 and LBW AOR: 4.2) were not statistically significant.
Maternal age, cigarette smoking and caesarean delivery were associated with LBW and PB. Findings highlight the need of maternal health interventions to improve new-born health outcomes.
低出生体重（LBW）和早产（PB）仍然是全球新生儿发病率和死亡率的主要原因。本研究旨在确定与低社会经济社区中 PB 和 LBW 相关的产妇人口统计学和产前因素。
在南非德班的母婴环境（MACE）出生队列中，在妊娠早期招募了 1099 名孕妇。通过标准化访谈获得了产妇因素，如人口统计学信息、健康状况、居住区域、职业、个人和环境吸烟以及生物质燃料使用情况，而临床状况则在每个孕期获得，产前 HIV 状况和治疗、梅毒以及妊娠高血压、糖尿病等情况的信息则从产前评估中提取。主要研究结果是早产和低出生体重。后者的数据是由助产士在分娩时进行的临床评估获得的。逻辑回归模型确定了与 PB 和 LBW 相关的因素。
在 760 例活产儿中，分别有 16.4%和 13.5%为早产儿和 LBW。与正常阴道分娩相比，行剖宫产的母亲有更高的 LBW 婴儿（调整后的优势比（AOR）：1.7；95%CI：1.1-2.7）和 PB（AOR：1.7，95%CI：1.1-2.7）的几率。年龄大于 30 岁（AOR：1.8，95%CI：1.1-2.9）和当前吸烟者（AOR：2.7，95%CI：1.3-5.8）有更高的 PB 婴儿的几率。与年轻母亲和非吸烟者相比。在 BMI 较高的母亲中（25.0-29.9kg/m）（PB：AOR：0.5，95%CI：0.3-0.9 和 LBW：AOR：0.5，0.5，CI：0.3-0.8）和肥胖 BMI（>30kg/m）（PB：AOR：0.5，95%CI：0.3-0.9 和 LBW：AOR：0.4，CI：0.2-0.7）也观察到 PB 和 LBW 的影响。母体 HIV（PB AOR：1.4 和 LBW AOR：1.2）和性传播感染史（PB AOR：2.7 和 LBW AOR：4.2）均无统计学意义。
母亲年龄、吸烟和剖宫产与 LBW 和 PB 相关。研究结果强调需要进行孕产妇健康干预，以改善新生儿健康结局。
