University Hospital Marqués de Valdecilla, Santander, Spain.
Department of Preventive Medicine and Public Health, University of Cantabria, Avda. Herrera Oria s/n, 39011, Santander, Spain.
BMC Pregnancy Childbirth. 2021 Jan 6;21(1):13. doi: 10.1186/s12884-020-03484-9.
Low birth weight rates are increasing in both developed and developing countries. Although several maternal factors have been identified as associated with low birth weight, little is known of economic or organization factors influencing this increase. This study aims to ascertain the twenty-first century relationships between the contextual country factors and low birth weight rates.
We analyse trends of low birth weight rates in Organisation for Economic Co-operation and Development (OECD) countries. Data from 2000 to 2015 were obtained from the OECD data base. Their relationships with demographic and economic variables, health habits, woman-related preventive measures, health care system organization and funding, health care work force and obstetric care were analysed using random-effects linear regression.
Low birth weight rates are higher in Southern Europe (7.61%) and lower in Northern Europe (4.68%). Low birth weight rates escalated about 20% in Southern Europe and to less extent in Easter Europe (7%) and Asian/Oceanian countries, while remained stable in America, Central Europe and Northern Europe. Investment in health care, private health system coverage, ratios of paediatricians and obstetricians, average length of admission due to pregnancy or birth and Caesarean section rate were associated with higher low birth weight rates. Factors associated with lower low birth weight rates were health care coverage, public health system coverage, hospitals per million inhabitants, and ratios of health care workers, physicians, midwives and nurses.
In OECD countries, LBW rates are related to contextual country characteristics such as GDP per capita, which is inversely related to LBW rate. Health care system factors, including health care coverage or investment in public health system, are directly associated with lower LBW rates.
发达国家和发展中国家的低出生体重率都在上升。尽管已经确定了一些与低出生体重相关的产妇因素，但对于影响这一增长的经济或组织因素知之甚少。本研究旨在确定 21 世纪国家背景因素与低出生体重率之间的关系。
我们分析了经济合作与发展组织（OECD）国家低出生体重率的趋势。数据来自 OECD 数据库，时间跨度为 2000 年至 2015 年。使用随机效应线性回归分析了这些国家与人口统计学和经济变量、健康习惯、妇女预防措施、医疗保健系统组织和资金、医疗保健劳动力以及产科护理的关系。
南欧的低出生体重率较高（7.61%），北欧的低出生体重率较低（4.68%）。南欧的低出生体重率上升了约 20%，东欧上升了 7%，亚洲/大洋洲国家也有所上升，而美洲、中欧和北欧的低出生体重率则保持稳定。卫生保健投资、私人卫生系统覆盖率、儿科医生和产科医生的比例、因妊娠或分娩而住院的平均时间以及剖腹产率与较高的低出生体重率相关。与较低的低出生体重率相关的因素包括卫生保健覆盖率、公共卫生系统覆盖率、每百万居民的医院数量以及卫生保健工作者、医生、助产士和护士的比例。
在经合组织国家，低出生体重率与国家背景特征有关，如人均国内生产总值，其与低出生体重率呈反比。医疗保健系统因素，包括卫生保健覆盖率或对公共卫生系统的投资，与较低的低出生体重率直接相关。
