尼泊尔西部一家三级医院中与小于胎龄儿相关的预后因素：一项横断面研究。
Prognostic factors associated with small for gestational age babies in a tertiary care hospital of Western Nepal: A cross-sectional study.
作者信息
Chaudhary Nagendra, Yadav Shree Narayan, Kalra Suresh Kumar, Pathak Santosh, Gupta Binod Kumar, Shrestha Sandeep, Patel Matthew, Satia Imran, Sadhra Steven, Bolton Charlotte Emma, Kurmi Om Prakash
机构信息
Department of Pediatrics Universal College of Medical Sciences Bhairahawa Nepal.
Department of Pediatrics Chitwan Medical College Bharatpur Nepal.
出版信息
Health Sci Rep. 2021 Feb 15;4(1):e250. doi: 10.1002/hsr2.250. eCollection 2021 Mar.
BACKGROUND
Small for gestational age (SGA) is common among newborns in low-income countries like Nepal and has higher immediate mortality and morbidities.
OBJECTIVES
To study the prevalence and prognostic factors of SGA babies in Western Nepal.
METHODS
A cross-sectional study (November 2016-October 2017) was conducted in a tertiary care hospital in Western Nepal. Socio-demographic, lifestyle factors including diet, and exposures including smoking and household air pollution in mothers who delivered newborns appropriate for gestational age (AGA), SGA and large for gestational age (LGA) were recorded. Logistic regression was carried out to find the odds ratio of prognostic factors after adjusting for potential confounders.
RESULTS
Out of 4000 delivered babies, 77% (n = 3078) were AGA, 20.3% (n = 813) were SGA and 2.7% (n = 109) were LGA. The proportion of female-SGA was greater in comparison to male-SGA (n = 427, 52.5% vs n = 386, 47.5%). SGA babies were born to mothers who had term, preterm, and postterm delivery in the following proportions 70.1%, 19.3%, and 10.6%, respectively. The average weight gain (mean ± SD) by mothers in AGA pregnancies was 10.3 ± 2.4 kg, whereas in SGA were 9.3 ± 2.4 kg. In addition to low socioeconomic status (OR 1.9, 95% CI 1.1, 3.2), other prognostic factors associated with SGA were lifestyle factors such as low maternal sleep duration (OR 5.1, CI 3.6, 7.4) and monthly or less frequent meat intake (OR 5.0, CI 3.2, 7.8). Besides smoking (OR 8.8, CI 2.1, 36.3), the other major environmental factor associated with SGA was exposure to household air pollution (OR 5.4, 4.1, 6.9) during pregnancy. Similarly, some of the adverse health conditions associated with a significantly higher risk of SGA were anemia, oligohydramnios, and gestational diabetes.
CONCLUSIONS
SGA is common in Western Nepal and associated with several modifiable prognostic factors.
背景
在尼泊尔等低收入国家，小于胎龄儿（SGA）在新生儿中很常见，且其直接死亡率和发病率更高。
目的
研究尼泊尔西部SGA婴儿的患病率及预后因素。
方法
于2016年11月至2017年10月在尼泊尔西部的一家三级护理医院进行了一项横断面研究。记录了分娩适于胎龄儿（AGA）、SGA和大于胎龄儿（LGA）的母亲的社会人口学、包括饮食在内的生活方式因素以及包括吸烟和家庭空气污染在内的暴露情况。在对潜在混杂因素进行调整后，进行逻辑回归以找出预后因素的比值比。
结果
在4000例分娩婴儿中，77%（n = 3078）为AGA，20.3%（n = 813）为SGA，2.7%（n = 109）为LGA。女性SGA的比例高于男性SGA（n = 427，52.5%对n = 386，47.5%）。SGA婴儿的母亲足月、早产和过期产的比例分别为70.1%、19.3%和10.6%。AGA妊娠母亲的平均体重增加（均值±标准差）为10.3±2.4kg，而SGA妊娠母亲为9.3±2.4kg。除了社会经济地位低（比值比1.9，95%置信区间1.1，3.2）外，与SGA相关的其他预后因素还有生活方式因素，如母亲睡眠持续时间短（比值比5.1，置信区间3.6，7.4）和每月或更不频繁的肉类摄入（比值比5.0，置信区间3.2，7.8）。除吸烟（比值比8.8，置信区间2.1，36.3）外，与SGA相关的另一个主要环境因素是孕期暴露于家庭空气污染（比值比5.4，4.1，6.9）。同样，与SGA风险显著更高相关的一些不良健康状况包括贫血、羊水过少和妊娠期糖尿病。
结论
SGA在尼泊尔西部很常见，且与几个可改变的预后因素相关。
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