Berhe Kidanemaryam, Weldegerima Lemlem, Gebrearegay Freweini, Kahsay Amaha, Tesfahunegn Afewerki, Rejeu Mehammedseid, Gebremariam Brhane
Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia.
Department of Epidemiology, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia.
BMC Nutr. 2021 Nov 16;7(1):72. doi: 10.1186/s40795-021-00475-7.
Under-nutrition during pregnancy affects birth outcomes and neonatal outcomes. Worldwide, 20.5 million children were low birth weight, mainly in poor countries. However, there is no longitudinal-based evidence on the effect of under-nutrition during pregnancy on birth weight in Tigray regional state. Therefore, this study aimed at investigating the effect of under-nutrition during pregnancy on low birth weight in Tigray regional state.
We conducted a prospective cohort study among consecutively selected 540 pregnant women attending antenatal care in hospitals from October 2019 to June 2020. Pregnant women with mid upper arm circumference (MUAC) < 23 cm were exposed and those with MUAC≥23 cm were unexposed. Data on socio-demographic, diet, hygiene and anthropometry measurements were collected using pretested and structured questionnaires. SPSS version 25 was used for analysis. A log-binomial model was used to estimate the adjusted risk ratio and its 95%CI of the risk factors for low birth weight. Multi-collinearity was checked using the variance inflation factor (VIF) at a cut-off point of 8 and there was no multi-collinearity.
The overall incidence of low birth weight was 14% (95%CI: 11.1, 17.4%). The incidence of low birth weight was 18.4 and 9.8% among the exposed and unexposed women, respectively. The difference in low birth weight incidence between the exposed and unexposed groups was statistically significant (p-value = 0.006). The risk factors of low birth weight were maternal illiteracy (ARR: 1.8, 95%CI: 1.01, 3.3), low monthly family income < 50 US Dollar (ARR: 1.6, 95%CI: 1.07, 2.2), lack of latrine utilization (ARR: 0.47, 95%CI: 0.28, 0.78), and diet diversity score < 5 (ARR: 1.9, 95%CI: 1.05, 2.61).
Low birth weight was significantly higher among the exposed pregnant women. Maternal illiteracy, low monthly income, lack of latrine utilization, and low DDS were risk factors of low birth weight. It is then important to strengthen nutritional assessment and interventions during pregnancy, with a special attention for illiterate, and low monthly income pregnant women. Again, there has to be a promotion of latrine utilization and consumption of diversified diets.
孕期营养不良会影响出生结局和新生儿结局。全球有2050万儿童出生时体重过低，主要集中在贫穷国家。然而，在提格雷地区，尚无基于纵向研究的证据表明孕期营养不良对出生体重的影响。因此，本研究旨在调查提格雷地区孕期营养不良对低出生体重的影响。
我们对2019年10月至2020年6月期间在医院连续选取的540名参加产前护理的孕妇进行了一项前瞻性队列研究。上臂中段周长（MUAC）<23厘米的孕妇为暴露组，MUAC≥23厘米的孕妇为非暴露组。使用经过预测试的结构化问卷收集社会人口统计学、饮食、卫生和人体测量学数据。采用SPSS 25版进行分析。使用对数二项模型估计低出生体重危险因素的调整风险比及其95%置信区间。使用方差膨胀因子（VIF）在截断点为8时检查多重共线性，未发现多重共线性。
低出生体重的总体发生率为14%（95%置信区间：11.1，17.4%）。暴露组和非暴露组低出生体重的发生率分别为18.4%和9.8%。暴露组和非暴露组低出生体重发生率的差异具有统计学意义（p值 = 0.006）。低出生体重的危险因素包括母亲文盲（调整风险比：1.8，95%置信区间：1.01，3.3）、家庭月收入<50美元（调整风险比：1.6，95%置信区间：1.07，2.2）、缺乏使用厕所（调整风险比：0.47，95%置信区间：0.28，0.78）以及饮食多样性得分<5（调整风险比：1.9，95%置信区间：1.05，2.61）。
暴露组孕妇的低出生体重发生率显著更高。母亲文盲、月收入低、缺乏使用厕所和饮食多样性得分低是低出生体重的危险因素。因此，加强孕期营养评估和干预非常重要，尤其要关注文盲和月收入低的孕妇。此外，还必须促进厕所的使用和多样化饮食的消费。
