Cabra-Bautista Ginna, Granados Rugeles Claudia Marcela, Grillo-Ardila Carlos Fernando, Gil Laverde Fabián Armando
Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana School of Medicine, Bogotá, Colombia.
Department of Pediatrics, Universidad del Cauca Health Sciences School, Popayán, Colombia.
Int J Gynaecol Obstet. 2022 Sep;158(3):619-625. doi: 10.1002/ijgo.14082. Epub 2022 Jan 24.
To determine the association between armed conflict and very low birth wright (VLBW), which is a multifactorial etiology public health problem that includes aspects of poverty and violence.
Case-control population study matched by year of delivery conducted in Cauca, Colombia, between 2010 and 2016. Cases of VLBW, with weights between 500 and 1499 g and controls weighing between 2500 and 3999 g. Cases and controls were identified through the vital statistics registry, and exposure was determined using a multidimensional index designed by the Colombian State. Multiple gestations were excluded. Conditional logistic regression for matched data was used, adjusting for confounding variables.
Overall, 7068 matched participants (1767 cases and 5301 controls) were included. Cases and controls had similar baseline characteristics. Participants were predominantly women in the second and third decades of life, 3222 (46%) were exposed to armed conflict, and 1902 (27%) were of African-Colombian or indigenous ethnicity. Maternal exposure to armed conflict significantly increased the odds of VLBW among women with rural birth (adjusted odds ratio [aOR] 3.86, 95% confidence interval [CI] 2.74-5.45) and inadequate prenatal care (aOR 10.38, 95% CI 8.20-13.12).
Exposure to armed conflict increases the odds of VLBW neonates. This factor needs to be considered in prenatal care.
确定武装冲突与极低出生体重（VLBW）之间的关联，极低出生体重是一个多因素病因的公共卫生问题，包括贫困和暴力等方面。
2010年至2016年在哥伦比亚考卡进行的按分娩年份匹配的病例对照人群研究。极低出生体重病例的体重在500至1499克之间，对照的体重在2500至3999克之间。通过生命统计登记处确定病例和对照，并使用哥伦比亚国家设计的多维指数确定暴露情况。排除多胎妊娠。对匹配数据使用条件逻辑回归，并对混杂变量进行调整。
总体而言，纳入了7068名匹配参与者（1767例病例和5301名对照）。病例和对照具有相似的基线特征。参与者主要是二三十岁的女性，3222人（46%）暴露于武装冲突，1902人（27%）为非裔哥伦比亚人或原住民。母亲暴露于武装冲突显著增加了农村出生妇女中极低出生体重的几率（调整后的优势比[aOR]为3.86，95%置信区间[CI]为2.74 - 5.45）以及产前护理不足的妇女中极低出生体重的几率（aOR为10.38，95%CI为8.20 - 13.12）。
暴露于武装冲突会增加极低出生体重新生儿的几率。在产前护理中需要考虑这一因素。
