Devaguru Amar, Gada Sandeep, Potpalle Dnyaneshwar, Dinesh Eshwar Mummareddi, Purwar Dipti
Paediatrics, People's Hospital, Hyderabad, IND.
Paediatrics, Mahavir Institute of Medical Sciences, Vikarabad, IND.
Cureus. 2023 May 5;15(5):e38587. doi: 10.7759/cureus.38587. eCollection 2023 May.
Background Low birth weight (LBW) is at the forefront of 100 core health issues that are used as indicators to assess the global nutrition monitoring framework as reported by the World Health Organization (WHO). Several factors could contribute to LBW, which essentially include intrauterine growth retardation and premature delivery/birth. Moreover, LBW predisposes neonates to several developmental disturbances including both physical and mental disorders. Given that LBW is more common in poor and developing countries, there is not much reliable data that could be used to formulate strategies for controlling this problem. This study, therefore, attempts to assess the prevalence of LBW among newborn babies and its associated maternal risk factors. Methods This hospital-based cross-sectional study was carried out between June 2016 and May 2017 (one year) and included 327 LBW babies. A predefined and prevalidated questionnaire was used to obtain data for the study. The data collected included age, religion, parity, birth spacing, pre-pregnancy weight, weight gain during pregnancy, height, mother's education, occupation, family income, socioeconomic status, obstetric history, previous history of stillbirths and abortions, and history of any LBW baby. Results The prevalence of LBW was noted to be 36.33%. The occurrence of LBW babies was predominant among mothers who were aged <19 years (62.26%) and >35 years (57.14%). Grand multipara women showed the highest rates (53.70%) of LBW babies. Additionally, LBW was predominantly noticed among newborns (46.66%) with a birth spacing of <18 months, those born to mothers with pre-pregnancy weight of <40 Kg (94.04%), mothers with a height of <145 cm (83.46%), mothers who gained <7 kg during the pregnancy (82.20%), illiterate mothers (43.75%), and mothers who were agricultural workers (63.76%). Other maternal factors that could predispose to LBW included lower monthly income (66.25%), low socioeconomic status (52.90%), less number of antenatal visits (59.65%), low blood hemoglobin (100%), history of strenuous physical activities (48.66%), smoking and/or tobacco chewing habit (91.42%), alcoholism (66.66%), lack of iron and folic acid supplementation during pregnancy (64.58%), history of stillbirths (51.51%), and mothers suffering from chronic hypertension, preeclampsia, and eclampsia (47.61%), and tuberculosis (75%). Religion-wise, Muslim mothers revealed the highest prevalence (48.57%) of LBW, followed by Hindus (37.71%) and Christians (20%). The mother's age, pre-pregnancy weight, weight gain during pregnancy, height of the mother, hemoglobin concentration, weight of the baby, and length of the newborn (p≤0.05) could influence the health of the newborn. However, maternal infections, previous bad obstetrics history, presence of systemic illnesses, and protein and calorie supplementation (p≥0.05) had no significant impact on birth weight. Conclusions The results showed that multiple factors are responsible for LBW. Maternal factors such as weight, height, age, parity, weight gained during pregnancy, and anemia during pregnancy could predispose to delivering LBW babies. Additionally, other risk factors for LBW identified in this study were the literacy level of mothers, occupation, family income, socioeconomic status, antenatal care, strenuous physical activity during pregnancy, smoking/tobacco chewing, alcohol/toddy consumption, and iron and folic acid supplementation during pregnancy.
低出生体重(LBW)位列世界卫生组织(WHO)报告的用于评估全球营养监测框架的100项核心健康问题之首。多种因素可能导致低出生体重,主要包括宫内生长迟缓以及早产/分娩。此外,低出生体重使新生儿易出现多种发育障碍,包括身体和精神方面的疾病。鉴于低出生体重在贫困和发展中国家更为常见,可用于制定控制该问题策略的可靠数据不多。因此,本研究试图评估新生儿中低出生体重的患病率及其相关的母亲风险因素。
本基于医院的横断面研究于2016年6月至2017年5月(一年)进行,纳入了327名低出生体重婴儿。使用预先定义和验证过的问卷获取研究数据。收集的数据包括年龄、宗教、产次、生育间隔、孕前体重、孕期体重增加、身高、母亲教育程度、职业、家庭收入、社会经济地位、产科病史、既往死产和流产史以及任何低出生体重婴儿的病史。
低出生体重的患病率为36.33%。低出生体重婴儿在年龄<19岁(62.26%)和>35岁(57.14%)的母亲中最为常见。多产妇中低出生体重婴儿的发生率最高(53.70%)。此外,生育间隔<18个月的新生儿(46.66%)、孕前体重<40千克的母亲所生的婴儿(94.04%)、身高<145厘米的母亲所生的婴儿(83.46%)、孕期体重增加<7千克的母亲所生的婴儿(82.20%)、文盲母亲所生的婴儿(43.75%)以及从事农业工作的母亲所生的婴儿(63.76%)中低出生体重情况最为明显。其他可能导致低出生体重的母亲因素包括月收入较低(66.25%)、社会经济地位低(52.90%)、产前检查次数少(59.65%)、血红蛋白水平低(100%)、有剧烈体力活动史(48.66%)、吸烟和/或咀嚼烟草习惯(91.42%)、酗酒(66.66%)、孕期缺乏铁和叶酸补充(64.58%)、有死产史(51.51%)以及患有慢性高血压、先兆子痫和子痫的母亲(47.61%),还有患结核病的母亲(75%)。按宗教划分,穆斯林母亲中低出生体重的患病率最高(48.57%),其次是印度教徒(37.71%)和基督教徒(20%)。母亲的年龄、孕前体重、孕期体重增加、母亲身高、血红蛋白浓度、婴儿体重和新生儿身长(p≤0.05)会影响新生儿的健康。然而,母亲感染、既往不良产科病史、存在全身性疾病以及蛋白质和热量补充(p≥0.05)对出生体重没有显著影响。
结果表明,多种因素导致低出生体重。母亲因素如体重、身高、年龄、产次、孕期体重增加和孕期贫血可能导致分娩低出生体重婴儿。此外,本研究中确定的低出生体重的其他风险因素包括母亲的识字水平、职业、家庭收入、社会经济地位、产前护理、孕期剧烈体力活动、吸烟/咀嚼烟草、饮酒/饮用棕榈酒以及孕期铁和叶酸补充。