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母亲因素与低出生体重儿及巨大儿的关系:加纳北部地区的一项横断面研究。

Maternal risk factors for low birthweight and macrosomia: a cross-sectional study in Northern Region, Ghana.

机构信息

School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4, Sakamoto, Nagasaki City, 852-8523, Japan.

Savelugu Municipal Hospital, Ghana Health Service, P.O. Box 45, Savelugu, Northern Region, Ghana.

出版信息

J Health Popul Nutr. 2023 Aug 29;42(1):87. doi: 10.1186/s41043-023-00431-0.

Abstract

BACKGROUND

Abnormal birthweights are critical public health challenges accountable for most non-communicable diseases and perinatal mortalities. Regardless of the myriad of mixed evidence on maternal factors responsible for abnormal birthweight globally, most of these findings are attained from urban and rural settings. This study serves as one of the key pieces of evidence in view of the increasing prevalence of abnormal birthweight particularly in some parts of semi-rural Ghana. The study, therefore, aims to estimate the prevalence of abnormal birthweight and identify some possible maternal risk factors for abnormal birthweight in Northern Ghana.

METHODS

A retrospective cross-sectional study was conducted in Savelugu municipality from February-March 2022. A total of 356 mothers aged 16-46 years, having a neonate and attending postnatal care service, were recruited as study participants. Data were collected from maternal and child health record books and through structured interviews. To identify the maternal risk factors for abnormal birthweight, chi-square/Fischer's exact test and multinomial logistic regression were employed as bivariate and multivariate analyses, respectively, at 95% confidence level.

RESULTS

Prevalence rates of low birthweight and macrosomia were 22.2% and 8.7%, respectively. Maternal anaemia in first trimester (AOR 3.226; 95% CI 1.372-7.784) and third trimester (AOR 23.94; 95% CI 7.442-70.01) of gestation was strong predictors for low birthweight. Mothers belonging to minority ethnic groups (AOR 0.104; 95% CI 0.011-0.995); mothers who had ≥ 8 antenatal care visits (AOR 0.249; 95% CI 0.103-0.602); and mothers having neonates whose birth length > 47.5 cm (AOR 0.271; 95% CI 0.113-0.651) had reduced odds for low birthweight. Alternatively, mothers with gestational weeks ≥ 42 (AOR 23.21; 95% CI 4.603-56.19) and mothers from the richest households (highest socioeconomic homes) (AOR 14.25; 95% CI 1.638-23.91) were more likely to birth to macrosomic infants.

CONCLUSION

The prevalence rates of low birthweight and macrosomia were relatively high. Anaemia in the first and third trimesters was strong determinants of low birthweight. Being minority ethnic group, frequency of antenatal visits, and childbirth length reduced the risk of low-weight births. Advanced gestational age and socioeconomic status of mothers were also predictors of macrosomia. Hence, nutrition counselling, community health education, and promotion of lifestyle improvement coupled with strengthening of health service delivery are recommended interventions.

摘要

背景

异常出生体重是影响大多数非传染性疾病和围产期死亡率的重要公共卫生挑战。尽管全球有大量关于导致异常出生体重的母体因素的混合证据,但这些发现大多来自城市和农村地区。鉴于异常出生体重,特别是在加纳部分半农村地区的流行率不断上升,本研究旨在提供其中一项重要证据。本研究旨在估计异常出生体重的流行率,并确定北部加纳可能导致异常出生体重的一些母体危险因素。

方法

这是一项 2022 年 2 月至 3 月在萨维卢古市进行的回顾性横断面研究。共招募了 356 名 16-46 岁的母亲,她们有新生儿并接受产后护理服务,作为研究参与者。数据来自母婴健康记录簿和结构化访谈。为了确定异常出生体重的母体危险因素,采用卡方/Fisher 精确检验和多变量逻辑回归进行了单变量和多变量分析,置信水平为 95%。

结果

低出生体重和巨大儿的患病率分别为 22.2%和 8.7%。妊娠早期(AOR 3.226;95%CI 1.372-7.784)和妊娠晚期(AOR 23.94;95%CI 7.442-70.01)的母体贫血是低出生体重的强烈预测因素。属于少数民族群体的母亲(AOR 0.104;95%CI 0.011-0.995);有≥8 次产前检查的母亲(AOR 0.249;95%CI 0.103-0.602);以及新生儿出生长度>47.5 厘米的母亲(AOR 0.271;95%CI 0.113-0.651),低出生体重的可能性降低。相反,妊娠周数≥42 周的母亲(AOR 23.21;95%CI 4.603-56.19)和来自最富裕家庭(最高社会经济家庭)的母亲(AOR 14.25;95%CI 1.638-23.91)更有可能生育巨大儿。

结论

低出生体重和巨大儿的患病率相对较高。妊娠早期和晚期的贫血是低出生体重的主要决定因素。属于少数民族群体、产前检查次数、分娩长度降低了低体重出生的风险。母亲的孕龄和社会经济地位也是巨大儿的预测因素。因此,建议采取营养咨询、社区健康教育、促进生活方式改善以及加强卫生服务提供等干预措施。

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