Ministry of Health, Putrajaya, Malaysia.
Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
PLoS One. 2024 Jul 12;19(7):e0306387. doi: 10.1371/journal.pone.0306387. eCollection 2024.
Pregnant mothers are at risk of many adverse pregnancy outcomes, including infants with low birth weight (LBW). The World Health Organization aimed to achieve a 30% reduction in the number of LBW infants by the year 2025. In this study, we aimed to determine the incidence and determinants of LBW infants among pregnant mothers attending government health clinics in Peninsular Malaysia.
A prospective cohort study "Relative Risk of Determinants of Adverse Pregnancy Outcomes Among Pregnant Mothers Attending Government Health Clinics, Peninsular Malaysia, PEN-MUM" was conducted from March 2022 until March 2023 at 20 government health clinics in Peninsular Malaysia that were randomly selected through a multistage sampling method. Malaysian pregnant mothers between 18 and 49 years old were recruited at 12-18 weeks of gestation and followed up at three time points: 1 (24-28 weeks of gestation), 2 (36-40 weeks of gestation), and 3 (post-delivery). Eight exposure factors of LBW were studied: gestational weight gain, dengue infection, urinary tract infection, COVID-19 infection, gestational hypertension, preeclampsia, maternal anemia, and gestational diabetes mellitus (GDM).
Among 507 participants enrolled in the cohort, 40 were lost to follow-up. A total of 467 were included in the final analysis, giving an attrition rate of 7.9%. The incidence of LBW infants in Peninsular Malaysia was 14.3%. After adjusting for three covariates (ethnicity, employment status, and gestational age at birth), three determinants of LBW were identified. The risk of giving birth to LBW infants was higher among those with inadequate gestational weight gain (aRR = 2.86, 95% CI: 1.12, 7.37, p = 0.03), gestational hypertension (aRR = 4.12; 95% CI: 1.66, 10.43; p = 0.002), and GDM (aRR = 2.21; 95% CI: 1.18, 4.14; p = 0.013) during the second and third trimesters.
The incidence of LBW infants in Peninsular Malaysia can be considered high. Having inadequate gestational weight gain, gestational hypertension, and GDM in the second and third trimesters increased the risk of LBW infants by threefold, fivefold, and twofold respectively. Thus, intervention strategies should target prevention, early detection, and treatment of gestational hypertension and GDM, as well as promoting adequate weight gain during antenatal care.
孕妇面临多种不良妊娠结局的风险，包括婴儿出生体重低（LBW）。世界卫生组织的目标是到 2025 年将 LBW 婴儿的数量减少 30%。本研究旨在确定在马来西亚半岛政府诊所就诊的孕妇中 LBW 婴儿的发生率和决定因素。
这是一项前瞻性队列研究，研究题目为“马来西亚半岛政府诊所孕妇不良妊娠结局相关风险的相对风险，PEN-MUM”，于 2022 年 3 月至 2023 年 3 月在马来西亚半岛通过多阶段抽样方法随机选择的 20 家政府诊所进行。18-49 岁的马来西亚孕妇在妊娠 12-18 周时入组，并在三个时间点进行随访：1（妊娠 24-28 周）、2（妊娠 36-40 周）和 3（产后）。研究了 8 个 LBW 的暴露因素：妊娠体重增加、登革热感染、尿路感染、COVID-19 感染、妊娠高血压、子痫前期、孕妇贫血和妊娠期糖尿病（GDM）。
在纳入的 507 名队列参与者中，有 40 名失访。共有 467 名参与者被纳入最终分析，失访率为 7.9%。马来西亚半岛 LBW 婴儿的发生率为 14.3%。在调整了三个协变量（种族、就业状况和出生时的胎龄）后，确定了三个 LBW 的决定因素。在妊娠第二和第三阶段体重增加不足（ARR = 2.86，95%CI：1.12，7.37，p = 0.03）、妊娠高血压（ARR = 4.12；95%CI：1.66，10.43；p = 0.002）和 GDM（ARR = 2.21；95%CI：1.18，4.14；p = 0.013）的孕妇中，LBW 婴儿的风险更高。
马来西亚半岛 LBW 婴儿的发生率较高。妊娠第二和第三阶段体重增加不足、妊娠高血压和 GDM 分别使 LBW 婴儿的风险增加了三倍、五倍和两倍。因此，干预策略应针对预防、早期发现和治疗妊娠高血压和 GDM，并在产前保健期间促进适当的体重增加。
