马拉维 Phalombe 区 Rev. John Chilembwe 医院的产妇因素不同分组的低出生体重预测因素及新生儿出生体重比较：回顾性病历回顾。

Predictors of low birthweight and comparisons of newborn birthweights among different groups of maternal factors at Rev. John Chilembwe Hospital in Phalombe district, Malawi: A retrospective record review.

机构信息

Agency for Scientific Research and Training, Lilongwe, Malawi.

Preluha Consultancy, Zomba, Malawi.

出版信息

PLoS One. 2024 Aug 29;19(8):e0291585. doi: 10.1371/journal.pone.0291585. eCollection 2024.

DOI:10.1371/journal.pone.0291585

PMID:39208326

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11361679/

Abstract

BACKGROUND

Birthweight has an impact on newborn's future health outcomes. Maternal factors, including age, delivery mode, HIV status, gestational age, parity and obstetric complications (preeclampsia or eclampsia [PE], antepartum hemorrhage [APH] and sepsis), however, have been shown as risk factors of low birthweight (LBW) elsewhere. For data-guided interventions, we aimed to identify predictors of LBW and compare newborn birthweights between different groups of maternal factors at Rev. John Chilembwe Hospital in Phalombe district, Malawi.

METHODS

Using a retrospective record review study design, we extracted data from maternity registers of 1244 women and their newborns from October, 2022 to March, 2023. Data were skewed. Median test was used to compare median birthweights. Chi-square or Fisher's exact tests were used to compare proportions of LBW among different groups of maternal factors. Multivariable logistic regression with stepwise, forward likelihood method was performed to identify predictors of LBW.

RESULTS

Median birthweight was 2900.00g (interquartile range [IQR]: 2600.00g to 3200.00g). Prevalence of LBW was 16.7% (n = 208). Proportions of LBW infants were higher in women with PE, APH, including women with sepsis than controls (10 [47.6%] of 21 vs 7 [58.3%] of 12 vs 191 [15.8%] of 1211, p < .001). Lower in term and postterm than preterm (46 [5.5%] of 835 vs 2 [3.7%] of 54 vs 160 [45.1%] of 355, p < .001). The odds of LBW infants were higher in preterm than term (AOR = 13.76, 95%CI: 9.54 to 19.84, p < .001), women with PE (AOR = 3.88, 95%CI: 1.35 to 11.18, p = .012), APH, including women with sepsis (AOR = 6.25, 95%CI: 1.50 to 26.11, p = .012) than controls.

CONCLUSION

Prevalence of LBW was high. Its predictors were prematurity, PE, APH and sepsis. Interventions aimed to prevent these risk factors should be prioritized to improve birthweight outcomes.

摘要

背景

出生体重会影响新生儿未来的健康状况。然而，在其他地方，母亲的年龄、分娩方式、HIV 状况、胎龄、产次和产科并发症（子痫前期或子痫[PE]、产前出血[APH]和败血症）等因素已被证明是低出生体重（LBW）的危险因素。为了进行数据驱动的干预，我们旨在确定 LBW 的预测因素，并比较马拉维 Phalombe 区 Rev. John Chilembwe 医院不同产妇因素组别的新生儿出生体重。

方法

使用回顾性病历回顾研究设计，我们从 2022 年 10 月至 2023 年 3 月期间 1244 名妇女及其新生儿的产妇登记处提取数据。数据偏态分布。中位数检验用于比较中位数出生体重。卡方检验或 Fisher 精确检验用于比较不同产妇因素组别的 LBW 比例。使用逐步向前似然法进行多变量逻辑回归，以确定 LBW 的预测因素。

结果

中位数出生体重为 2900.00g（四分位距[IQR]：2600.00g 至 3200.00g）。LBW 的患病率为 16.7%（n=208）。PE、APH 包括败血症的妇女的 LBW 婴儿比例高于对照组（21 例中有 10 例[47.6%]，12 例中有 7 例[58.3%]，1211 例中有 191 例[15.8%]，p<.001）。足月和过期的婴儿比例低于早产（835 例中有 46 例[5.5%]，54 例中有 2 例[3.7%]，355 例中有 160 例[45.1%]，p<.001）。早产的 LBW 婴儿的可能性高于足月（OR=13.76，95%CI：9.54 至 19.84，p<.001），PE（OR=3.88，95%CI：1.35 至 11.18，p=0.012），APH 包括败血症（OR=6.25，95%CI：1.50 至 26.11，p=0.012）。