Grbic Dragana, Supic Zorica Terzic, Todorovic Jovana, Nesic Dejan, Karic Svetlana, Jurisic Aleksandar, Kocic Sanja, Bukumiric Zoran, Cirkovic Andja, Jankovic Svetlana
Medical Faculty Belgrade, Gynecology Obstetric University Clinic Narodni Front, Belgrade, Serbia.
Institute of Social Medicine, Medical Faculty Belgrade, University of Belgrade, Belgrade, Serbia.
Front Public Health. 2024 Dec 10;12:1394060. doi: 10.3389/fpubh.2024.1394060. eCollection 2024.
Low birth weight, defined as a birth weight below 2,500 g, represents a significant public health concern with a multifactorial risk dimension. Socio-demographic factors and individual characteristics of women and their social environment could influence low birth weight. This study aimed to analyze the association between the socio-demographic and reproductive characteristics of women living in low-income households and low birth weight in Serbia, Kosovo, and Montenegro.
This study was conducted as secondary data analysis during the Multiple Indicator Cluster Survey - Round 6 in Serbia, Kosovo, and Montenegro. The household questionnaire and the individual questionnaire for women aged 15-49 were used as standard research instruments. We analyzed 1,019 women whose households belonged to the first (poorest) or second (poor) wealth index quintiles and who had given birth to a live child within the 2 years preceding the study. A multivariate logistic regression was applied with low birth weight in newborns as the outcome variable.
The univariate regression analysis showed that women with low birth weight newborns were significantly more likely to live in settlements mainly inhabited by Roma, reside in urban areas, marry or enter a union before age 18, have lower education levels, experience higher illiteracy rates, and receive antenatal care not provided by a medical doctor compared to women whose newborns weighed 2.5 kg or more. A multivariate logistic regression model with a low birth weight of newborns as an outcome variable showed the association between women's illiteracy (OR: 1.741; 95% CI: 1.060-2.859) and antenatal care not provided by a medical doctor (OR: 2.735; 95% CI: 1.229-6.087).
Illiteracy and limited access to medical doctor services during pregnancy were factors that increased the likelihood of low birth weight in newborns born to women living in low-income households in the selected Western Balkans populations. The cross-sectional design of this study does not allow the establishment of causal relationships among variables, but it can provide important evidence for future prevention strategies. Interventions are needed to enhance the education of women and to improve access to antenatal care across Serbia, Kosovo, and Montenegro.
低出生体重定义为出生体重低于2500克，是一个具有多因素风险维度的重大公共卫生问题。社会人口因素以及女性的个人特征及其社会环境可能会影响低出生体重。本研究旨在分析塞尔维亚、科索沃和黑山低收入家庭中女性的社会人口和生殖特征与低出生体重之间的关联。
本研究作为塞尔维亚、科索沃和黑山多指标类集调查第六轮期间的二次数据分析进行。家庭问卷和15 - 49岁女性的个人问卷被用作标准研究工具。我们分析了1019名女性，其家庭属于第一（最贫困）或第二（贫困）财富指数五分位数，且在研究前2年内生育了活产婴儿。以新生儿低出生体重作为结果变量应用多变量逻辑回归。
单变量回归分析表明，与新生儿体重2.5千克或以上的女性相比，新生儿为低出生体重的女性更有可能居住在主要由罗姆人居住的定居点、居住在城市地区、在18岁之前结婚或建立伴侣关系、教育水平较低、文盲率较高，并且接受非医生提供的产前护理。以新生儿低出生体重作为结果变量的多变量逻辑回归模型显示了女性文盲（比值比：1.741；95%置信区间：1.060 - 2.859）与非医生提供的产前护理（比值比：2.735；95%置信区间：1.229 - 6.087）之间的关联。
文盲以及孕期获得医生服务的机会有限是选定的西巴尔干地区低收入家庭中女性所生新生儿低出生体重可能性增加的因素。本研究的横断面设计不允许确定变量之间的因果关系，但可为未来的预防策略提供重要证据。需要采取干预措施来提高塞尔维亚、科索沃和黑山女性的教育水平，并改善获得产前护理的机会。
