Adeoye Ikeola A, Unogu Chioma O, Adediran Kofoworola, Gbadebo Babatunde M
Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Consortium of Advanced Research Training in Africa, Nairobi, Kenya.
PLOS Glob Public Health. 2025 Jan 31;5(1):e0004199. doi: 10.1371/journal.pgph.0004199. eCollection 2025.
Adverse perinatal outcomes (APO) are unfavourable incidents of at least one of the following: low birth weight, preterm delivery, stillbirths, neonatal deaths, and perinatal deaths. They contribute significantly to neonatal and infant morbidity and mortality, developmental abnormalities, and long-term impairments. Studies are lacking on the influence of maternal lifestyle on APO in Nigeria. Hence, we investigated the determinants of APO using the Ibadan Pregnancy Cohort Study (IbPCS) data and examined 1,339 mothers who had hospital delivery. The outcome variable was APO (low birth weight, birth asphyxia and preterm delivery). Explanatory variables comprised Antepartum Depression (Edinburgh Depression Scale ≥ 12), Physical activity (Pregnancy Physical Activity Questionnaire (PPAQ), Dietary pattern (Qualitative Food Frequency Questionnaire (FFQ), Maternal Stress (Perceived Stress Scale), Alcohol consumption, and Tobacco exposure. We used binary and multiple logistic regression to assess the associations between the risk factors and adverse perinatal outcomes at a significant P-value <0.05. Prevalence of APO was 26.7%, 95%CI (24.4-29.1); low birth weight - 8.5%, 95%CI (7.0-10.1) preterm delivery 14.8%, 95% CI (12.9-16.7); birth asphyxia 16.3%, 95%CI (14.0-18.9). The factors associated with LBW were being a female infant AOR: 2.00, 95%CI (1.13 -3.52); emergency caesarean section AOR: 2.40, 95%CI (1.06-5.42); a history of hypertension in pregnancy AOR: 3.34, 95%CI (1.45 -7.52). Preterm birth was associated with being poor AOR: 2.00, 95%CI (1.13 -3.52); history of stillbirth AOR: 2.05, 95%CI (1.14-3.68); antepartum depression AOR: 1.87, 95%CI (1.08-3.25). Of the lifestyle factors examined, only a high protein diet with a non-alcoholic beverage dietary pattern had a statistically significant association with preterm birth [AOR: 0.50, 95%CI (1.08-3.52)]. However, lifestyle factors had no significant association with LBW and birth asphyxia in our study. Understanding these risk factors can help policymakers and healthcare professionals create cost-effective interventions to curtail the burden of APO in Nigeria.
围产期不良结局（APO）是指以下至少一种不良事件：低出生体重、早产、死产、新生儿死亡和围产期死亡。它们对新生儿和婴儿的发病率和死亡率、发育异常以及长期损害有重大影响。关于尼日利亚母亲生活方式对围产期不良结局的影响，目前缺乏相关研究。因此，我们利用伊巴丹妊娠队列研究（IbPCS）的数据调查了围产期不良结局的决定因素，并对1339名在医院分娩的母亲进行了研究。结局变量为围产期不良结局（低出生体重、出生窒息和早产）。解释变量包括产前抑郁（爱丁堡抑郁量表≥12）、身体活动（妊娠身体活动问卷（PPAQ））、饮食模式（定性食物频率问卷（FFQ））、母亲压力（感知压力量表）、饮酒和烟草暴露。我们使用二元和多元逻辑回归来评估风险因素与围产期不良结局之间的关联，显著P值<0.05。围产期不良结局的患病率为26.7%，95%置信区间（24.4 - 29.1）；低出生体重为8.5%，95%置信区间（7.0 - 10.1）；早产为14.8%，95%置信区间（12.9 - 16.7）；出生窒息为16.3%，95%置信区间（14.0 - 18.9）。与低出生体重相关的因素包括女婴（比值比：2.00，95%置信区间（1.13 - 3.52））、急诊剖宫产（比值比：2.40，95%置信区间（1.06 - 5.42））、妊娠高血压病史（比值比：3.34，95%置信区间（1.45 - 7.52））。早产与贫困（比值比：2.00，95%置信区间（1.13 - 3.52））、死产史（比值比：2.05，95%置信区间（1.14 - 3.68））、产前抑郁（比值比：1.87，95%置信区间（1.08 - 3.25））有关。在所研究的生活方式因素中，只有高蛋白饮食与非酒精饮料的饮食模式与早产有统计学上的显著关联[比值比：0.50，95%置信区间（1.08 - 3.52）]。然而，在我们的研究中，生活方式因素与低出生体重和出生窒息没有显著关联。了解这些风险因素有助于政策制定者和医疗保健专业人员制定具有成本效益的干预措施，以减轻尼日利亚围产期不良结局的负担。
