Awoke Aynadis, Yetwale Aynalem, Biyazin Tsegaw, Wolde Tegegn, Sinaga Makeda
School of Midwifery, Faculty of Health Science, Institute of Health, Jimma University, Jimma, Ethiopia.
School of Midwifery, College of Medicine and Health Science, Woldia University, Woldia, Ethiopia.
PLoS One. 2025 Sep 18;20(9):e0332596. doi: 10.1371/journal.pone.0332596. eCollection 2025.
Fetal malnutrition is a major public health burden affecting developing nations, potentially leading to cerebral and neurologic disabilities in later life. Despite its prevalence, little is known about its associated factors in the study area. Thus, this study aimed to assess prevalence and associated factors of fetal malnutrition among term newborn babies in Jimma Zone Public Hospitals.
A cross-sectional study was carried out among 449-term newborns using systematic sampling techniques in Jimma Zone Public Hospitals from April 1, 2024, to July 30, 2024. Maternal data were collected using an interviewer-administered questionnaire and newborn data were collected using clinical assessment of fetal nutrition (CAN score) scoring system and entered into Epi-data version 4.6 and exported to SPSS version 26 for analysis. Bivariate logistic regression was performed and variables with a p-value ≤0.25 were entered into multivariable logistic regression analysis. P-value less than 0.05 were considered statistically significant and data were presented using text, figures, and tables.
A total of 449 newborns with their mothers were involved in the study with the response rate of 100%. The prevalence of fetal malnutrition was 91/449 (20.3%) (95% CI, 16.5-24). Among delivered newborns 229/449 (51%) were females and the remaining are males. Maternal age less than nineteen was 60/449 (13.4%) (AOR = 2.930, 95% CI (2.518-13.967)), maternal MUAC ≤23 were 181/449 (40.3%) (AOR = 4.094, 95% CI (2.155-7.77)), infection during pregnancy 97/449 (21.6%) (AOR = 2.729, 95% CI (1.286-5.792)), malaria 99/449 (22%) (AOR = 2.125, 95% CI (1.002-4.510)), not taking Iron and Folic Acid 300/449 (66.8%) (AOR = 2.897, 95% CI (1.330-6.309)), complication during current pregnancy 116/449 (25.8%) (AOR = 4.629, 95% CI (2.444-8.767)), anemia 301/449 (67%) (AOR = 3.669, 95% CI (1.968-6.840)), low birth weight 77/449 (17.1%) (AOR = 5.363, 95% CI (2.760-10.420)), low placental weight 204/449 (45.4%) (AOR = 4.984, 95% CI (2.530-9.816)), antenatal depression 153/449 (34%) (AOR = 7.184, 95% CI (3.733-13.827)), and intimate partner violence 153/449 (34%) (AOR = 5.613, 95% CI (3.011-10.328)), were significantly associated with fetal malnutrition.
The prevalence of fetal malnutrition in this study indicates one in five delivered newborn. Newborns with low birth weight, low placental weight, and mothers having anemia, intimate partner violence (IPV), antenatal depression, teenage pregnancy, malaria, infection, and complications during pregnancy were a strong association with fetal malnutrition. Therefore, this study recommends that all concerned bodies, should prioritize efforts to reduce intimate partner violence, prevent infections during pregnancy, enhance maternal nutrition counseling, and address the issue of teenage pregnancy.
胎儿营养不良是影响发展中国家的一项重大公共卫生负担，可能导致日后出现脑和神经残疾。尽管其普遍存在，但在研究区域对其相关因素了解甚少。因此，本研究旨在评估吉马地区公立医院足月新生儿中胎儿营养不良的患病率及其相关因素。
2024年4月1日至2024年7月30日期间，在吉马地区公立医院采用系统抽样技术对449名足月新生儿进行了一项横断面研究。通过访谈式问卷收集母亲的数据，并使用胎儿营养临床评估（CAN评分）系统收集新生儿数据，录入Epi - data 4.6版本并导出到SPSS 26版本进行分析。进行二元逻辑回归分析，将p值≤0.25的变量纳入多变量逻辑回归分析。p值小于0.05被认为具有统计学意义，数据以文字、图表形式呈现。
共有449名新生儿及其母亲参与了本研究，应答率为100%。胎儿营养不良的患病率为91/449（20.3%）（95%可信区间，16.5 - 24）。在分娩的新生儿中，229/449（51%）为女性，其余为男性。母亲年龄小于19岁的有60/449（13.4%）（调整后比值比[AOR]=2.930，95%可信区间[2.518 - 13.967]），母亲上臂中段臂围（MUAC）≤23 cm的有181/449（40.3%）（AOR = 4.094，95%可信区间[2.155 - 7.77]），孕期感染的有97/449（21.6%）（AOR = 2.729，95%可信区间[1.286 - 5.792]），患疟疾的有99/449（22%）（AOR = 2.125，95%可信区间[1.002 - 4.510]），未服用铁剂和叶酸的有300/449（66.8%）（AOR = 2.897，95%可信区间[1.330 - 6.309]），本次孕期有并发症的有116/449（25.8%）（AOR = 4.629，95%可信区间[2.444 - 8.767]），贫血的有301/449（67%）（AOR = 3.669，95%可信区间[1.968 - 6.840]），低出生体重的有77/449（17.1%）（AOR = 5.363，95%可信区间[2.760 - 10.420]），胎盘重量低的有204/449（45.4%）（AOR = 4.984，95%可信区间[2.530 - 9.816]），产前抑郁的有153/449（34%）（AOR = 7.184，95%可信区间[3.733 - 13.827]），以及亲密伴侣暴力的有153/449（34%）（AOR = 5.613，95%可信区间[3.011 - 10.328]），均与胎儿营养不良显著相关。
本研究中胎儿营养不良的患病率表明每五名分娩的新生儿中就有一名受影响。低出生体重、低胎盘重量的新生儿，以及母亲患有贫血、遭受亲密伴侣暴力（IPV）、产前抑郁、青少年怀孕、疟疾、感染和孕期并发症的情况，均与胎儿营养不良密切相关。因此，本研究建议所有相关机构应优先努力减少亲密伴侣暴力，预防孕期感染，加强孕产妇营养咨询，并解决青少年怀孕问题。
