Stüsser R, Paz G, Ortega M, Pineda S, Infante O, Martín P, Ordóñez C
Policlínico Docente Plaza de la Revolución, Ciudad de La Habana, Cuba.
Bol Oficina Sanit Panam. 1993 Mar;114(3):229-41.
The objective of this study was to confirm the risk factors (RF) for low birth-weight (LBW) and suggest new risk factors, which were analyzed separately and together, in order to define a program to be coordinated by family doctors to reduce the frequency of this problem. For this purpose, a retrospective cross-sectional survey was carried out with 57 cases (mothers who had had LBW babies) and 58 controls (mothers who had not had LBW babies). In addition, data were obtained from the prenatal records of mothers who received care at family doctors' offices and at the clinica in the Plaza de la Habana Area. Estimates were made of the relative risk and the percentage attributable risk of 107 hypothetical RF for LBW from a clinical-epidemiological and social standpoint. One-way analysis of variance, the chi-square test, multiple linear regression, and logistic regression were used to analyze the results, which suggested the following RF for LBW: family dysfunction, family crisis, lack of spousal support, extended family, failure to attend prenatal group sessions for pregnant women, and failure to receive education on how to prevent LBW. The multifactorial risk profile was the following: risk of [corrected] intrauterine growth retardation, family dysfunction, threat of preterm delivery, coffee-drinking, attendance at fewer than 11 prenatal checkups, and failure to attend prenatal group sessions for pregnant women. The variables excluded from the model were: low weight-for-height, lack of spousal support, smoking more than 10 cigarettes a day, and family history of LBW. The findings confirmed 10 of the suspected risk factors for LBW in Cuba and nine of those described in the international literature. Maternal age, spontaneous abortion, and alcohol consumption were not confirmed. Six RF for LBW preventable by the family doctor through his/her actions at the family and community level are identified, as is a multifactorial profile of six RF for LBW. On the basis of these results, proposals are made in regard to programming priorities and the implementation of strategies aimed at preventing LBW, and it is recommended that the study be continued with a larger sample.
本研究的目的是确定低出生体重（LBW）的风险因素（RF），并提出新的风险因素，对这些因素分别和综合进行分析，以制定一个由家庭医生协调的计划，以减少这一问题的发生频率。为此，对57例病例（生育低出生体重儿的母亲）和58例对照（未生育低出生体重儿的母亲）进行了回顾性横断面调查。此外，还从在家庭医生诊所和哈瓦那广场地区诊所接受护理的母亲的产前记录中获取了数据。从临床流行病学和社会角度对107个假设的低出生体重风险因素的相对风险和归因风险百分比进行了估计。采用单因素方差分析、卡方检验、多元线性回归和逻辑回归分析结果，结果提示低出生体重的风险因素如下：家庭功能障碍、家庭危机、配偶支持不足、大家庭、未参加孕妇产前小组会议、未接受如何预防低出生体重的教育。多因素风险概况如下：[校正后]宫内生长迟缓风险、家庭功能障碍、早产威胁、喝咖啡、产前检查次数少于11次、未参加孕妇产前小组会议。从模型中排除的变量有：身高体重偏低、配偶支持不足、每天吸烟超过10支、低出生体重家族史。研究结果证实了古巴10个疑似低出生体重风险因素中的9个以及国际文献中描述的9个风险因素。母亲年龄、自然流产和饮酒未得到证实。确定了家庭医生可通过其在家庭和社区层面的行动预防的6个低出生体重风险因素，以及6个低出生体重风险因素的多因素概况。基于这些结果，就预防低出生体重的规划重点和战略实施提出了建议，并建议继续进行更大样本量的研究。
