Brown H L, Watkins K, Hiett A K
Department of Obstetrics and Gynecology, Indiana University Medical Center, Indianapolis, USA.
Am J Obstet Gynecol. 1996 Apr;174(4):1279-83. doi: 10.1016/s0002-9378(96)70671-3.
Our purpose was to compare the birth outcomes of pregnant women in the Women, Infants and Children Food Supplement Program with women not in the program.
The vital records of 4713 women, 2895 enrolled in the Women, Infants and Children Food Supplement Program and 1812 not enrolled in the program, whose infants were delivered at Wishard Memorial Hospital over 18 months were reviewed with respect to age, education, race, substance habits, trimester of entry into prenatal care, maternal weight gain, and status in the program. The primary outcome variables evaluated were low birth weight, as defined by the delivery of an infant < 2500 gm, and infant mortality. The primary predictor was program participation versus nonparticipation. Analysis was by t test, chi2, and logistic regression models.
Black women, women with no prenatal care, and women who smoke were more likely to deliver a low-birth-weight infant. The incidence of low birth weight was 13.1% for nonparticipants versus 10.2% for program participants (p < 0.05). Univariate analysis confirmed program participants to be at significantly less risk for a low-birth-weight delivery (odds ratio = 0.75, p < 0.05). This relation, however, was not significant in the multivariate model (odds ratio = 0.88), indicating that the effect of participating in the program is being confounded by race, entry into prenatal care, and smoking. The overall infant mortality rate was 12.4 per 1000 for participants and 16 per 1000 for nonparticipants (p = not significant).
Nutritional and nonnutritional benefits to participation in the Women, Infants and Children Food Supplement Program were confirmed. Women enrolled in the program were less likely to deliver a low-birth-weight infant. Multiple variables likely contribute to the poorer outcome for nonparticipants.
我们的目的是比较参加妇女、婴儿和儿童食品补充计划的孕妇与未参加该计划的孕妇的分娩结局。
回顾了4713名妇女的生命记录，其中2895名参加了妇女、婴儿和儿童食品补充计划，1812名未参加该计划，她们的婴儿在维沙德纪念医院分娩，时间跨度为18个月。对她们的年龄、教育程度、种族、物质使用习惯、开始产前护理的孕期、孕妇体重增加情况以及在该计划中的状态进行了评估。评估的主要结局变量为低出生体重（定义为出生婴儿体重<2500克）和婴儿死亡率。主要预测因素是是否参加该计划。采用t检验、卡方检验和逻辑回归模型进行分析。
黑人妇女、未接受产前护理的妇女以及吸烟妇女更有可能分娩低体重婴儿。未参加计划者的低出生体重发生率为13.1% , 而参加计划者为10.2%（p<0.05）。单因素分析证实参加计划者分娩低体重婴儿的风险显著较低（优势比=0.75，p<0.05）。然而，在多变量模型中这种关系并不显著（优势比=0.88），这表明参加该计划的影响被种族、开始产前护理情况和吸烟所混淆。参与者的总体婴儿死亡率为每1000人中有12.4人，未参与者为每1000人中有16人（p不显著）。
证实了参加妇女、婴儿和儿童食品补充计划在营养和非营养方面的益处。参加该计划的妇女分娩低体重婴儿的可能性较小。多个变量可能导致未参与者出现较差的结局。
