scholarly journals Which factors could explain the low birth weight paradox?

2006 ◽  
Vol 40 (4) ◽  
pp. 648-655 ◽  
Author(s):  
Antônio Augusto Moura da Silva ◽  
Heloisa Bettiol ◽  
Marco Antonio Barbieri ◽  
Luiz Gustavo Oliveira Brito ◽  
Márcio Mendes Pereira ◽  
...  

OBJECTIVE: Low birth weight children are unusual among well-off families. However, in Brazil, low birth weight rate was higher in a more developed city than in a less developed one. The study objective was to find out the reasons to explain this paradox. METHODS: A study was carried out in two municipalities, Ribeirão Preto (Southeastern Brazil) and São Luís (Northeastern Brazil), which low birth weight rates were 10.7% and 7.6% respectively. Data from two birth cohorts were analyzed: 2,839 newborns in Ribeirão Preto in 1994 and 2,439 births in São Luís in 1997-1998. Multiple logistic regression analysis was performed, adjusted for confounders. RESULTS: Low birth weight risk factors in São Luís were primiparity, maternal smoking and maternal age less than 18 years. In Ribeirão Preto, the associated variables were family income between one and three minimum wages, maternal age less than 18 and equal to or more than 35 years, maternal smoking and cesarean section. In a combined model including both cohorts, Ribeirão Preto presented a 45% higher risk of low birth weight than São Luís. When adjusted for maternal smoking habit, the excess risk for low birth weight in Ribeirão Preto compared to São Luís was reduced by 49%, but the confidence interval was marginally significant. Differences in cesarean section rates between both cities contributed to partially explain the paradox. CONCLUSIONS: Maternal smoking was the most important risk factor for explaining the difference in low birth weight between both cities. The other factors contributed little to explain the difference in low birth weight rates.

2020 ◽  
Vol 16 ◽  
Author(s):  
Reza Omani-Samani ◽  
Saman Maroufizadeh ◽  
Nafise Saedi ◽  
Nasim Shokouhi ◽  
Arezoo Esmailzadeh ◽  
...  

Background: Advanced maternal age is an important predictor for maternal and neonatal outcomes such as maternal mortality, low birth weight, stillbirth, preterm birth, cesarean section and preeclampsia. Objective: To determine the association of advanced maternal age and adverse maternal and neonatal outcomes in Iranian pregnant women. Methods: In this hospital-based cross-sectional study, 5117 pregnant women from 103 hospitals in Tehran, Iran, were participated in the study in 2015. The required data were gathered from hospitals which equipped to the department of obstetrics and gynecology. Advanced maternal age was considered as an independent variable and unwanted pregnancy, preeclampsia, preterm birth, cesarean section and low birth weight were considered as interested outcomes. Results: In our study, the prevalence of advanced maternal age was 12.08%. Advanced maternal age was significantly associated with higher risk of unwanted pregnancy (OR: 1.39, 95% CI: 1.12-1.73), preterm birth (OR: 1.75, 95% CI: 1.28- 2.39) and cesarean section (OR: 1.34, 95% CI: 1.03-1.74). In our study, there was no significant relationship between advanced maternal age and preeclampsia but this relationship could be clinically important (OR: 1.48, 95% CI: 0.99-2.20, P=0.052), and there is no significant relationship between advanced maternal age and low birth weight (OR: 1.08, 95% CI: 0.67-1.74, P=0.736). Conclusion: Advanced maternal age is associated with higher risk of unintended pregnancy, preterm birth and cesarean section but our findings did not support advanced maternal age as a risk factor associated with low birth weight.


2019 ◽  
Vol 10 (3) ◽  
pp. 1904-1909
Author(s):  
Adel J. Hussein

The LBW infants as weighting less than 2.5kg at birth. Infants with low birth weight are probable to suffer medical troubles and delay development from the time of delivery to adult life. This study was planned to discover the prevalence of LBW infants in Ad-Diwaniyah city (Iraq) and the maternal risk factors, which contribute to the occurrence of low birth weight, and it is rated and what the suitable recommendations can be made to prevent this problem.  Unfortunately, in Iraq, several studies reveal an increase in the delivery of LBW infants in the last years. The present study was aimed to identify the prevalence of LBW and possible maternal factors in children, teaching hospital in Al-Diwaniyah city during the period of the beginning of February 2017 to February 2018. This is a cross-sectional survey held out in Pediatric, teaching hospital through 1012 pregnant mothers giving a live LBW. Whole children weight on a weighing machine. Data was collected through the interview of mothers. Maternal age and education level, socioeconomic condition, number of prenatal visits, interpregnancy interval and maternal diseases, and infant gender were registered in questionnaire format. The result of the current study detects that the rate of LBW was 20.2%. The highest percentage of them (LBW) was preterm 67.4% and full, term (IUGR) 32.5%. 61.5% of the children in the LBW group were male, and 38.4% were female.  Besides the outcome indicates that there are many important risk factors contributed to the incidence of LBW, these are; multiple pregnancies were found to be 66.8% of LBW infants,  maternal age 21 – 35 years (39.7%),  lack of Prenatal Care (60.3%),  delivery by cesarean section (70.6%),  mothers who illiterate (64.8%),  a large number of mothers from the rural area (68.6%),  the presence of maternal diseases (63.5%),  all these are considered a risk factor. The current study demonstrates the essential elements give rise to low birth weight in neonates are gestational age (preterm delivery), maternal education and age, multiple births, regular prenatal care, cesarean section, and bad obstetric history.


2012 ◽  
Vol 10 (2) ◽  
pp. 15-17
Author(s):  
Sadikchya Singh Rana

Introduction: Teenage childbearing is linked to a host of negative social, economic and medical consequences for both mother and child. Maternal mortality among girls under 18 years is two to five times higher than that of women in their 20s. This study was conducted to determine the relationship between maternal age on fetal weight. Method: It was a prospective, hospital based study, carried out in 491 primigravidas with fullterm singleton pregnancy. The study population was divided into two groups, women who were 19 and less than 19 years of age and women who were more than 19 years of age. Fetal weight as the outcome variable was compared between these groups. Results: The age of the mother ranged from 16 to 37 years. 24.8% women in the study population were <19 years of age. Although the difference was not clinically significant (p=0.51), 1/3rd of the mothers who were <19 had low birth weight. Conclusion: the relation of low birth weight and young maternal age could not be proven in this study. DOI: http://dx.doi.org/10.3126/mjsbh.v10i2.6457 Medical Journal of Shree Birendra Hospital July-Dec 2011 10(2) 15-17


2000 ◽  
Vol 34 (6) ◽  
pp. 596-602 ◽  
Author(s):  
Marco A Barbieri ◽  
Antônio AM Silva ◽  
Heloisa Bettiol ◽  
Uilho A Gomes

OBJECTIVE: To identify risk factors for low birth weight (LBW) among live births by vaginal delivery and to determine if the disappearance of the association between LBW and socioeconomic factors was due to confounding by cesarean section. METHODS: Data were obtained from two population-based cohorts of singleton live births in Ribeirão Preto, Southeastern Brazil. The first one comprised 4,698 newborns from June 1978 to May 1979 and the second included 1,399 infants born from May to August 1994. The risks for LBW were tested in a logistic model, including the interaction of the year of survey and all independent variables under analysis. RESULTS: The incidence of LBW among vaginal deliveries increased from 7.8% in 1978--79 to 10% in 1994. The risk was higher for: female or preterm infants; newborns of non-cohabiting mothers; newborns whose mothers had fewer prenatal visits or few years of education; first-born infants; and those who had smoking mothers. The interaction of the year of survey with gestational age indicated that the risk of LBW among preterm infants fell from 17.75 to 8.71 in 15 years. The mean birth weight decreased more significantly among newborns from qualified families, who also had the highest increase in preterm birth and non-cohabitation. CONCLUSIONS: LBW among vaginal deliveries increased mainly due to a rise in the proportion of preterm births and non-cohabiting mothers. The association between cesarean section and LBW tended to cover up socioeconomic differences in the likelihood of LBW. When vaginal deliveries were analyzed independently, these socioeconomic differences come up again.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bolanle Olapeju ◽  
Xiumei Hong ◽  
Guoying Wang ◽  
Amber Summers ◽  
Irina Burd ◽  
...  

Abstract Background Given the trend of increasing maternal age and associated adverse reproductive outcomes in the US, this study aimed to assess whether this association is due to an independent aging or confounded by sociodemographic, biomedical, or behavioral determinants in a predominantly Black US population. Methods Data was from 8509 women enrolled in the Boston Birth Cohort. Adverse reproductive outcomes included spontaneous preterm delivery, cesarean delivery, and low birth weight. Covariates included sociodemographic (parity, race/ethnicity, education, marital status, income, receipt of public assistance, nativity); biomedical (obesity, hypertensive disorders, diabetes mellitus); and behavioral (consistent intake of multivitamin supplements, support from father of baby, support from family, major stress in pregnancy, cigarette smoking, alcohol intake). Analysis included Lowess and marginal probability plots, crude and adjusted sequential logistic regression models to examine age-outcome associations and to what degree the association can be explained by the above covariables. Result Overall, the study sample had high levels of spontaneous preterm birth (18%), cesarean delivery (33%) and low birth weight (26%). Unadjusted models showed no significant difference odds of spontaneous preterm birth by maternal age but higher odds of cesarean section (aOR: 1.77, 95% CI: 1.60, 1.95) and low birth weight (aOR: 1.15, 95% CI: 1.04, 1.28) among women 30 years or older. Adjustment for sociodemographic factors, biomedical conditions and behavioral factors revealed higher odds of spontaneous preterm birth: (aOR: 1.30, 95% CI: 1.14, 1.49), cesarean section deliveries (aOR: 1.68, 95% CI: 1.51, 1.87) and low birth weight (aOR: 1.36, 95% CI: 1.21, 1.53). Across all ages, optimal BMI status and consistent multivitamin supplement intake were protective of spontaneous preterm birth and low birth weight. Conclusion In this high-risk minority population, we demonstrated that the association between increasing maternal age and adverse pregnancy outcomes was due to an independent aging effect and the presence of confounding by sociodemographic, biomedical, and behavioral factors. Some modifiable risk factors to counteract aging effect, include optimizing BMI and consistent intake of multivitamin supplement. A fundamental change in how care is provided to women, particularly low income Black women, is needed with emphasis on the protective role of optimal nutritional status. Trial registration ClinicalTrials.gov Identifier: NCT03228875


2003 ◽  
Vol 37 (6) ◽  
pp. 693-698 ◽  
Author(s):  
Antônio Augusto Moura da Silva ◽  
Heloísa Bettiol ◽  
Marco Antônio Barbieri ◽  
Valdinar Sousa Ribeiro ◽  
Vânia Maria de Farias Aragão ◽  
...  

OBJECTIVE: To compare estimates of low birth weight (LBW), preterm birth, small for gestational age (SGA), and infant mortality in two birth cohorts in Brazil. METHODS: The two cohorts were performed during the 1990s, in São Luís, located in a less developed area in Northeastern Brazil, and Ribeirão Preto, situated in a more developed region in Southeastern Brazil. Data from one-third of all live births in Ribeirão Preto in 1994 were collected (2,839 single deliveries). In São Luís, systematic sampling of deliveries stratified by maternity hospital was performed from 1997 to 1998 (2,439 single deliveries). The chi-squared (for categories and trends) and Student t tests were used in the statistical analyses. RESULTS: The LBW rate was lower in São Luís, thus presenting an epidemiological paradox. The preterm birth rates were similar, although expected to be higher in Ribeirão Preto because of the direct relationship between preterm birth and LBW. Dissociation between LBW and infant mortality was observed, since São Luís showed a lower LBW rate and higher infant mortality, while the opposite occurred in Ribeirão Preto. CONCLUSIONS: Higher prevalence of maternal smoking and better access to and quality of perinatal care, thereby leading to earlier medical interventions (cesarean section and induced preterm births) that resulted in more low weight live births than stillbirths in Ribeirão Preto, may explain these paradoxes. The ecological dissociation observed between LBW and infant mortality indicates that the LBW rate should no longer be systematically considered as an indicator of social development.


2018 ◽  
Vol 1 (2) ◽  
pp. 89-94
Author(s):  
Intan Sari

Low Birth Weight (LBW) is an infant born with a birth weight of less than 2500 grams regardless of gestation. Birth weight is the weight of the baby weighed in 1 hour after birth. (Depkes RI, 2009). Based on WHO and UNICEF data, in 2013 about 222 million babies were born in the world, of which 16% were born with low birth weight. The percentage of LBW in developing countries is 16.5% twice that of developed countries (7%) (Scholar Unand, 2014). The purpose of this study was to determine whether there is a relationship between anemia and Smoking Habit in Pregnant Women with LBW occurrence in General Hospital Dr. Mohammad Hoesin Palembang Year 2016. This research use analytical survey method with cross sectional approach. The population in this study were all mothers who gave birth monthly in Midwifery Installation of Dr. General Hospital Mohammad Hoesin Palembang in 2016 as many as 315 respondents. The sample of this research is some of mothers who give birth enough month in Midwifery Installation of Dr. General Hospital Mohammad Hoesin Palembang Year 2016 as many as 315 respondents. ". From the results of bivariate analysis of anemic respondents with the occurrence of LBW obtained statistical test X2 count = 23.22 which means there is a significant relationship between anemia with the incidence of BBLR. Respondents smoking with the occurrence of LBWR obtained statistical test X2 count = 41.20 which means there is a relationship Meaningful between smoking and LBW incidence. From the results of this study is expected that this research can be a reference material and is a complete information and useful for the development of knowledge about LBW.


Author(s):  
Juliana Widyastuti Wahyuningsih Juliana Widyastuti Wahyuningsih

ABSTRACT   Low birth weight (LBW) infants with birth weight is less than 2500 grams, regardless of gestational age. Statistically showed 90 % incidence of LBW obtained in developing countries with a mortality rate 35 times higher tinggi.Di South Sumatra Province Infant Mortality Rate ( IMR ) is 29 per 1,000 live births. In Palembang BARI hospitals incidence of LBW in 2013 amounted to 317 cases . The purpose of this study is to determine is there a relationship between the factors of age, education, and parity with the incidence of Low Birth Weight in Palembang BARI hospitals in 2013. This study used survey method crosss sectional analytic approach. The study population was all women who gave birth and was admitted to hospital obstetrics Palembang BARI installations in 2013 amounted to 901. This research was conducted in February 2014. Samples were taken with a random sampling method sistematic. Analyze data using statistical test Chi - Square. Results of univariate analysis of this study showed that 193 (69.4 %) of the respondents had low birth weight, and 85 (30.6 %) respondents had BBLN. 63 (22.7 %) of respondents with a high risk of maternal age and 215 (77.3 %) of respondents with a low risk of maternal age. 157 (56.5 %) respondents with low education mothers and 121 (43.5 %) of respondents with higher education mothers. 48 (17.3 %) respondents with high parity mothers and 230 (82.7 %) respondents with low parity mothers. So the bivariate analysis showed no significant association between maternal age with the incidence of LBW with P value = 0.035, no significant association between education and the incidence of LBW with P value = 0.006, and no significant relationship between the incidence of low birth weight with parity P value = 0.041. It is recommended for health care workers (midwives) hospital in order to be used as material information regarding the occurrence of LBW and as an input as well as the evaluation of success in good health or when needed to do counseling and care of LBW, especially to mothers who give birth to low birth weight baby.   ABSTRAK Berat badan lahir rendah (BBLR) adalah bayi dengan berat lahir kurang dari 2500 gram tanpa memandang masa gestasi. Secara statistik menunjukkan 90% kejadian BBLR didapatkan di negara berkembang dengan angka kematiannya 35 kali lebih tinggi.Di Propinsi Sumatera Selatan Angka Kematian Bayi (AKB) sebesar 29 per 1.000 kelahiran hidup. Di RSUD Palembang BARI Tahun 2013 angka kejadian BBLR berjumlah 317 kasus. Tujuan Penelitian ini adalah untuk mengetahui adakah hubungan antara faktor umur, pendidikan, dan paritas dengan kejadian Berat Badan Lahir Rendah di RSUD Palembang BARI Tahun 2013. Penelitian ini menggunakan metode survey analitik dengan pendekatan crosss sectional. Populasi penelitian ini adalah semua ibu yang melahirkan dan dirawat inap di instalasi kebidanan RSUD Palembang BARI Tahun 2013 berjumlah 901. Penelitian ini dilakukan pada bulan Februari 2014. Sampel penelitian diambil dengan metode sistematic random sampling. Analisa data menggunakan uji statistik Chi – Square. Hasil penelitian analisis univariat ini menunjukkan bahwa 193 (69,4%) responden mengalami BBLR, dan 85 (30,6%) responden mengalami BBLN. 63 (22,7%) responden dengan umur ibu resiko tinggi dan 215 (77,3%) responden dengan umur ibu resiko rendah. 157 (56,5%) responden dengan ibu pendidikan rendah dan 121 (43,5%) responden dengan ibu pendidikan tinggi. 48 (17,3%) reponden dengan ibu paritas tinggi dan 230 (82,7%) responden dengan ibu paritas rendah. Sehingga analisa bivariat menunjukkan ada hubungan yang bermakna antara umur ibu dengan kejadian BBLR dengan P value = 0,035, ada hubungan yang bermakna antara pendidikan dengan kejadian BBLR dengan P value = 0,006 dan ada hubungan yang bermakna antara paritas dengan kejadian BBLR dengan P value = 0,041. Disarankan bagi petugas kesehatan (bidan) rumah sakit agar dapat dijadikan sebagai bahan informasi mengenai terjadinya BBLR dan sebagai bahan masukan serta evaluasi keberhasilan dalam pelayanan kesehatan yang baik atau bila perlu dilakukannya penyuluhan serta asuhan  tentang BBLR khususnya kepada ibu yang melahirkan Bayi dengan BBLR.  


2016 ◽  
Vol 15 (2) ◽  
Author(s):  
Keline Soraya Santana Nobre ◽  
Maria Vera Lúcia Moreira Leitão Cardoso ◽  
Juliana Lopes Teixeira ◽  
Márcia Maria Coelho Oliveira Lopes ◽  
Fernanda Cavalcante Fontenele

Aim:  analyze  the  use  of  peripherally  inserted  central  catheter  in terms of the aspects of technique, positioning and maintenance, as well as the influence on the number of venous dissections in hospitalized infants in a neonatal unit. Method: descriptive,  retrospective,  quantitative  study,  in  reference  maternity  unit  of  a  city  in northeastern  Brazil.  Sample  composed  of  1,599  peripherally  inserted  central  catheter insertions in 1,204 infants during the years 2006 to 2013. Instruments were used that recorded  aspects  of  the  insertion  of  peripherally  inserted  central  catheter  and  venous dissection.  Results:  most  babies  were  premature,  of  low  birth  weight  and  male.  The veins  of  the  cubital  region  were  the  most  punctured  with  insertion  success  until  the fourth  puncture.  The  central  positioning  of  the  catheter  tip predominated,  with  a permanency  time  between  11  and  20  days,  removing  it  at  the  end  of  the  treatment. Over  the  years,  the  number  of  venous  dissections  was  inversely  proportional  to  the insertion  of  peripherally  inserted  central  catheter.  Conclusion:  this  transvenous  device was  shown  to  be  important  for  the  treatment  of  hospitalized  newborns,  favoring reduction of venous dissections.


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