ارتباط برخی از خصوصیات جمعیت شناختی مادر در دوران بارداری با کم‌وزنی بدو تولد در ایران: یک مطالعه مرور سیستماتیک و فراتحلیل

نوع مقاله : مروری

نویسندگان

1 کارشناس ارشد اپیدمیولوژی، گروه اپیدمیولوژی، دانشکده بهداشت، دانشگاه علوم پزشکی ایلام، ایلام، ایران.

2 دانشیار گروه آمار زیستی، مرکز تحقیقات پیشگیری از آسیب‌های روانی اجتماعی، دانشکده پزشکی، دانشگاه علوم پزشکی ایلام، ایلام، ایران.

3 استاد گروه اپیدمیولوژی بالینی، دانشکده پزشکی،‌ دانشگاه علوم پزشکی ایلام، ایلام، ایران.

چکیده

مقدمه: کم‌وزنی بدو تولد نوزادان یکی از جدی‌ترین مسائل و مشکلات بهداشتی بسیاری از جوامع به خصوص جوامع در حال توسعه و دومین عامل مرگ‌و‌میر نوزادان است که تحت تأثیر عوامل خطر متعددی به خصوص در دوران بارداری قرار دارد. مطالعه حاضر با هدف تعیین ارتباط عوامل مادری و نوزادی طی بارداری با کم‌وزنی بدو تولد به صورت فراتحلیل در ایران انجام شد.
روش‌‌کار: در این مطالعه مرور سیستماتیک و فراتحلیل طی جستجو در بانک‌های اطلاعاتی SID،Medlib ،Irandoc ، Magiran، Scopus، Google scholar،Pubmed  و  ISIو با استفاده از واژگان ‌کلیدی کم وزنی بدو تولد، نوع زایمان، افزایش وزن دوران بارداری، شاخص توده‌بدنی، Birth order و ترکیبات آن‌ها، تمام مقالات مرتبط بین سال‌های 1375 تا 1395 استخراج شدند. نتایج مطالعات با استفاده از نرم‌افزار STATA (نسخه 2/11) و SPSS (نسخه 16) با هم ترکیب شدند.
یافته‌ها: تعداد ۲2 مقاله با حجم نمونه 34591 نفر وارد مطالعه شدند. وزن‌گیری مادر در دوران بارداری (13/3:OR، 32/8-18/1: 95% CI)، شاخص توده‌بدنی مادر (19/2:OR، 46/3-33/1: 95% CI)، فاصله بین بارداری (13/2:OR، 75/2-65/1: 95% CI) و رتبه تولد (3/1:OR، 49/1-14/1: 95% CI)ارتباط آماری معنی‌داری با کم وزنی بدو تولد داشتند.
نتیجه‌گیری: وزن‌‌‌گیری نا‌مناسب مادر طی بارداری، شاخص توده بدنی زیر 18 در مادر، فاصله تولد کمتر از 2 سال و رتبه تولد نوزاد کمتر از 3 باعث افزایش تولد نوزاد کم‌وزن می‌شود. با توجه به اینکه این عوامل خطر قابل تعدیل می‌باشند، لذا توصیه می‌شود با ارائه دستورالعمل‌های مناسب توسط مسئولین ذیربط تولد نوزاد کم‌وزن را در کشور کاهش داد.

کلیدواژه‌ها


عنوان مقاله [English]

The relationship between some demographic characteristics of the mother during pregnancy with low birth weight in Iran: A systematic review and meta-analysis

نویسندگان [English]

  • Arezoo Karimi 1
  • Salman Daliri 1
  • Koorosh Sayeh Miri 2
  • Ali Delpisheh 3
1 M.Sc. in Epidemiology, Department of Epidemiology, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran.
2 Associate Professor, Department of Biostatistics, Social-Mental Injuries Prevention Research Center, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran.
3 Professor, Department of Clinical Epidemiology, Faculty of Medicine, Medical University of Ilam, Ilam, Iran.
چکیده [English]

Introduction: Low birth weight of infants is one of the most serious health problems in many communities, especially in developing countries and is the second cause of infants' mortality which is affected by several risk factors, especially during pregnancy. This study was performed with aim to assess the relationship between maternal and neonatal factors during pregnancy and low birth weightas meta-analysis in Iran.
Methods: In this systematic review and meta-analysis study, by searching in databases of SID, Medlib, Irandoc, Google scholar, Pubmed, ISI, Iranmedex, Scopus and Magiran, using the keywords of low birth weight, mode of delivery, pregnancy weight gain, BMI, birth order and their compounds, all related articles from 1996 to 2016 were extracted. The results of studies were combined using the STATA software (version 11.2) and SPSS software (version 16).
Results: A total of 22 articles with sample size of 34591 cases were entered to the study. Mother’s weight gain during pregnancy (OR: 3.13, CI 95%:1.18 – 8.32), Maternal BMI (OR: 2.19, CI95%: 1.33 – 3.46), pregnancy interval (OR: 2.13, CI95%: 1.65 – 2.75), and birth order (OR: 1.3, CI95%: 1.14 – 1.49) had statistically significant association with low birth weight.
Conclusion: Improper weight gain of mother during pregnancy, maternal body mass index < 18, birth interval of less than 2 years and the birth order < 3 will increase the LBW infant. Since these risk factors are modifiable, thus it is recommended to provide appropriate instructions by the relevant authorities and reduce the birth of LBW infants in the country.

کلیدواژه‌ها [English]

  • Iran
  • Maternal and neonatal factors
  • Meta-analysis
  • Low birth weight
  1. Ramazanali F, Dastjerdi MV, Beigi A, Moini A. The relationship between maternal HCT levels, birth weight and risk of low birth weight. Iran J Pediatr 2006; 16(4):447-54.
  2. National Center for Health Satisticics Vitalsat. Center for Disease Control and Perventation (CDC). Available at: URL: http://www.cdc.gov/nchs/VitalStats.htm; 2010.
  3. Cunningham F, Leveno K, Gilstrap L, Bloom S, Hauth J. Williams Obstetrics. Trans: Ghazijahani B. 3rd Ed. Tehran, Iran: Golban Publication; 2006. (Persian).
  4. Baker JL, Olsen LW, Sensen TI. Weight of birth and all-cause mortality in adulthood. Epidemiology 2008; 19(2):197-203.
  5. Wardlaw TM. Low birthweight: country, regional and global estimates. New York: UNICEF; 2004.
  6. Pettitt DJ, Jovanovic L. Low birth weight as a risk factor for gestational diabetes, diabetes, and impaired glucose tolerance during pregnancy. Diabetes Care 2007; 30(Suppl 2):S147-9.
  7. Nazari F, Vaisi Z, Sayehmiri K, Vaisani Y, Esteki T. Prevalence and trends of low birth weight in Iran: a systematic review and meta-analysis study. J Shahid Beheshti Univ Nurs Midwifery 2013; 22(79):16-23. (Persian).
  8. Cunningham F, Leveno K, Bloom S, Hauth J, Rouse D, Spong C. Williams obstetrics. 2nd ed. New York: McGraw-Hill; 2005.
  9. Hoffman MC, Jeffers S, Carter J, Duthely L, Cotter A, Gonzalez-Quintero V. Pregnancy at or beyond age 40 years is associated with an increased risk of fetal death and other adverse outcomes. Am J Obstet Gynecol 2007; 169(5):e11-3.
  10. Biernacka JB, Hanke W. The effect of occupational and non-occupational psychosocial stress on the course of pregnancy and its outcome. Med Pr 2006; 57(3):281-90.
  11. Bisai S, Mahalanabis D, Sen A, Bose K, Datta N. Maternal early second trimester pregnancy weight inrelation to birth outcome among Bengalee Hindus of Kolkata, India. Ann Hum Biol 2007; 34(1):91-101.
  12. Salimi S, Nokhostin B, Alijahan R, Hazrati S. Investigating the relationships between maternal hemoglobin concentration and maternal body mass index in pregnancy and neonatal birth weight. Iran J Obstet Gynecol Infertil 2012; 15(14):14-20. (Persian).
  13. Esmaili H, Shah Fraht A, Najmabadi KM, Dadgar S, Karimi A, Gelaiemi MK. The relationship between Body Mass Index at the beginning of pregnancy, birth weight and pregnancy outcomes. Iran J Obstet Gynecol Infertil 2014; 16(85):1-10. (Persian).
  14. Ghavi A, Sougheh KF, Niknamy M, Kazemnejad E. Investigating the relationship between maternal lifestyle during pregnancy and low-birth-weight of term neonates. Iran J Obstet Gynecol Infertil 2012; 15(29):14-24. (Persian).
  15. Zarbakhsh Bhari MR, Hoseinian S, Afrooz G, Hooman H. The comparison of many biological characteristics, economical conditions, general health (Mental), of mothers with low and normal birth weight at gilan province. J Payavard Salamat 2012; 5(5):67-78. (Persian).
  16. von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Int J Surg 2014; 12(12):1495-9.
  17. Ranjbaran M, Jafary-Manesh H, Sajjadi-Hazaneh L, Eisaabadi S, Talkhabi S, Khoshniyat AS. Prevalence of low birth weight and some associated factors in Markazi Province. World J Med Sci 2015; 12(3):252-8.
  18. Fadakar Soogheh K, Ghavi A, Niknami M, Kazemnejad Leili E. Relationship between mothers’ nutritional status and weight gain during pregnancy with low birth weight. J Guilan Univ Med Sci 2012; 21(83):27-35.
  19. Davoudi N, Khezri M, Asgarpour M, Khatami S, Hoseinpour M, Azarian AA. Prevalence and related factors of low birth weight in Mashhad, Iran. Iran J Neonatol 2012; 3(2):69-76.
  20. Tayebi T, Zahrani ST, Mohammadpour R. Relationship between adequacy of prenatal care utilization index and pregnancy outcomes. Iran J Nurs Midwifery Res 2013; 18(5):360.
  21. Tabatabi S, Moradi M. Determining risk factors predictive of low birth weight infants born in Tehran 2007. J Sch Nurs Midwifery 2010; 20(71):29-35. (Persian).
  22. Nachvak SM, Jabari H, Ostadrahimi A, Djafarian K. Weight gain during pregnancy and birth weight outcome in pregnant women, Tabriz, Iran. J Health Res 2012; 1(1):1-10.
  23. Koohdani F, Rezaie M, Dabiran S, Khaje NF, Khosravi S. Relationship between maternal nutrition status and infants' birth weight. Payesh 2010; 10(1):21-5. (Persian).
  24. Eftaekhar H, Aghahmolaie T, Abedini S. Risk factors associated with intrauterine growth retardation (IUGR) in infants Bandar Abbas, Iran. Payesh 2007; 6(3):201-8.
  25. Tootoonchi P. Low birth weight among newborn infants at Tehran hospitals. Iran J Pediatr 2008; 17(2):186-92. (Persian).
  26. Mirzarahimi M, Saadati H, Berack M, Abasgholizadeh N, Azamie A, Enteshari A. Incidence and risk factors of low-birth-weight infants. J Ardabil Univ Med Sci 2009; 9(1):69-79. (Persian).
  27. Ansari H, Parisae Z, Rahimi E, Rakhshaei F. Assessment of relationship between violence exposure pregnancy and low birth weight:a case-control study. Pars J Med Sci 2008; 6(2):17-26. (Persian).
  28. Delaram M, Akbari N. Weight gain in pregnancy and its correlation with birth weight of infants. Knowledge Health 2007; 3(2):39-43.
  29. Taheri FA, Kazemi T. Risk factors for low birth weight in Birjand, Iran (a case-control study). J Birjand Univ Med Sci 2006; 14(3):9-15.
  30. Roudbari M, Yaghmaei M, Soheili M. Perevalence and risk factors of low-birth-weight infant in Zahedan, Islamic Republic Iran. East Miditerr Health J 2007; 13(4):838-45.
  31. Sohrabi D, Asadi F. Some of the factors and consequences of low birth weight in nulliparous women in Vali Asr Hospital in Zanjan. Med J 2007; 4(1):29-33. (Persian).
  32. Jafari, Eftekhar H, Pourreza A, Mousavi J. Socio-economic and medical determinants of low birth weight in Iran: 20 years after establishment of a primary healthcare network. Public Health 2010; 124(3):153-8.
  33. Tabandeh A, Kashani E. Effects of maternal body mass index and weight gain during pregnancy on the outcome of delivery. J Gorgan Univ Med Sci 2007; 9(1):20-4. (Persian).
  34. Rafati S, Borna H, Akhavirad M, Fallah N. Maternal determinants of giving birth to low-birth-weight neonates. Arch Iran Med 2005; 8(4):277-81.
  35. Karimian S, Molamohamadi M, Jandaghi GR. Prevalence of low birth weight infants and its related factors in Qom delivery units, 2000. Feyz 2003; 7(3):76-80. (Persian).
  36. Eslami Z, Aflatoonian A. A study to determine the prevalence of low birth weight (LBW) infants in Yazd. J Shahid Sadoughi Univ Med Sci Health Serv 2002; 10(2):3-8.
  37. Yadav H, Lee N. Maternal factors in predicting low birth weight babies. Med J Malaysia 2012; 68(1):44-7.
  38. Hassan NE, Shalaan AH, El-Masry SA. Relationship between maternal characteristics and neonatal birth size in Egypt. East Mediterr Health J 2011; 17(4):281-9.
  39. Cunningham F, Lereno K, Bloom S, Hauth J, Rouse D, Spong C. Williams obstetrics. 23nd ed. New York: MCGraw Hill Companies Tnc; 2010. P. 202, 1007, 1026, 1058.
  40. Eshraghian F, Abghasemi J, Ghafari J, Rajaei S. The effects of risk factor of pregnancy period on infant´s weight. J Qazvin Univ Med Sci 2008; 11(4):60-5. (Persian).