| Objective The objective of this study was to analyze the influencing factors for low birth weight and the law of growth and development among the infants in Shenzhen Longhua district.In order to provide evidence for interventions which can reduce the occurrence of low birth weight and promote the growth of low birth weight infants.Methods A 1:2 matched case-control study design and cohort study were used in this study to analyze the influencing factors associated with low birth weight and the condition of growth and development among the infants.Based on the low birth weight definition those infants whose birth weight was less than 2500 g included in the study as low birth weight infants.For each LBWI,two normal birth weight infants with same sex and simultaneous birth(difference < 1 month)weighed 2500 g and above were included.1.Objects: The study was conducted between March and November 2016.Babies and their parents who took children’s physical examination orimmunization in Shenzhen Longhua district maternal and child health care hospital or Longhua district central hospital and meet the requirements of this study were selected as the research objects.2.Methods of collection: The questionnaire was completed by a trained team through face-to-face interviews with mothers in a separate health examination room and filled in according to mother and child health booklet.The questionnaire contained questions regarding socio-demography,marital and obstetrical history,pre-pregnancy behaviors,ante-natal care related issues,and so on.Questionnaires were collected on the spot after completing and the data were checked for completeness and inconsistencies on site,cross-checked again on the same day.Information about pregnancy test,delivery register and neonatal growth were retrieved from Shenzhen maternal and infant health management system.Telephone follow-up was used to collect physical examination results of infants.3.Data processing and analysis: The questionnaires were numbered uniformly.Epidata version 3.1 was used to cross double entry and consistency check.The coded data were entered SPSS version 22.0 for further processing and analysis after being cleaned and logical detected.The association between the independent variables and low birth weight was evaluated through bivariate and multiple conditional Logistic regression analyses.Standard deviation score method and growth curvature were used to assess the law and standard of growth among infants.T-test,analysis of variance,nonparametric test and χ2 test were performed to determine the difference of growth and feeding patterns between LBWIs and NBWIs.Results 1.General information: 148 LBWIs and 296 NBWIs were included in the study.The average weight and length of LBWIs were 2119.39±315.41 grams and 45.58±3.11 cm,and the average weight and length of NBWIs were 3186.60±346.46 grams and 49.83±0.96 cm.Among the total respondents,half of LBWIs and NBWIs are boys.2.Influencing Factors for low birth weight: The factorial analysis revealed that pregnancy outcome,fetus number,hypertensive disorder complicating pregnancy,delivery history,early prenatal care,reasonable combination of meals during pregnancy,anemia during pregnancy and intrauterine growth retardation(IUGR)have significant association with low birth weight in the multiple logistic regression analyses,the adjusted odds ratio and 95%CI are 185.88(95% CI=39.34-878.37),5.63(95% CI=1.15-27.46),5.41(95% CI=1.25-23.31),0.39(95% CI=0.16-0.94),0.12(95% CI=0.04-0.38),4.95(95% CI=1.98-12.36),0.18(95% CI=0.07-0.47)and 26.00(95%CI=3.40-198.75).3.Feeding situations: The rate of mixed feeding and artificial feeding among LBWIs during 1 to 9 months of age is higher than that among NBWIs(P<0.05)while there is no difference of feeding patterns between two groups during 12 months of age(P>0.05).Additive time of complementary food of LBWIs is later than that of NBWIs(P<0.05).4.Growth situations: The growth trends of length,weight,BMI and head circumference of the NBW group within 12 months of age were basically consistent with the WHO standard,and the Z-scores fluctuates around 0.The length,weight,BMI,head circumference and their Z-scores of LBW group were less than that of NBW group during 1 months of age,the growth is less,too(P<0.05).The growth velocity of length,weight and head circumference of LBW group began to accelerate after 1 month of age,and then the growth rate both peaked during the period of 1~3 months of age.Each indicator was close to the level of NBW group,and the Z-scores were gradually close to 0.However,the length,weight and head circumference of LBW group were still less than that of NBW group in 12 months of age(P<0.05).5.Growth deviation: The incidence of underweight and growth retardation within 12 months of age and microcephaly within 3 months of age among LBW group was higher than NBW group(P< 0.05).The incidence of growth deviation of LBW group was decreased in different degrees between different month of age(P<0.05).Conclusions 1.The findings of this study showed that premature birth,IUGR,twin pregnancy,hypertensive disorder complicating pregnancy,multipara,early prenatal care,reasonable combination of meals during pregnancy and anemia during pregnancy were influencing factors for low birth weight.Advocation for early pregnancy test is needed and strengthen health education during pregnancy,especially for those are primipara and twin pregnancy.Pregnant women’s health awareness during pregnancy and utilization degree of health service should be improved.Pay attention to the risk factors for premature birth and prevent risk factors for adverse pregnancy outcome including fetal intrauterine growth restriction,gestational hypertension and other factors.Making a healthy lifestyle and eating habits including paying attention to balanced diet during pregnancy are also the important measures to prevent the low birth weight.2.Low birth weight infants will restore normal growth by catch-up growth after birth.The first six months are critical periods for catch-up growth and the head circumference appears catch-up growth first.However,catch-up growth has not been completed in one year of age.The follow-up management is needed and feeding should be reasonable according to the characteristics and laws of catch-up growth.Replenish enough nutrients to ensure that the low birth weight infants have sufficient energy to pursue the growth.At the same time,the behavioral intervention measures such as touching and hearing stimulation which can promote the growth and development are also needed so that to restore normal growth. |
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