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Rev Med Chil. 1993 Oct;121(10):1210-9.

[Risk factors for low birth weight and intrauterine growth retardation in Santiago, Chile].

[Article in Spanish]

Author information

1
Facultad de Medicina, Universidad de Chile, Santiago de Chile.

Abstract

An epidemiologic case-control study to ascertain the determinants of low birthweight was carried out in Santiago, Chile, from January to December 1989. The cases were defined as livebirths < 2500 g. The controls were livebirths > or = 2500 g of birthweight. All cases and a random sample (1:1) of controls were selected among 8,254 singleton births occurring at the El Salvador Hospital in the Eastern area of Santiago. These deliveries represented 50% of institutional deliveries in the area. Home deliveries (2%) and private hospital deliveries were not included in the study. Information was obtained from hospital medical records by six trained medical students. Some information could not be obtained from the hospital medical records. Thus the second step in data collection was the tracking of all the selected subjects to their referring neighborhood health centers. For the analysis, the data were divided into 3 case (outcome) categories: 453 subjects were the total case group. From these, 153 were the IUGR case group and 300 were the LBW preterm case group. The general control group consisted of 605 normal birthweight infants. 565 were the IUGR control group and 40 were the preterm control group. A total of 25 risk factors showed a significant crude odds ratio for at least one of the groups. In the multivariate logistic regression analysis eight variables: No. of pregnancies, previous adverse outcomes, previous LBW, pregnancy maternal weight, No. of visits, month of first prenatal care visit, maternal smoking and intrahepatic cholestasis of pregnancy, were significantly associated with LBW after adjustment by confounding. Eight risk factors: IUGR in previous pregnancies, Previous adverse outcome, Maternal smoking, intrahepatic cholestasis, maternal pregnancy weight, maternal height, month first prenatal visit, No. of visit, were significant to IUGR. Only two variables: pregnancy weight, divorced mother, were significantly associated with low birth weight in the preterm group. The most relevant risk factors were included in stepwise logistic regression models carried out for the outcome LBW for the general group, term group and preterm group, in order to adjust by confounding. Adjusted odds ratios were then obtained. Prenatal care related factors and maternal adverse obstetric factors were at higher significance for LBW in the general and IUGR groups. Only nutritional factors were related to LBW in preterm group. Women who delivered a LBW or IUGR infant were more likely to have fewer pregnancies, a history of previous LBW, lower prepregnancy weight and lower gestational weight gain. ICP was associated with an elevated risk of LBW that was independent of gestational age.

PIP:

Births occurring in 1989 in the El Salvador Hospital in Santiago's Metropolitan East Health Service were retrospectively studied to determine risk factors for low birth weight and intrauterine growth retardation (IUGR) in the urban Chilean population. 453 of the 605 births at weights between 500 and 2499 g were the cases; complete information was unavailable for the other 152. The 605 controls were the births over 2500 g immediately following low weight births. A total of 8254 singleton live births occurred during 1989. The general prevalence of low birth weight in the study population was 6.8%. The data were classified into three groups according to outcome. 300 were preterm low birth weight cases, 153 were IUGR cases, and 605 were normal birthweight controls. Data were analyzed for the entire group and separately for the preterm and IUGR groups. 25 of the risk factors showed significant crude odds ratios for at least one of the groups. Eight variables were significantly associated with low birth weight in multivariate logistic regression analysis after adjustment for confounding variables. The eight variables were number of pregnancies, previous adverse outcome, previous low birth weight, maternal weight during pregnancy, number of prenatal visits, month of first prenatal visit, smoking, and intrahepatic cholestasis of pregnancy. Eight risk factors were significantly associated with IUGR, but only two, prepregnancy weight and divorced mother, were significantly associated with low birth weight in the preterm group. A stepwise logistic regression was carried out for the entire group, IUGR group, and preterm group, to adjust for confounding variables. Adjusted odds ratios were obtained. In the general and IUGR groups, mothers were likely to have fewer pregnancies, a history of low birth weight, and lower prepregnancy weight and weight gain during pregnancy. Only nutritional factors were related to low birth weight in the preterm group. Intrahepatic cholestasis of pregnancy was associated with increased risk of low birth weight independent of gestational age.

PMID:
8191127
[Indexed for MEDLINE]
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