عوامل خطر مادري موثر بر كم وزني هنگام تولد نوزادان در شهرستان رفسنجان در سال 1397: يك مطالعه مورد شاهدي

Maternal Risk Factors Affecting Low Birth Weight in Rafsanjan Township in 2018: A Case Control Study

زﻣﯿﻨﻪ و ﻫﺪف: ﮐﻢ وزﻧﯽ ﻫﻨﮕﺎم ﺗﻮﻟﺪ ﯾﮑﯽ از ﻣﺸﮑﻼت ﻋﻤﺪه ﺑﻬﺪاﺷﺖ ﻋﻤﻮﻣﯽ ﺑﻪ ﺷﻤﺎر ﻣﯽآﯾﺪ و ﺑﺎ ﻣﯿﺰان ﺑﺎﻻي ﻣﺮگ در دوره ﻧﻮزادي ارﺗﺒﺎط دارد. اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺎ ﻫﺪف ﺗﻌﯿﯿﻦ ﻋﻮاﻣﻞ ﺧﻄﺮ ﻣﺎدري ﻣﺆﺛﺮ ﺑﺮ ﮐﻢ وزﻧﯽ ﻫﻨﮕﺎم ﺗﻮﻟﺪ ﻧﻮزادان در ﺳﻄﺢ ﺑﯿﻤﺎرﺳﺘﺎنﻫﺎي ﺷﻬﺮﺳﺘﺎن رﻓﺴﻨﺠﺎن ﻃﺮاﺣﯽ ﮔﺮدﯾﺪ. ﻣﻮاد و روشﻫﺎ: اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﻣﻮرد ﺷﺎﻫﺪي از 120 ﻧﻮزاد ﮐﻢ وزن )ﮐﻢﺗﺮ از 2500 ﮔﺮم( ﺑﻪ ﻋﻨﻮان ﮔﺮوه ﻣﻮرد و 120 ﻧﻮزاد ﺑﺎ وزن ﻃﺒﯿﻌﯽ )2500 ﮔﺮم و ﺑﯿﺶﺗﺮ( ﺑﻪ ﻋﻨﻮان ﺷﺎﻫﺪ در ﺳﺎل 1397 ﺗﺸﮑﯿﻞ ﺷﺪه اﺳﺖ. دادهﻫﺎ ﺑﻪ وﺳﯿﻠﻪ ﯾﮏ ﭼﮏ ﻟﯿﺴﺖ ﻣﺤﻘﻖ ﺳﺎﺧﺘﻪ ﺑﻪ ﻃﻮر ﺗﺼﺎدﻓﯽ از روي ﭘﺮوﻧﺪه ﻣﺎدران زاﯾﻤﺎن ﮐﺮده در ﺑﯿﻤﺎرﺳﺘﺎنﻫﺎي ﺷﻬﺮﺳﺘﺎن رﻓﺴﻨﺠﺎن ﺟﻤﻊآوري و دادهﻫﺎ ﺑﺎ اﺳﺘﻔﺎده از آزﻣﻮنﻫﺎي آﻣﺎري ﻣﺠﺬور ﮐﺎي، t ﻣﺴﺘﻘﻞ و رﮔﺮﺳﯿﻮن ﻟﺠﺴﺘﯿﮏ ﺗﺠﺰﯾﻪ و ﺗﺤﻠﯿﻞ ﺷﺪﻧﺪ. ﯾﺎﻓﺘﻪﻫﺎ: ﺑﺮ اﺳﺎس ﻧﺘﺎﯾﺞ آزﻣﻮنﻫﺎ ﺗﻌﺪاد ﻣﺮاﻗﺒﺖﻫﺎي ﺑﺎرداري و ﺳﻦ ﺑﺎرداري ﻫﻨﮕﺎم زاﯾﻤﺎن در ﮔﺮوه ﻣﻮرد ﮐﻢﺗﺮ از ﺷﺎﻫﺪ ﺑﻮد اﻣﺎ ﺳﺎﺑﻘﻪ ﺗﻮﻟﺪ ﻧﻮزاد ﮐﻢ وزن در ﮔﺮوه ﻣﻮرد ﺑﯿﺶﺗﺮ از ﺷﺎﻫﺪ ﺑﻮد. در رﮔﺮﺳﯿﻮن ﻟﺠﺴﺘﯿﮏ ﺳﺎﺑﻘﻪ ﺗﻮﻟﺪ ﻧﻮزاد ﮐﻢ وزن )4/196=OR , 0/008=P( در ﮔﺮوه ﻣﻮرد ﺑﯿﺶﺗﺮ از ﺷﺎﻫﺪ و ﻣﯿﺎﻧﮕﯿﻦ ﻓﺎﺻﻠﻪ ﺑﯿﻦ ﺗﻮﻟﺪﻫﺎ )0/992=P=0/036, OR( و ﺳﻦ ﺑﺎرداري ﻫﻨﮕﺎم زاﯾﻤﺎن )0/61=P<0/001, OR( در ﮔﺮوه ﻣﻮرد ﮐﻢﺗﺮ از ﺷﺎﻫﺪ ﺑﻮد. ﻧﺘﯿﺠﻪﮔﯿﺮي: ﮐﻢ ﺑﻮدن ﺗﻌﺪاد ﻣﺮاﻗﺒﺖﻫﺎي ﺑﺎرداري، داﺷﺘﻦ ﺳﺎﺑﻘﻪ ﺗﻮﻟﺪ ﻧﻮزاد ﮐﻢ وزن، زاﯾﻤﺎن زودرس و ﻓﺎﺻﻠﻪ ﮐﻢ ﺑﯿﻦ زاﯾﻤﺎنﻫﺎ در ﺗﻮﻟﺪ ﻧﻮزاد ﮐﻢ وزن ﻧﻘﺶ دارد. ﻟﺬا ﻣﺮاﻗﺒﺖﻫﺎي ﺑﺎرداري و ﺗﻮﺟﻪ ﺑﻪ ﻣﺎدراﻧﯽ ﮐﻪ ﺳﺎﺑﻘﻪ ﺗﻮﻟﺪ ﻧﻮزاد ﮐﻢ وزن و زاﯾﻤﺎن زودرس دارﻧﺪ و اﻓﺰاﯾﺶ ﻓﺎﺻﻠﻪ ﺑﯿﻦ زاﯾﻤﺎنﻫﺎ ﻣﯽﺗﻮاﻧﺪ ﺑﺎﻋﺚ ﮐﺎﻫﺶ ﺗﻮﻟﺪ ﻧﻮزاد ﮐﻢ وزن ﺷﻮد.

Low birth weight is one of the most widespread public health problems associated with high infant mortality. This study aimed to identify maternal risk factors affecting low birth weight neonates in Rafsanjan hospitals. Materials and Methods: This case-control study consisted of 120 low birth weight infants (less than 2500 grams) as the case group and 120 normal weight infants (2500 grams and more) as controls in 2018. The data were collected by a randomized checklist from the records of the delivery mothers in the hospitals of Rafsanjan and were analyzed using Chi-square, independent t-test and logistic regression. Results: According to the results of the tests, the number of prenatal care and gestational age at birth was lower in the case group than in the control group, but the history of low birth weight was higher in the case group. Logistic regression for the history of low birth weight (OR=4.196, p=0.008) in the case group was more than the control and mean birth interval (OR=0.992, p=0.036) and gestational age at birth delivery (p<0.001, OR=0.61) was lower in the case group than in the control group. Conclusion: Findings showed that low number of prenatal care, having low birth weight, preterm delivery, and low birth interval have a role in low birth weight. Therefore, increasing pregnancy care coverage and paying attention to mothers who have low birth weight and preterm birth and increasing the interval between births can decrease low birth weight infants.