PDF(Pubmed)
Abstract：
OBJECTIVE: Pregnant mothers are at risk of many adverse pregnancy outcomes, including infants with low birth weight (LBW). The World Health Organization aimed to achieve a 30% reduction in the number of LBW infants by the year 2025. In this study, we aimed to determine the incidence and determinants of LBW infants among pregnant mothers attending government health clinics in Peninsular Malaysia.
METHODS: A prospective cohort study \"Relative Risk of Determinants of Adverse Pregnancy Outcomes Among Pregnant Mothers Attending Government Health Clinics, Peninsular Malaysia, PEN-MUM\" was conducted from March 2022 until March 2023 at 20 government health clinics in Peninsular Malaysia that were randomly selected through a multistage sampling method. Malaysian pregnant mothers between 18 and 49 years old were recruited at 12-18 weeks of gestation and followed up at three time points: 1 (24-28 weeks of gestation), 2 (36-40 weeks of gestation), and 3 (post-delivery). Eight exposure factors of LBW were studied: gestational weight gain, dengue infection, urinary tract infection, COVID-19 infection, gestational hypertension, preeclampsia, maternal anemia, and gestational diabetes mellitus (GDM).
RESULTS: Among 507 participants enrolled in the cohort, 40 were lost to follow-up. A total of 467 were included in the final analysis, giving an attrition rate of 7.9%. The incidence of LBW infants in Peninsular Malaysia was 14.3%. After adjusting for three covariates (ethnicity, employment status, and gestational age at birth), three determinants of LBW were identified. The risk of giving birth to LBW infants was higher among those with inadequate gestational weight gain (aRR = 2.86, 95% CI: 1.12, 7.37, p = 0.03), gestational hypertension (aRR = 4.12; 95% CI: 1.66, 10.43; p = 0.002), and GDM (aRR = 2.21; 95% CI: 1.18, 4.14; p = 0.013) during the second and third trimesters.
CONCLUSIONS: The incidence of LBW infants in Peninsular Malaysia can be considered high. Having inadequate gestational weight gain, gestational hypertension, and GDM in the second and third trimesters increased the risk of LBW infants by threefold, fivefold, and twofold respectively. Thus, intervention strategies should target prevention, early detection, and treatment of gestational hypertension and GDM, as well as promoting adequate weight gain during antenatal care.
METHODS: A prospective cohort study \"Relative Risk of Determinants of Adverse Pregnancy Outcomes Among Pregnant Mothers Attending Government Health Clinics, Peninsular Malaysia, PEN-MUM\" was conducted from March 2022 until March 2023 at 20 government health clinics in Peninsular Malaysia that were randomly selected through a multistage sampling method. Malaysian pregnant mothers between 18 and 49 years old were recruited at 12-18 weeks of gestation and followed up at three time points: 1 (24-28 weeks of gestation), 2 (36-40 weeks of gestation), and 3 (post-delivery). Eight exposure factors of LBW were studied: gestational weight gain, dengue infection, urinary tract infection, COVID-19 infection, gestational hypertension, preeclampsia, maternal anemia, and gestational diabetes mellitus (GDM).
RESULTS: Among 507 participants enrolled in the cohort, 40 were lost to follow-up. A total of 467 were included in the final analysis, giving an attrition rate of 7.9%. The incidence of LBW infants in Peninsular Malaysia was 14.3%. After adjusting for three covariates (ethnicity, employment status, and gestational age at birth), three determinants of LBW were identified. The risk of giving birth to LBW infants was higher among those with inadequate gestational weight gain (aRR = 2.86, 95% CI: 1.12, 7.37, p = 0.03), gestational hypertension (aRR = 4.12; 95% CI: 1.66, 10.43; p = 0.002), and GDM (aRR = 2.21; 95% CI: 1.18, 4.14; p = 0.013) during the second and third trimesters.
CONCLUSIONS: The incidence of LBW infants in Peninsular Malaysia can be considered high. Having inadequate gestational weight gain, gestational hypertension, and GDM in the second and third trimesters increased the risk of LBW infants by threefold, fivefold, and twofold respectively. Thus, intervention strategies should target prevention, early detection, and treatment of gestational hypertension and GDM, as well as promoting adequate weight gain during antenatal care.
摘要：
目的：孕妇面临许多不良妊娠结局的风险，包括低出生体重（LBW）的婴儿。世界卫生组织的目标是到2025年将低出生体重婴儿的数量减少30%。在这项研究中,我们旨在确定在马来西亚半岛政府健康诊所就诊的孕妇中LBW婴儿的发生率和决定因素.
方法：一项前瞻性队列研究“在政府健康诊所就诊的怀孕母亲中不良妊娠结局决定因素的相对风险，马来西亚半岛，PEN-MUM“于2022年3月至2023年3月在马来西亚半岛的20个政府卫生诊所进行，这些诊所是通过多阶段抽样方法随机选择的。在妊娠12-18周时招募18至49岁的马来西亚孕妇，并在三个时间点进行随访：1（妊娠24-28周），2（妊娠36-40周），和3（交付后）。研究了LBW的八个暴露因素：妊娠期体重增加，登革热感染,尿路感染,COVID-19感染，妊娠期高血压,先兆子痫,产妇贫血,和妊娠期糖尿病（GDM）。
结果：在加入队列的507名参与者中，40人失去了后续行动。共有467人被列入最终分析,流失率为7.9%。马来西亚半岛LBW婴儿的发病率为14.3％。在调整了三个协变量(种族，就业状况,和出生时的胎龄)，确定了LBW的三个决定因素。妊娠体重增加不足的婴儿中，分娩LBW婴儿的风险较高（aRR=2.86，95％CI：1.12，7.37，p=0.03），妊娠期高血压(aRR=4.12;95%CI:1.66,10.43;p=0.002),和GDM(aRR=2.21;95%CI:1.18,4.14;p=0.013)在妊娠中期和晚期。
结论：马来西亚半岛LBW婴儿的发病率可以认为很高。妊娠期体重增加不足，妊娠期高血压,妊娠中期和晚期GDM使LBW婴儿的风险增加了三倍，五倍，分别是双重的。因此，干预策略应以预防为目标，早期发现,妊娠期高血压和GDM的治疗，以及在产前护理期间促进足够的体重增加。
方法：一项前瞻性队列研究“在政府健康诊所就诊的怀孕母亲中不良妊娠结局决定因素的相对风险，马来西亚半岛，PEN-MUM“于2022年3月至2023年3月在马来西亚半岛的20个政府卫生诊所进行，这些诊所是通过多阶段抽样方法随机选择的。在妊娠12-18周时招募18至49岁的马来西亚孕妇，并在三个时间点进行随访：1（妊娠24-28周），2（妊娠36-40周），和3（交付后）。研究了LBW的八个暴露因素：妊娠期体重增加，登革热感染,尿路感染,COVID-19感染，妊娠期高血压,先兆子痫,产妇贫血,和妊娠期糖尿病（GDM）。
结果：在加入队列的507名参与者中，40人失去了后续行动。共有467人被列入最终分析,流失率为7.9%。马来西亚半岛LBW婴儿的发病率为14.3％。在调整了三个协变量(种族，就业状况,和出生时的胎龄)，确定了LBW的三个决定因素。妊娠体重增加不足的婴儿中，分娩LBW婴儿的风险较高（aRR=2.86，95％CI：1.12，7.37，p=0.03），妊娠期高血压(aRR=4.12;95%CI:1.66,10.43;p=0.002),和GDM(aRR=2.21;95%CI:1.18,4.14;p=0.013)在妊娠中期和晚期。
结论：马来西亚半岛LBW婴儿的发病率可以认为很高。妊娠期体重增加不足，妊娠期高血压,妊娠中期和晚期GDM使LBW婴儿的风险增加了三倍，五倍，分别是双重的。因此，干预策略应以预防为目标，早期发现,妊娠期高血压和GDM的治疗，以及在产前护理期间促进足够的体重增加。
