Births of children of low and very low weight at the University Hospital in Olomouc (1993–2011)


Authors: M. Větr
Authors‘ workplace: Porodnicko-gynekologická klinika LF UP a FN, Olomouc, přednosta prof. MUDr. R. Pilka, Ph. D.
Published in: Čes. Gynek.2013, 78, č. 1 s. 41-55

Overview

Objective:
Evaluation of the births of children of low and very low weight, analysis of factors that may influence low birth weight and selected indicators to assess the state of the neonate after birth.

Design:
Retrospective epidemiological cohort study.

Setting:
Department of Gynaecology and Obstetrics, Faculty of Medicine and University Hospital Olomouc.

Methods:
Evaluation of maternal and newborn records from databases. The studied data set includes 33,126 births of children born in the period from 1. 1. 1993 to 31. 12. 2011 at the University Hospital in Olomouc. In sub-analyzes are compared subgroups of low and very low birth weight with a control group of children in the category from 2500 grams. Cohort of children under 2500 g contains a low birth weight infants with growth retardation.

Results:
The frequency (prevalence) of the neonates LBW is 11.6% (3851 neonates). Perinatal mortality in the weight category less than 2500 g was 57 per thousand, in the category from and more than 2500 g 2 per thousand, relative risk, RR = 7.14 (95% CI 6.67 to 7.54). Perinatal mortality in the category in 1500 grams compared with the control group is 157 per mille vs 2 per mille RR = 26.20 (23.55 to 29.16) Children with low weight in the total perinatal mortality contributes 78.9%, stillbirth 1.6% vs 0.1%, RR = 5.48 (4.69 to 6.40). (Stillbirth rate is reported from 1,000 g fetal weight.) Congenital anomalies 4.3% vs 1.6%, RR = 2.32 (95% CI 2.03 to 2. 65) The frequency of caesarean births of low weight babies was 62, 6% vs control group 18.9% (RR 3.31, 95% CI 3.20 to 3.42, p = 0.00000000). Caesarean sections in a file with a very low fetal weight compared with the control group, 83.8% vs. 18.9% (RR 4.43, 95% CI 4.27 to 4.60, p = 0.00000000). Since the mid nineties, there was a significant increase in multiple pregnancies in relation to IVF (Cox-Stuart test p = 0.039); 31.6% of children of low birth weight in multiple pregnancies vs 2.4% of children in the control group, RR = 7.48 (95% CI 7.11 to 7.86). Multivariate analysis also confirmed the existence of independent risk factors, especially social nature (education, unmarried woman, body mass index, smoking, parity, maternal age).

Conclusion:
The analysis shows the increase in births of children in category 2000–2500 grams. There has been a significant increase and proportion of iatrogenic factors, multiple pregnancies and caesarean sections. Also show some influence social and health characteristics of the mother. Low weight children have higher mortality and worse health. Despite a significant decrease perinatal mortality contributes to three quarters of perinatal deaths. It is clear that it is not possible substantially affect the prevalence of low birth weight. Children with low and very low birth weight despite intensive obstetric and neonatal care are a continuing medical problem. Finding good practices can contribute to better health of children with disabilities.

Keywords:
low birth weight – risk factors – perinatal deaths – trends


Sources

1. Boyle, CA., Boulet, S., Schieve, LA., et al. Trends in the prevalence of developmental disabilities in US children, 1997–2008. Pediatrics, 2011, 127, 6. p. 1034–1042.

2. Camp, BW., Broman, SH., Nichols, PL., Leff, M. Maternal and neonatal risk factors for mental retardation: defining the ‚at-risk‘ child. Early Human Development, 1998, 50, 2, p. 159–173.

3. Cleary-Goldman, J., Robinson, JN. Intrapartum management of the low birthweight fetus. Uptodate, http://46.4.230.144/web/UpToDate.v19.2/contents/f30/16/31261.htm, 2012.

4. Flídrová, E., Krejsek, J. Vrozená imunita v patogenezi intraamniální infekce u těhotenství komplikovaného předčasným odtokem plodové vody. Čes Gynek, 2011, 76, 1, s. 46–50.

5. Hinkle, SN., Schieve, LA., Stein, AD., et al. Associations between maternal prepregnancy body mass index and child neurodevelopment at 2 years of age. Int J Obes (Lond), 2012, 36, 10, p. 1312–1319.

6. Hvidtjørn, D., Grove, J., Schendel, D., et al. Multiplicity and early gestational age contribute to an increased risk of cerebral palsy from assisted conception: a population-based cohort study. Hum Reprod, 2010, 25, 8, p. 2115–2123.

7. Isaranurug, S., Mo-suwan, L., Choprapawon, C. A population-based cohort study of effect of maternal risk factors on low birthweight in Thailand. J Med Assoc Thai, 2007, 90, 12, p. 2559–2564.

8. Koucký, M., Hájek, Z., Pařízek, A. Diagnostika a management infekce u předčasného porodu. Čes Gynek, 2006, 71, 1, s. 6–13.

9. Li, J., Wang, QH., Wu, HM., et al. A survey of neonatal births in maternity departments in urban China in 2005. Zhongguo Dang Dai Er Ke Za Zhi, 2012, 14, 1, p. 7–10.

10. Liláková, D., Hejcmanová, D., Krylová, K. Celkový stav nedonošených dětí ošetřených pro retinopatii nedonošených v letech 2007–2009. Čes Slov Oftal, 2010, 66, 4, s. 176–178.

11. Lim, JW. The changing trends in live birth statistics in Korea, 1970 to 2010. Korean J Pediatr, 2011, 54, 11, p. 429–435.

12. Marba, ST., Caldas, JP., Vinagre, LE., Pessoto, MA. Incidence of periventricular/intraventricular hemorrhage in very low birth weight infants: a 15-year cohort study. J Pediatr (Rio J), 2011, 87, 6, p. 505–511.

13. Marková, A., Jurčuková, M., Dort, J., et al. Hodnocení rizikových faktorů vzniku ROP, oční vady a psychomotorický vývoj nedonošených dětí v západočeském regionu, dvanáctileté sledování. Čes Slov Oftal, 2009, 65, 1, s. 24–28.

14. Mavalankar, DV., Gray, RH., Trivedi, CR. Risk factors for preterm and term low birthweight in Ahmedabad, India. Int J Epidemiol, 1992, 21, 2, p. 263–272.

15. Musilová, I., Kacerovský, M., Tambor, V., Tošner, J. Proteomika a biomarkery předčasného porodu: systematický přehled literatury. Čes Gynek, 2011, 76, 1, s. 37–45.

16. Negi, KS., Kandpal, SD., Kukreti, M. Epidemiological factors affecting low birth weight JK Science. J Med Educat Res, 2006, 8,1, p. 31–34.

17. Nour, NM. Premature delivery and the millennium development goal. Rev Obstet Gynecol, 2012, 5, 2, p. 100–105.

18. Panaretto, K., Lee, H., Mitchell, M., et al. Risk factors for preterm, low birth weight and small for gestational age birth in urban aboriginal and torres strait Islander women in Townsville. Aust N Z J Public Health, 2006, 30, 2, p. 163–170.

19. Shapiro-Mendoza, CK., Lackritz, EM. Epidemiology of late and moderate preterm birth. Semin Fetal Neonatal Med, 2012, 17, 3, s. 120–125.

20. Schieve, LA., Meikle, SF., Ferre, C., et al. Low and very low birth weight in infants conceived with use of assisted reproductive technology. N Engl J Med, 2002, 346, p. 731–737.

21. Schieve, LA., Baio, J., Rice, CE., et al. Risk for cognitive deficit in a population-based sample of U.S. children with autism spectrum disorders: variation by perinatal health factors. Disabil Health J, 2010, 3, 3, p. 202–212.

22. Štembera, Z., Velebil, P. Prognóza úrovně perinatální péče v České republice do nejbližší budoucnosti z pohledu vývoje ukazatelů v ČR. Čes Gynek, 2011, 76, 1, s. 4–10.

23. Terzic, S., Heljic, S. Assessing mortality risk in very low birth weight infants. Med Arh, 2012, 66, 2, s.76–79.

24. Uphoff, R., Hindemith, J. Die zivilrechtliche Haftung des Geburtshelfers. Z Geburtshilfe Neonatol, 2011, 215, 6, S. 223–229.

25. Vanderweele, TJ., Lantos, JD., Lauderdale, DS. Rising preterm birth rates, 1989–2004: Changing demographics or changing obstetric practice? Soc Sci Med, 2012, 74, 2, p. 196–201.

26. Vega, J., Sáez, G., Smith, M., et al. Risk factors for low birth weight and intrauterine growth retardation in Santiago, Chile. Rev Med Chil, 1993, 121, 10, p. 1210–1219.

27. Větr, M. Laboratorní a klinické ukazatele stavu novorozence po porodu. Čes Gynek, 2010, 75, 5, s. 447–454.

28. World Health Organization (WHO). Low birth weight, country, regional and global estimates United Nations Children’s Fund (UNICEF) Strategic Information Unit, Division of Policy and Planning 2004, http://www.childinfo.org/files/low_birthweight_from_EY.pdf , www.unicef.org

29. Zamrazilová, H., Hainer, V., Černá, M., et al. Vliv časné postnatální výživy u předčasně narozených dětí na jejich antropometrické a hormonální charakteristiky ve věku 10 let. Čas Lék čes, 2007, 146, s. 278–283.

30. Zoban, P., Borek, I., Budošová, H., et. al. Změny incidence postižení vývoje u dětí s velmi nízkou a extrémně nízkou porodní hmotností ve 24 měsících korigovaného věku,narozených v letech 1997–2007. Čes Gynek, 2010, 75, 5, s. 455–461.

31. Žúbor, P., Žigo, I., Zibolen, M., Danko, J. Perinatologické výstupy Žilinského kraja Slovenskej republiky za 10ročné obdobie (2000–2009). Čes Gynek, 2011, 76, 1, s. 25–36.

Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine

Article was published in

Czech Gynaecology

Issue 1

2013 Issue 1

Most read in this issue

This topic is also in:


Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account