Characteristics of black South African adult and adolescent women who gave premature birth to growth-restricted infants at Kalafong hospital, Gauteng

[摘要] INTRODUCTION: The objective of the study was to determine the prevalence ofcertain known risk factors for intra-uterine growth restriction (IUGR) in women whogave premature birth to growth-restricted infants at a large regional hospital(Kalafong) in the Gauteng province of South Africa and to investigate the possibleassociations between the presence of various risk factors and the severity of growthrestriction found in these infants.METHOD: The study was designed as cross-sectional, descriptive and observational.The subjects included singleton growth-restricted premature infants (n=80), withoutcongenital abnormalities and their mothers (n=80). Anthropometric data [weight,height, mid-upper arm circumference (MUAC) and triceps skinfold thickness (TSF)]were collected from these mothers three to four days post-partum. Infant birth weightswere recorded at birth, while the lengths and head circumferences were recordedwithin 2 days post-partum. Additional information, such as birth spacing, maternalage, smoking habits and alcohol use, was collected by personal interview and bloodpressure data and HIV status was obtained from medical records. Data capturing anddescriptive statistics were done using Microsoft Excel and comparative analyticalstatistics were performed with the Statistical Package for the Social Sciences (SPSS),version 12.0.RESULTS: The study demonstrated a high prevalence (69%) of infants born with abirth weight <3rd percentile. In the sample, 81% of the mothers were aged 17-34 yearsand most (93%) had their children 18 months or longer apart. Malnutrition prevalencewas moderate. In 58% of the mothers the BMI was normal (18.5-24.9 kg/m2) and in47% the upper arm muscle area (UAMA) was between the 10th-85th percentile. GradeIII overweight occurred in 3% and TSF ≤5th percentile occurred in 35% of themothers. About half (51%) of the mothers in the sample population had hypertensionduring the second trimester of pregnancy. Smoking and alcohol use during pregnancywas rare (1% and 6% respectively) and the prevalence of HIV infection in the motherswas 26%. The prevalence (16%) of Grade II overweight among the mothers ofsymmetric growth-restricted (SGR) infants was higher than among the mothers of asymmetric growth-restricted (AGR) infants (7%). Of the hypertensive mothers, 55%had infants with SGR compared to 45% with AGR (p=0.47). Although rare, smokingoccurred only in mothers with AGR infants (3%). No significant differences werefound between the smoking and non-smoking group (p=0.21). Although the use ofalcohol was more prevalent at 6% in mothers with SGA infants and 7% in motherswith AGR infants, no significant associations were found (p=0.95). Although notsignificant (p=0.76), there was a higher prevalence of HIV infection in mothers withSGR infants at 29%, compared to 23% of mothers of AGR infants.CONCLUSION: Although further studies are needed before intervention strategiescan be planned and implemented, the findings of this study suggest that apart from theusual factors (maternal age and nutritional status, smoking and alcohol use duringpregnancy and birth spacing) that may influence intra-uterine growth, hypertensionmay contribute greatly to IUGR in this study population.

[发布机构] Stellenbosch University