Characteristics of black South African adult and adolescent women who gave premature birth to growth-restricted infants at Kalafong hospital, Gauteng
Date
2006-12
Authors
Gilfillan, Marlene
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : University of Stellenbosch
Abstract
INTRODUCTION: The objective of the study was to determine the prevalence of
certain known risk factors for intra-uterine growth restriction (IUGR) in women who
gave premature birth to growth-restricted infants at a large regional hospital
(Kalafong) in the Gauteng province of South Africa and to investigate the possible
associations between the presence of various risk factors and the severity of growth
restriction 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), without
congenital 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 weights
were recorded at birth, while the lengths and head circumferences were recorded
within 2 days post-partum. Additional information, such as birth spacing, maternal
age, smoking habits and alcohol use, was collected by personal interview and blood
pressure data and HIV status was obtained from medical records. Data capturing and
descriptive statistics were done using Microsoft Excel and comparative analytical
statistics 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 a
birth weight <3rd percentile. In the sample, 81% of the mothers were aged 17-34 years
and most (93%) had their children 18 months or longer apart. Malnutrition prevalence
was moderate. In 58% of the mothers the BMI was normal (18.5-24.9 kg/m2) and in
47% the upper arm muscle area (UAMA) was between the 10th-85th percentile. Grade
III overweight occurred in 3% and TSF ≤5th percentile occurred in 35% of the
mothers. About half (51%) of the mothers in the sample population had hypertension
during the second trimester of pregnancy. Smoking and alcohol use during pregnancy
was rare (1% and 6% respectively) and the prevalence of HIV infection in the mothers
was 26%. The prevalence (16%) of Grade II overweight among the mothers of
symmetric 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, smoking
occurred only in mothers with AGR infants (3%). No significant differences were
found between the smoking and non-smoking group (p=0.21). Although the use of
alcohol was more prevalent at 6% in mothers with SGA infants and 7% in mothers
with AGR infants, no significant associations were found (p=0.95). Although not
significant (p=0.76), there was a higher prevalence of HIV infection in mothers with
SGR infants at 29%, compared to 23% of mothers of AGR infants.
CONCLUSION: Although further studies are needed before intervention strategies
can be planned and implemented, the findings of this study suggest that apart from the
usual factors (maternal age and nutritional status, smoking and alcohol use during
pregnancy and birth spacing) that may influence intra-uterine growth, hypertension
may contribute greatly to IUGR in this study population.
Description
Thesis (MNutr (Interdisciplinary Health Sciences. Human Nutrition))--University of Stellenbosch, 2006.
Keywords
Intra-uterine, Growth nutrition, Preterm, Risk factors, Fetus -- Growth, Premature infants -- Diseases, Neonatology -- Research, Dissertations -- Nutrition, Theses -- Nutrition