Seasonality of birth outcomes in rural Sarlahi District, Nepal: a population-based prospective cohort
Seasonality of birth outcomes in rural Sarlahi District, Nepal: a population-based prospective cohort
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DOI：
10.1186/1471-2393-14-310
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发表时间：
2014-09-06
影响因子：
3.1
通讯作者：
Tielsch, James M.
中科院分区：
文献类型：
--
作者：
Hughes, Michelle M.;Katz, Joanne;Tielsch, James M.
背景：虽然出生结果的季节性在各种环境中都有记录，但缺乏南亚农村的数据。我们报告的季节性早产，低出生体重，小于胎龄儿，新生儿死亡，死产在平原的Nepal.Methods：使用随机对照试验的新生儿皮肤和脐带清洗洗必泰前瞻性收集的数据进行描述性研究，我们分析了2002年9月至2006年1月出生的23,662名婴儿的队列。项目工作人员收集了婴儿家庭的出生结果数据。提供了在同一现场进行的其他研究的补充数据，以提供背景。95%的置信区间构建在每月估计检查统计学意义的findings.Results. Month的出生与不良结局（新生儿死亡率，低出生体重，早产，小于胎龄）的风险较高，即使控制产妇的特点。婴儿有87%（95%CI：27-176%）的新生儿死亡的风险增加时，出生在八月，高点，与三月，低点。结论：新生儿死亡，死产，出生体重，胎龄，小于胎龄的季节性被发现在尼泊尔。母体因素、气象条件、传染病和营养状况可能与这些不良出生结局有关。需要进一步的研究来理解解释不良出生结果的季节性的因果机制。
Background: While seasonality of birth outcomes has been documented in a variety of settings, data from rural South Asia are lacking. We report a descriptive study of the seasonality of prematurity, low birth weight, small for gestational age, neonatal deaths, and stillbirths in the plains of Nepal.Methods: Using data collected prospectively during a randomized controlled trial of neonatal skin and umbilical cord cleansing with chlorhexidine, we analyzed a cohort of 23,662 babies born between September 2002 and January 2006. Project workers collected data on birth outcomes at the infant's household. Supplemental data from other studies conducted at the same field site are presented to provide context. 95% confidence intervals were constructed around monthly estimates to examine statistical significance of findings.Results: Month of birth was associated with higher risk for adverse outcomes (neonatal mortality, low birthweight, preterm, and small for gestational age), even when controlling for maternal characteristics. Infants had 87% (95% CI: 27-176%) increased risk of neonatal mortality when born in August, the high point, versus March, the low point.Conclusion: Seasonality of neonatal deaths, stillbirths, birth weight, gestational age, and small for gestational age were found in Nepal. Maternal factors, meteorological conditions, infectious diseases, and nutritional status may be associated with these adverse birth outcomes. Further research is needed to understand the causal mechanisms that explain the seasonality of adverse birth outcomes.