Document Detail

Maternal-fetal disproportion and birth asphyxia in rural Sarlahi, Nepal.
MedLine Citation:
PMID:  19581544     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess the risk of birth asphyxia associated with maternal and newborn size. DESIGN: Cohort study. SETTING: Rural community in the Sarlahi district of Nepal. PARTICIPANTS: Mothers and newborns (n = 3189). OUTCOME MEASURE: Birth asphyxia, defined as an infant who failed to cry at birth, and who was unable to breathe or suckle normally after birth or had convulsions. RESULTS: Birth asphyxia occurred in 78 of 1000 live births, and asphyxia-specific mortality was 11 per 1000 live births. After controlling for confounding factors, mothers with height shorter than 145 cm were more likely to have an infant with birth asphyxia compared with mothers 145 cm or taller (adjusted relative risk [RR], 1.5; 95% confidence interval [CI], 1.1-2.0). Mothers with mid-upper arm circumference smaller than 21.5 cm carried a higher risk of delivering an infant with birth asphyxia compared with those with arm circumference greater than 23 cm (adjusted RR, 1.5; 95% CI, 1.1- 2.0). Asphyxia was more common among newborns with head circumference greater than 33.5 cm than those with head circumferences 32.6 to 33.5 cm (adjusted RR, 1.6; 95% CI, 1.1-2.2). Birth weight was not independently associated with birth asphyxia; however, there was significant interaction between maternal stature and birth weight (P = .01); a 3300-g infant born to a mother shorter than 145 cm carried a 3.8 times higher asphyxia risk (95% CI, 2.2-6.5) than an infant of median weight (2620 g) born to a mother taller than 145 cm. CONCLUSIONS: In rural Nepal, maternal stunting and wasting and large infant head circumference carried higher risk of neonatal asphyxia. Maternal-fetal disproportion resulted in a synergistic elevation in asphyxia risk.
Anne C C Lee; Gary L Darmstadt; Subarna K Khatry; Steven C LeClerq; Sharda Ram Shrestha; Parul Christian
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of pediatrics & adolescent medicine     Volume:  163     ISSN:  1538-3628     ISO Abbreviation:  Arch Pediatr Adolesc Med     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-07     Completed Date:  2009-08-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9422751     Medline TA:  Arch Pediatr Adolesc Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  616-23     Citation Subset:  AIM; IM    
Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD 21205, USA.
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MeSH Terms
Arm / anatomy & histology
Asphyxia Neonatorum / mortality*
Birth Weight
Body Height
Cluster Analysis
Cohort Studies
Confounding Factors (Epidemiology)
Double-Blind Method
Infant Mortality / trends*
Infant, Newborn
Logistic Models
Nepal / epidemiology
Risk Factors
Rural Population
Comment In:
Arch Pediatr Adolesc Med. 2009 Jul;163(7):671-2   [PMID:  19581555 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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