Investigating the relationship between the lifestyle of mothers during pregnancy and low birth weight of term babies in the health centers of Rasht city in 2019

Dissertation for receiving a master's degree in nursing education

(children's orientation)

Abstract

Introduction: The birth of a low birth weight baby is considered one of the most serious health problems in the world, which imposes tremendous pressure on the health service system and family members. Among the maternal factors related to underweight, the lifestyle of the mother during pregnancy plays the most important role on the birth weight of babies. Methodology: This research is a historical cohort study. The research units included 1177 mothers who visited health centers or health centers for post-natal care or vaccination of their children up to two months old and had health records. The tool used was a three-part questionnaire about the lifestyle of mothers during pregnancy, which was completed by observing the health records of mothers and organized interviews from the research units. Based on the birth weight of the babies, the studied units were divided into two groups: mothers of low weight babies (2500 grams and less) and mothers of babies with normal weight (more than 2500 grams to 4000 grams).

Results: The results of the study indicated that there is a statistically significant relationship between the lifestyle of the mother during pregnancy and the birth weight of the baby (P>0.004). Also, in each of the lifestyle areas, a statistically significant relationship was observed between the nutritional status (P>0.008), activity and rest (P>0.001) and social relations (P>0.0001) of the mother during pregnancy with the birth weight of the baby, while no statistically significant relationship was found between how to deal with stress and self-care during pregnancy with the baby's birth weight.

Conclusion: With Paying attention to the lifestyle and areas of nutrition, activity and rest status and social interaction during pregnancy related to low birth weight, the importance of the role of health officials in increasing public awareness in the field of appropriate lifestyle during pregnancy to prevent the results of low birth weight babies.

Key words: pregnancy / nursing education / lifestyle / mothers / low birth weight babies / birth weight rtl;"> 

Field of research:

          Birth weight is considered as an important indicator of reproductive health and public health status of society (1). Determining this index is one of the most common and simplest methods for assessing growth and examining the health status of infants in a society, because birth weight is the most important factor in human survival during infancy and one of the predictors of physical abilities and future development (2). Also, birth weight is one of the important factors affecting the mortality of babies and children (3).

          Today, low birth weight babies [1] are considered one of the most serious health problems in the world (2). Due to their special conditions, premature and low birth weight babies are not able to adapt to the extrauterine environment and are more at risk of death (4). The mortality rate of low birth weight babies is 40 times higher and very low birth weight babies [2] are 200 times higher than normal birth weight babies. In Iran, two-thirds of newborn deaths occur in low birth weight babies in the first 24 hours after birth. Premature birth[3] and intrauterine growth delay[4] are two causes of low birth weight. The main cause of low birth weight in the United States is premature birth [5] and in developing countries, intrauterine growth retardation. Since the last two decades, the rate of low birth weight babies has increased (5). So that almost 20 million low birth weight babies are born in the world every year. The incidence of underweight is not uniform throughout the world; Rather, its range varies from 4 to 5 percent of babies born in developed countries to nearly 50 percent in underdeveloped countries (1). Between 1984 and 2005, the percentage of low birth weight babies increased by 6.7% to 8.2%, and between 1980 and 2005, the birth rate of very low birth weight babies increased by 1.2% to 1.5% (5). According to the statistics of the World Health Organization, 95% of low birth weight babies are born in developing countries.Until 2004, this organization found the prevalence of underweight in sub-Saharan Africa to be 15%; 10% in the Middle East and North Africa; 10% in East Asian countries; 33% in South Asia; 9% in Latin America; 6% in developed countries; 18% in developing countries; It has reported 17% in the whole world and 10% in Iran. In a study conducted in Rasht in 1384 by "Adal Shaar" with the aim of determining the maternal factors predicting low birth weight, they reported a prevalence of 2.5% of low birth weight (2). Low birth weight in both developed and developing countries imposes tremendous pressure on the health service system and family members (1). The dollar cost of resources used to care for low birth weight babies is one of the indicators to determine the economic burden for the country. About seven percent of low-birth-weight babies born in the United States account for more than one-third of health care costs. If we examine a case, the cost of saving the lives of very small babies by performing special care often exceeds several thousand dollars. Besides survival, another important issue for low birth weight babies is the quality of their future life (6). Despite the survival of some very small babies under long and very expensive special care, the results are still not promising (7) and these low birth weight babies suffer neurodevelopmental complications and congenital abnormalities three times more often than normal weight babies (8). Even in childhood, these babies suffer from movement disorders, speech, hearing and inability to learn at a higher rate (2). so that the possibility of cerebral palsy, mental retardation, sudden death; Septicemia and diarrhea are more common in children who were born underweight (5,1). Even research conducted on teenagers has shown that mental and behavioral disorders in people who were underweight at birth are three times more than others, the main of which is hyperactivity disorder. Lack of social skills, interaction disorders in relation with peers, reduced level of social activities and low self-confidence are other common cases in this group. It is interesting to note that recent epidemiological studies show that the risk of middle age diseases such as middle age hypertension, kidney diseases, diabetes, stroke and obesity is higher in people with a history of low birth weight (1 and 2).

          Therefore, birth weight is considered as one of the important health indicators in the evaluation of prenatal care and the scale that determines the health of newborns at the community level, which is related to the process of growth and development and survival. Babies in the future are closely related (1).

Many factors affect low birth weight, the most important of which are genetics, environmental, fetal, placental, and maternal factors (2, 8). Among these, maternal factors, based on the researches, have the most important role on the birth weight of babies (2). Maternal factors during pregnancy such as age, body mass index, socio-economic factors, medical, activity, type of nutrition, how to spend free time, smoking habits, adverse life situation during pregnancy and how to deal with stress, how to use healthcare services and so on. They are among the things that form part of the mother's lifestyle during pregnancy, and the results of some studies admit that these factors may be related to the birth of a low birth weight baby (9). There is also evidence that lifestyle health promotion behaviors [6] during pregnancy are essential in maintaining women's health in order to deliver a healthy baby and reduce the risk of low birth weight (10). So that Walt [7] (2005) also stated in his study that the lifestyle of the mother during pregnancy is one of the interfering factors in the birth of a low birth weight baby (11). Health professionals have described lifestyle as one of the important factors that affect health (9). Health promoting behaviors are important for all members of society, especially for women (10). Because the health and progress of any society is highly dependent on women's health, pregnancy and childbirth have a significant effect on women's health and health, and it is considered an important indicator for national health. On the other hand, the mother's lifestyle has a permanent and long-term effect on the health of the mother and the child (9).