Retrospective Analysis Between Low Birth Weight and Quality of Prenatal Care

Objective To explore the relationship between low birth weight (LBW) (birth weight <2500 g) and the quality of prenatal care. Methods According to Kessner's Adequency of Prenatal Care Index, prenatal care quality of 2964 pregnancy women with single pregnancy who received prenatal examination at First Affiliated Hospital of Medical College, Xi'an Jiaotong University from January 2008 to December 2009 were included into this study. All of them had the survey about Prenatal Examination Questionnaire. A total of 2928 valid questionnaires were collected after excluding questionaires with missing items ≥5. The recovery rate was 98.79%. The qualified 2928 questionnaires were classified three groups according to different prenatal examination quality: Adequate group (n=1262), intermediate group (n=1502) and inadequate group (n=164). General information, prenatal examination, gestational and delivery status within 2-7 d after delivery were analyzed retrospectively. The relationship between LBW related risk factors and prenatal examination were analyzed by non-conditional logistic regression. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of First Affiliated Hospital of Medical College, Xi'an Jiao Tong University. Informed consent was obtained from all participants. Results Incidence rates of LBW was 3.49% (44/1262) for adequate group, 5.26% (79/1502) for intermediate group, and 19.51%(32.164) for inadequate group. The inadequate group had the highest incidence rate of LBW infant compared with those in the other two groups (P 0.05). There had significant differences between LBW infants and normal infants (birth weight ≥2500 g) on mean times of maternal prenatal care quality, maternal age, marital status, parity, pregnancy complications, hospital delivery, gestational weight gain, and pregnancy week delivery (χ2=96.05, 58.84, 21.41, 52.38, 38.10, 33.44, 66.32, 258.42, P<0.05). Compared with normal birth weight infants, the mean times of prenatal care was lower than that in LBW infants [(7.6±3.1) vs. (5.4±2.9); t=9.16, P<0.01]. The prevalence of LBW infant in adequate group was lower than that in intermediate group (OR=0.51, 95%CI: 0.35-0.72). After adjusting maternal age, marital status, pregnancy complications, gestational weight gain, hospital delivery and gestational age, a significant increased risk of LBW remained for infants of women with inadequate prenatal care (OR=4.56, 95%CI: 3.02-6.84). Conclusions Kessner's Adequency of Prenatal Care Index was more objective and accurate to evaluate the quality of prenatal care. Inadequately prenatal care was an independent effect on LBW. Key words: prenatal care; low birth weight; risk factor; quality evaluation