Nutritional status during pregnancy of puerperant women who gave birth to babies with low birth weights

Öz

Aim: The study aimed at determining factors that caused low birth weight. Methods: The study was a case-control study. No sampling was made and 40 puerperant women who had babies whose birth weights were lower than 2500 gr. (as case-group) and another 40 puerperant women who had babies whose birth weights were higher than 2500 gr. (as control-group) were included in the study between the 1st of January and 31st of January 2015 at a state hospital in Balikesir. A questionnaire form that was designed by the researchers and that addressed socio-demographic characteristics, pregnancy-related problems and nutritional status of puerperant women was employed. For the data evaluation; numbers, percentage distributions, Chi-Square test, Fisher’s exact test, Independent Sample T test were used. Results were considered significant at p<0.05. Odds Ratio values were estimated in order to find out how many times risk factors increased low birth weights. Findings: When the participant puerperant women were examined; mean age of case-group was 29.62±5.88 years while mean age of control group was 29.92±3.73 years. 40% of the case-group had secondary school degree while 35% of the control-group had primary school degree. Mean birth weight of the newborns was 2323.25±104.52 gr. in case-group and 3322.97±412.82 gr. in control-group. In the study, it was found out that nausea increased the risk for low birth weight by 2.8 times, vomiting by 3 times, heartburn 3.5 times, consuming milk and dairy products less than 2-3 portions in a week by 5.2 times, consuming fruits less than 2-3 portions in a week by 9.1 times during pregnancy period. Mean weight was 2610.60±536.84 gr. among those neonates whose mothers consumed milk and dairy products poorly and 2419.33±278.93 gr. among those neonates whose mothers consumed fruits poorly. Results: Low birth weight is caused by factors that can be prevented. It is necessary to consume all kinds of foods in a sufficient and balanced way during pregnancy. In light of these findings, it was argued that dietary training to be given to the pregnant women was important in order to prevent low birth weight. In this sense; responsibility of nurses who are the ones who most frequently meet pregnant women is very big.

Anahtar Kelimeler

• -

Düşük doğum ağırlıklı bebek doğuran lohusaların gebeliklerinde ki beslenme durumları

Öz

Amaç: Bu çalışma, düşük doğum ağırlığına neden olan durumları belirlemektir. Yöntem: Araştırma vaka kontrol çalışmasıdır. Örneklem seçimi yapılmamış olup, Balıkesir’de bir devlet hastanesinde 1-31 Ocak 2015 tarihleri arasında doğum ağırlığı 2500 gramın altında bebeği olan 40 loğusa vaka, 2500 gramın üzerinde bebeği olan 40 lohusa kontrol grubu olarak alınmıştır. Araştırmacılar tarafından geliştirilen lohusaların sosyodemografik özellikleri ile gebelik dönemlerindeki rahatsızlıkları ve beslenme durumlarını içeren anket formu kullanılmıştır. Verilerin değerlendirilmesinde; Sayı, yüzde dağılımı, Ki-Kare testi, Fisher’s exact testi, Independent Sample T testi kullanılmıştır. Önem düzeyi.05 dir. Risk faktörlerinin düşük doğum ağırlığı riskini kaç kat arttırdığını bulmak için ise Odds Ratio değerleri hesaplanmıştır. Bulgular: Çalışmada lohusalar incelendiğinde vaka grubunun yaş ortalaması 29.62±5.88, kontrol grubunun yaş ortalaması ise 29.92±3.73’dür. Eğitim durumları ise vaka grubunun %40’ı ortaokul, kontrol grubunun %35’i ilkokul mezunudur. Yenidoğanların ortalama doğum ağırlıkları vaka grubunda 2323.25±104.52, kontrol grubunda ise 3322.97±412.82’dir. Çalışmada, gebelik döneminde bulantı 2.8 kat, kusma 3 kat, mide yanması 3.5 kat, süt ve süt ürünlerini haftada 2-3 porsiyonun altında tüketme 5.2 kat, meyveleri haftada 2-3 porsiyonun altında tüketme 9.1 kat düşük doğum ağırlıklı bebek doğurma riskini arttırdığı bulunmuştur. Yenidoğanların kilo ortalaması, yetersiz süt ve süt ürünü tüketenlerde 2610.60±536.84, yetersiz meyve tüketenlerde ise 2419.33±278.93’dir. Sonuç: Düşük doğum ağırlığı önlenebilir nedenlerle görülmektedir. Gebelikte yeterli ve dengeli bir şekilde besin gruplarının tüketilmesi gerekmektedir. Bu sonuçlar doğrultusunda, düşük doğum ağırlığını önlemek açısından gebelere verilecek beslenme eğitimi önemlidir. Bu konuda gebeler ile en sık karşılaşan meslek grubu olan ebelere büyük görevler düşmektedir.

Anahtar Kelimeler

• Düşük doğum ağırlığı, beslenme, gebelik rahatsızlıkları

Kaynakça

1. OECD health statistics 2015, HYPERLINK “http://dx.doi. org/10.1787/health-data-en.%20(Erişim”
2. org/10.1787/health-data-en. (Erişim tarihi 06.12.2015).
3. Food and nutrition guidelines for healthy pregnant and breastfeeding women, a background paper. The Ministry of Health PO Box 5013, Wellington, New Zealand 2008.
4. Nkwabong E, Kamgnia Nounemi N, Sando Z, Mbu RE, Mbede J, Risk factors and placental histopathological findings of term born low birth weight neonates. Placenta, 2015; 36: 138-141.
5. Yan J. Maternal pre-pregnancy BMI, gestational weight gain, and infant birth weight: A within-family analysis in the United States, Economics and Human Biology. 2015; 18: 1-12.
6. Uzdil Z, Özenoğlu A. Gebelikte çeşitli besin öğeleri tüketiminin bebek sağlığı üzerine etkileri. Balıkesir Sağlık Bilimleri Dergisi, 2015; 4(2): 117-127.
7. Türkiye Nüfus ve Sağlık Araştırması, 2013. Hacettepe Nüfus Etütleri Enstitisü, Ankara, 2014, s 172.
8. Samur G. Gebelik ve emziklilik döneminde beslenme, Ankara: Klasmat Matbaacılık; 2008, s. 8-20.

9. Colón-Ramos U, Racette SB, Ganiban J, Nguyen TG, Kocak M, Carroll KN, Völgyi E, Tylavsky FA, Association between dietary patterns during pregnancy and birth size measures in a diverse population in Southern US. Nutrients 2015; 7: 1318-1332.
10. Taşkın L. Gebelikte Beslenme, Doğum ve Kadın Sağlığı Hemşireliği, Ankara: Akademisyen Tıp Kitabevi; 2016, s. 237-248.
11. Baysal A. Gebe ve Emzikli Kadınların Beslenmesi, Beslenme, Hatiboğlu Yayınevi, Ankara, 2002; s 419-429.
12. Clinical Practice Guideline Nutrition for Pregnancy, İnstitute of Obstetricians and Gynaecologists. Royal College of Physicians of Ireland and Directorate of Clinical Strategy and Programmes. Health Service Executive 2013.
13. Bloomfield FH, Spiroski AM, Harding JE. Fetal growth factors and fetal nutrition. Seminars İn Fetal&Neonatal Medicine 213; 18: 118-123.
14. Abubakari A, Kynast-Wolf G, Jahn A. Maternal determinants of birth weight in Northern Ghana. PLOS ONE 2015; August 17: 1-15.
15. Prentice A. Nutrition and pregnancy. Women’s Health Medıcıne 2004; 1(1): 22-24.
16. Black RE, Alderman H, Bhutta ZA, Gillespie S, Haddad L, Horton S, Lartey A, Mannar V, Ruel M, Victora CG, Walker SP, Webb P. Maternal and child nutrition: Building momentum for impact. The Lancet 2013; 382: 372-375.
17. Han Z, Lutsiv O, Mulla S, Rosen A, Beyene J, Mcdonald SD. Low gestational weight gain and the risk of preterm birth and low birthweight: a systematic review and meta-analyses. Acta Obsteticia Et Gynecologia Scandinavica 2011; 90: 935– 954.
18. Balázs P, Rákóczi I, Grenczer A, Foley KL. Bırth-Weıght dıfferences of Roma and non-Roma neonates- Publıc health ımplıcatıons from a populatıon-based study ın Hungary. Cent Eur J Public Health 2014; 22(1): 24–28.
19. Young MF, Nguyen PH, Addo OY, Hao W, Nguyen H, Pham H, Martorell R, Ramakrishnan U. The relative influence of maternal nutritional status before and during 3 pregnancy on birth outcomes in Vietnam. European Journal of Obstetrics & Gynecology and Reproductive Biology 2015; 9121: 1-5.
20. Karakaş N, Pehlivan E. Malatya’da iki hastanede düşük doğum ağırlıklı bebeklerde anneye ait doğurganlık ve prenatal dönem özelliklerinin incelenmesi. İnönü Üniversitesi Sağlık Bilimleri Dergisi 2013; 1: 34-38.
21. Arthur Chortatos A, Haugen M, Iversen PO,Vikanes A, Eberhard-Gran M, Bjelland EK, Magnus P, Veierİd MB. Pregnancy complications and birth outcomes among women experiencing nausea only or nausea and vomiting during pregnancy in the Norwegian mother and child cohort study. BMC Pregnancy and Childbirth 2015; 15(138): 2-11.
22. Noğay NK. Gebe kadınların beslenme durumlarının değerlendirilmesi. Electronic Journal Of Vocational Colleges 2011; Aralık: 51-57.
23. Sarı O, Babayıgıt MA, Turker T, Kocak N, Aydoğan Ü, Akpak YK, Ersoy H, Kılıç S. Gebelerin “gebelikte beslenme” konusundaki bilgi düzeyleri, beslenme alışkanlıkları ve etkileyen faktörler. Journal of Clinical and Analytical Medicine 2015; 1-6.
24. Thompson JM, Wall C, Becroft DM, Robinson E, Wild CJ, Mitchell EA. Maternal dietary patterns in pregnancy and the association with small-for-gestational-age infants. Br. J. Nutr. 2010; 103: 1665-1673.
25. Chatzi L, Mendez M, Garcia R, Roumeliotaki T, Ibarluzea J, Tardon A, Amiano P, Lertxundi A, Iniguez C, Vioque J, Kogevinas M, Sunyer J. Mediterranean diet adherence during pregnancy and fetal growth: Inma (Spain) and Rhea (Greece) mother-child cohort studies. Br. J. Nutr. 2012; 107: 135-145. 25. Akbari Z, Mansourian M, Kelishadi R. Relationship of the intake of different food groups by pregnant mothers with the birth weight and gestational age: need for public and individual educational programs. J Educ Health Promot. 2015; 4: 23.
26. Applegate L. Mineral maddeler, Özpınar H, çev. ed. Beslenme ve Diyet Temel İlkeleri. İstanbul: Medikal Yayıncılık; 2011: 191-204.
27. Burris HH, Mitchell A, Werler MM. Periconceptional multivitamin use and ınfant birth weight disparities. Ann Epidemiol. 2010; 20: 233-40.
28. Grieger JA, Clifton VL. A review of the ımpact of dietary ıntakes in human pregnancy on ınfant birthweight. Nutrients 2015; 7: 153-178.
29. Hassan NE, Shalaan AH, El-Masry SA. Relationship between maternal characteristics and neonatal birth size in Egypt. East Mediterr Health J. 2011; 17(4): 281–289.
30. Rao S, Yajnik CS, Kanade A, Fall CHD, Margetts BM, Jackson AA, Shier R, Joshi S, Rege S, Lubree H, Desai B. Intake of micronutrient-rich foods in rural Indian mothers is associated with the size of their babies at birth: Pune Maternal Nutrition Study. J Nutr. 2001; 131(4): 1217-1224.
31. Mccowan LM, Roberts CT, Dekker GA, Taylor RS, Chan EHY, Kenny LC, Baker PN, Moss-Morris R, Chappell LC, North RA, Risk factors for small-for-gestational-age infants by customised birthweight centiles: data from an international prospective cohort study. BJOG. 2010; 117(13): 1599-1607.
32. Loy SL, Marhazlina M, Azwany YN, Hamid Jan JM. Higher intake of fruits and vegetables in pregnancy is associated with birth size. Southeast Asian J Trop Med Public Health. 2011; 42(5): 1214-1223.
33. Ricci E, Chiaffarino F, Cipriani S, Malvezzi M, Parazzini F. Diet in pregnancy and risk of small for gestational age birth: results from a retrospective case–control study in Italy. Matern Child Nutr. 2010; 6(4): 297–305.