FAKTORI RIZIKA I KARAKTERISTIKE I EFEKTI PROGRAMA ZA PREVENCIJU MALE TELESNE MASE NA ROĐENJU
Ključne reči:
porođaj, maternalno zdravlje, ishrana, telesna masa, novorođenče, prevencija
Sažetak
Svetska zdravstvena organizacija (SZO) je okviru Globalnih ciljeva uhranjenosti, postavila cilj da se broj novorođenčadi sa telesnom masom manjom od 2500 grama na rođenju u svetu smanji za 30% do 2025. godine. Cilj ovog mini preglednog rada je da se prikažu faktori rizika i karakteristike, efekti i izazovi preventivnih programa za smanjenje prevalencije male telesne mase na rođenju. Preventivni programi imaju poseban značaj zbog rastuće incidencije faktora rizika u zemljama sa niskim nivoom socijalno-ekonomskog razvoja. Faktori rizika povezani sa malom telesnom masom na rođenju (TM<2500g.) obuhvataju i rizike za prevremeni porođaj i zastoj u intrauterinom rastu ploda i mogu se podeliti na zdravstvene, nutritivne, socijalne i sanitarno – higijenske i njima pridružene faktore. Preventivni programi i intervencije su imali cilj smanjenje stope TM<2500g. na rođenju (uključujući i prevremeni porođaj i zastoj u intrauterinom rastu ploda) i smanjenje incidence faktora rizika koji dovode do ove pojave. Najveći efekat na smanjenje stope i rizika za TM<2500g. na rođenju su imali programi vezani za suplementaciju višestrukih mikronutritijenata i balansirane proteinsko-energetske ishrane, programi odvikavanja od pušenja i korišćenja alkoholnih pića u trudnoći, programi jačanja kvaliteta antenatalne zdravstvene zaštite i programi profilakse infekcija u trudnoći. Intervencije psihosocijalne podrške trudnicama su dale pozitivan efekat u sklopu drugih aktivnosti za efikasnije dostizanje globalnih ciljeva za smanjenje prevalencije TM<2500g. na rođenju. Najveći izazovi preventivnih programa za smanjenje prevalencije TM<2500g. na rođenju su siromaštvo, nepismenost, nezaposlenost i nedostatak socijalne zaštite. Multikauzalnost i kompleksnost nastanka TM<2500g. na rođenju, kao i mnogobrojni rizici koji utiču na ovaj nepovoljan ishod trudnoće, otežavaju implementaciju preventivnih programa koji će dovesti do značajnog smanjenja prevalencije u kraćem vremenskom roku. Prepoznavanje uloge žene u društvu i jačanja socijalne i zdravstvene zaštite u sveobuhvatnim preventivnim programima ima perspektivu za smanjenje prevalencije TM<2500g, na rođenju, kao i unapređenje reproduktivnog zdravlja žena u celini.
Reference
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5. Sharma D, Shastri S, Farahbakhsh N, Sharma P. Intrauterine growth restriction–part 1. J Matern Fetal Neonatal Med. 2016; 29:3977–87.
6. Low birthweight. UNICEF. https://data.unicef.org/topic/nutrition/low-birthweight/ Pristupljeno 1.10.2023. godine
7. Blencowe H, Krasevec J, de Onis M, Black RE, An X, Stevens GA, Borghi E, et al. National, regional, and worldwide estimates of low birthweight in 2015, with trends from 2000: a systematic analysis. Lancet Glob Health. 2019 Jul;7(7):e849-e860.
8. Chawanpaiboon S, Vogel JP, Moller A-B, et al. Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis. Lancet Glob Health 2019;7:e37–46.
9. Lee ACC, Kozuki N, Cousens S, et al. Estimates of burden and consequences of infants born small for gestational age in low and middle income countries with INTERGROWTH-21st standard: analysis of CHERG datasets. BMJ 2017;358:j3677.
10. UNICEF. Undernourishment in the womb can lead to diminished potential and predispose infants to early death. New York: UNICEF; 2016.
11. Sharrow D, Hug L, You D, Alkema L, Black R, Cousens S, et al. Global, regional, and national trends in under-5 mortality between 1990 and 2019 with scenario-based projections until 2030: a systematic analysis by the UN Inter-agency Group for Child Mortality Estimation. Lancet Glob Health. 2022 Feb;10(2):e195-e206.
12. Hodek JM, von der Schulenburg JM, Mittendorf T. Measuring economic consequences of preterm birth: methodological recommendations for the evaluation of personal burden on children and their caregivers. Health Econ Rev 2011;1(1):6.
13. Mizuno S, Nagaie S, Tamiya G, Kuriyama S, Obara T, Ishikuro M, et al. Establishment of the early prediction models of low-birth-weight reveals influential genetic and environmental factors: a prospective cohort study. BMC Pregnancy Childbirth. 2023 Aug 31;23(1):628. doi: 10.1186/s12884-023-05919-5. PMID: 37653383; PMCID: PMC10472725.
14. Beaumont RN, Kotecha SJ, Wood AR, Knight BA, Sebert S, McCarthy MI, et al. Common maternal and fetal genetic variants show expected polygenic effects on risk of small- or large-for-gestational-age (SGA or LGA), except in the smallest 3% of babies. PLoS Genet. 2020 Dec 7;16(12):e1009191. doi: 10.1371/journal.pgen.1009191. PMID: 33284794; PMCID: PMC7721187.
15. da Pereira PPS, Da Mata FAF, Figueiredo ACG, de Andrade KRC, Pereira MG. Maternal active smoking during pregnancy and low birth weight in the Americas: a systematic review and meta-analysis. Nicotine Tob Res. 2017;19:497–505.
16. Mariscal M, Palma S, Llorca J, Pérez-Iglesias R, Pardo-Crespo R, Delgado-Rodríguez M. Pattern of alcohol consumption during pregnancy and risk for low birth weight. Ann Epidemiol. 2006 Jun;16(6):432-8. doi: 10.1016/j.annepidem.2005.07.058. Epub 2005 Oct 27. PMID: 16257229.
17. Padhi BK, Baker KK, Dutta A, Cumming O, Freeman MC, Satpathy R, et al. Risk of Adverse Pregnancy Outcomes among Women Practicing Poor Sanitation in Rural India: A Population-Based Prospective Cohort Study. PLoS Med. 2015 Jul 7;12(7):e1001851.
18. Johnson HL, Ghanem KG, Zenilman JM, Erbelding EJ. Sexually transmitted infections and adverse pregnancy outcomes among women attending inner city public sexually transmitted diseases clinics. Sex Transm Dis. 2011 Mar;38(3):167-71. doi: 10.1097/OLQ.0b013e3181f2e85f. PMID: 20852454.
19. Nelson HD, Darney BG, Ahrens K, Burgess A, Jungbauer RM, Cantor A, et al. Associations of Unintended Pregnancy With Maternal and Infant Health Outcomes: A Systematic Review and Meta-analysis. JAMA. 2022 Nov 1;328(17):1714-1729. doi: 10.1001/jama.2022.19097. PMID: 36318133; PMCID: PMC9627416.
20. Han Z, Mulla S, Beyene J, Liao G, McDonald SD; Knowledge Synthesis Group. Maternal underweight and the risk of preterm birth and low birth weight: a systematic review and meta-analyses. Int J Epidemiol. 2011 Feb;40(1):65-101. doi: 10.1093/ije/dyq195. Epub 2010 Nov 22. PMID: 21097954.
21. Bouvier D, Forest J-C, Dion-Buteau E, Bernard N, Bujold E, Pereira B, et al. Association of maternal weight and gestational weight gain with maternal and neonate outcomes: a prospective cohort study. J Clin Med. 2019;8:2074.
22. Jonker H, Capelle N, Lanes A, Wen SW, Walker M, Corsi DJ. Maternal folic acid supplementation and infant birthweight in low- and middle-income countries: A systematic review. Matern Child Nutr. 2020 Jan;16(1):e12895. doi: 10.1111/mcn.12895. Epub 2019 Nov 4. Erratum in: Matern Child Nutr. 2021 Jul;17(3):e13193. PMID: 31680411; PMCID: PMC7038878.
23. Bauserman M, Conroy AL, North K, Patterson J, Bose C, Meshnick S. An overview of malaria in pregnancy. Semin Perinatol. 2019 Aug;43(5):282-290. doi: 10.1053/j.semperi.2019.03.018. Epub 2019 Mar 16. PMID: 30979598; PMCID: PMC7895297.
24. Agrawal A, Wenger NK. Hypertension During Pregnancy. Curr Hypertens Rep. 2020;22(9):64. Published 2020 Aug 27. doi:10.1007/s11906-020-01070-0.
25. Uguz F, Yakut E, Aydogan S, Bayman MG, Gezginc K. The impact of maternal major depression, anxiety disorders and their comorbidities on gestational age, birth weight, preterm birth and low birth weight in newborns. J Affect Disord. 2019 Dec 1;259:382-385. doi: 10.1016/j.jad.2019.08.076. Epub 2019 Aug 24. PMID: 31470182.
26. Han Y, Li M, Ma H, Yang H. Cervical insufficiency: a noteworthy disease with controversies. J Perinat Med. 2020 Sep 25;48(7):648-655. doi: 10.1515/jpm-2020-0255. PMID: 32692707.
27. Raatikainen K, Heiskanen N, Heinonen S. Under-atending free antenatal care is associated with adverse pregnancy outcomes. BMC Public Health. 2007 Sep 27;7:268.
28. Silvestrin S, da Silva CH, Hirakata VN, Goldani AAS, Silveira PP, Goldani MZ. Maternal education level and low birth weight: A meta-analysis. J Pediatr (Versão em Port). 2013;89:339–45.
29. Stojanovski K, Holla A, Hoxha I, Howell E, Janevic T. The Influence of Ethnicity and Displacement on Quality of Antenatal Care: The Case of Roma, Ashkali, and Balkan Egyptian Communities in Kosovo. Health Hum Rights. 2017 Dec;19(2):35-48.
30. Bekkar B, Pacheco S, Basu R, DeNicola N. Association of Air Pollution and Heat Exposure With Preterm Birth, Low Birth Weight, and Stillbirth in the US: A Systematic Review. JAMA Netw Open. 2020 Jun 1;3(6):e208243. doi: 10.1001/jamanetworkopen.2020.8243. Erratum in: JAMA Netw Open. 2020 Jul 1;3(7):e2014510. PMID: 32556259; PMCID: PMC7303808.
31. Roberman J, Emeto TI, Adegboye OA. Adverse Birth Outcomes Due to Exposure to Household Air Pollution from Unclean Cooking Fuel among Women of Reproductive Age in Nigeria. Int J Environ Res Public Health. 2021 Jan 13;18(2):634.
32. Partap U, Chowdhury R, Taneja S, et al. Preconception and periconception interventions to prevent low birth weight, small for gestational age and preterm birth: a systematic review and meta-analysis. BMJ Glob Health. 2022;7(8):e007537. doi:10.1136/bmjgh-2021-007537
33. Koivu AM, Haapaniemi T, Askari S, Bhandari N, Black RE, Chico RM, et al. What more can be done? Prioritizing the most promising antenatal interventions to improve birth weight. Am J Clin Nutr. 2023 Jun;117 Suppl 2(Suppl 2):S107-S117. doi: 10.1016/j.ajcnut.2022.10.022. PMID: 37331758; PMCID: PMC10447483.
34. Lassi ZS, Padhani ZA, Rabbani A, Rind F, Salam RA, Bhutta ZA. Effects of nutritional interventions during pregnancy on birth, child health and development outcomes: A systematic review of evidence from low- and middle-income countries. Campbell Syst Rev. 2021 Jun 21;17(2):e1150. doi: 10.1002/cl2.1150. PMID: 37131924; PMCID: PMC8356342.
35. Middleton P, Gomersall JC, Gould JF, Shepherd E, Olsen SF, Makrides M. Omega-3 fatty acid addition during pregnancy. Cochrane Database Syst Rev. 2018;11(11):CD003402. Published 2018 Nov 15. doi:10.1002/14651858.CD003402.pub3
36. Leghi GE, Muhlhausler BS. The eHect of n-3 LCPUFA supplementation on oxidative stress and inflammation in the placenta and maternal plasma during pregnancy. Prostaglandins, Leukotrienes and Essential Fatty Acids 2016;113:33-9.
37. Hunter PJ, Muthiani Y, Näsänen-Gilmore PK, Koivu AM, Pörtfors P, Bastola K, et al. A modular systematic review of antenatal interventions to address undernutrition during pregnancy in the prevention of low birth weight. Am J Clin Nutr. 2023 Jun;117 Suppl 2:S134-S147. doi: 10.1016/j.ajcnut.2023.01.024. PMID: 37331760.
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