36 • PERINATOLOGY Vol 24 • No. 1 • May–Aug 2023 Original Article Mohite RV. Effect of Maternal and Obstetric Factors and Placental Weight on Neonatal Birth Weight Study procedure An interview was conducted, and data pertaining to maternal and neonatal characteristics were recorded in a pretested, structured questionnaire. All selected neonates underwent a thorough clinical evaluation, and the data on gestational age, birth weight, sex, Apgar score at birth, and maternal medications such as antihypertensives were recorded. Gestational age assessment was done using the New Ballard scoring system. Neonates were weighed using an electronic scale (Standard Steel Company, New Delhi, India) to record their birth weight.7,8 Data on maternal medical history, demography (eg, age, weight, nutritional status, occupation, and education), and obstetric history (eg, period of amenorrhea, complications in pregnancy such as antepartum hemorrhage, pregnancy-induced hypertension (PIH), and bad obstetric history) were also recorded. Gross placental examination was done, and data on placental weight, umbilical cord anomalies, and cord insertion anomalies were noted. The neonates were categorized based on their birth weight as per the commonly accepted classification (described under the Introduction section). The various factors responsible for this classification were correlated with the birth weight of the neonate. In the Indian context, the placenta of a healthy mother is said to weigh > 400 g, appear flat and disc-like and white–red, have a diameter of 22 cm, and be 1.5-cm thick. The umbilical cord should be 50-cm long and have 3 vessels. Statistical analyses The data were entered in MS Excel. SPSS version 20 for Windows (IBM Corp, Armonk, NY, USA) was used to analyze the data, and χ2 test was used to test the statistical significance of the association between the study variables. Results Of all the neonates delivered during the study period, 110 neonates were randomly selected and included in this study. Table 1 shows the classification of neonates based on birth weight. Overall, 51.7% neonates were LBW, which is higher than the proportion of NBW neonates. Among the NBW neonates, most neonates had a birth weight closer to the LBW range (49.1%). Table 1. Classification of the Neonates Based on Their Birth Weight Birth Weight, g Frequency (%) (N = 110) Macrosomia, > 4000 3 (2.7) Normal Birth Weight, 2500–3999 50 (45.4%) Low Birth Weight, < 2500 28 (25.4) Very Low Birth Weight, < 1500 17 (15.4) Extremely Low Birth Weight, < 1000 12 (10.9) There was a significant correlation between maternal age and birth weight of neonates (P < .05). The proportion of LBW neonates was high (71.5%) when the maternal age was < 20 years at the time of delivery (Table 2). Most mothers (67.2%) were of normal height; Table 2. Correlation Between Maternal Factors and Neonatal Birth Weight Maternal Factors Total, n (%) LBW Neonates n (%) NBW Neonates, n (%) Χ2; P Value Age, y < 20 38 (34.5) 27 (71.5) 11 (28.9) 8.6; .001a 21–30 61 (55.4) 25 (40.9) 36 (59) > 30 11 (10) 5 (45.4) 6 (54.5) Maternal Height, cm < 145 36 (32.7) 20 (55.5) 16 (44.4) 0.2; .58 > 145 74 (67.2) 37 (50) 37 (50) Parity 1 42 (38.1) 29 (69) 13 (30.9) 8.6; .001a 2–3 58 (46.3) 25 (43.1) 33 (56.8) ≥ 4 10 (15.4) 3 (30) 7 (70) Anemia, g% Severe, < 7 11 (10) 8 (54.5) 3 (45.4) 7.4; .02a Mild to Moderate, 7–10.9 28 (25.4) 19 (60.7) 9 (39.2) Nil, > 11 71 (64.5) 30 (47.8) 41 (52.1) aP value is statistically significant at 95% confidence interval. LBW, low birth weight; NBW, normal birth weight.
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