Prediction of low birth weight outcome in Thailand: multiple regression analysis.

In the present study the risk approach using maternal risk factors for LBW newborns in Thailand is applied. The study may be considered as a managerial tool for developing local strategies and is particularly useful in maternal and child health care. The main objective is to develop a model to predict LBW outcome with an aim to screen those at risk at the level of health centres, district and provincial hospitals. Using MLR analysis, it is concluded that Model I and Model II (Table 3 and 4) can be used to predict which pregnant women are likely to deliver LBW newborns. The prediction can be made as early as the first trimester. If the prediction is shown to be accurate, the two models will be very helpful for use in Thai people. For general use, the investigators believe that Model I will be appropriate for application at the level of provincial and district hospitals, while Model II should be used at the health centre level peripheral to the health delivery system.

Maternal risk factors for low birth weight newborn in Thailand.

The present study assesses the risk approach for maternal risk factors for LBW newborn in Thailand. This study can be considered as a managerial tool for developing local strategies and is particularly useful in the field of maternal and child health care. A summary of maternal risk factors for LBW newborn as listed in Table 7 and can be used as a health educational tool for pregnant women and as basic data for marital counseling. It can also be used to keep the public informed about the maternal risk factors for LBW newborn which will help Thai women of reproductive age avoid the chance of having such babies.

PIP: This multi-center, unmatched, case-control study was conducted at all the 5 maternal-child health care centers in Thailand by administering questionnaires by trained interviewers. Additionally, Chulalongkorn Hospital Medical School and the Maharaj Hospital were also included. The entire sample of 2000 cases were recruited from all pregnant women who delivered a low birth weight (LBW) newborn weighing 2500 gm. 4095 controls were selected from pregnant women in the same hospitals who delivered neonates weighing 2500-4000 gm. Among biological factors influencing LBW, small maternal stature and weight ( 45 kg) was highly associated with LBW neonates (113 cases and 50 controls, relative risk [RR] = 7.15). Maternal age of less than 18 years and 35 years and over ranked 2nd for relative risk (390 cases and 499 controls, RR = 1.75). The other risk factors were parity of 1 or greater than 4 (1379 cases and 2396 controls, RR = 1.68), Quetelet's index of less than 20 (1696 cases and 3259 controls, RR = 1.37). These were all statistically significant risk factors. An accident during the 2nd trimester (RR = 1.34) was also a risk factor. The maternal psychosocial risk factors for LBW newborns were: low family income (RR = 1.75), education ( 4 years of formal education, RR = 1.35), hard work such as agricultural labor (RR = 1.46), and the need to travel (RR = 1.50) or to walk more than 2 hours to the work place (RR = 1.29). Paternal status of being a laborer, an agricultural worker, unemployed (RR = 1.39), or under 19 years old (RR = 1.74) were also risk factors. Pregnancy weight gain of 10 kg had the highest degree of association with having an LBW newborn (RR = 2.21). Other risk factors were: decreased food intake during pregnancy, maternal hematocrit count below 30%, and interpregnancy interval of less than 12 months. Maternal obstetrical risk factors for LBW included: vaginal bleeding during early pregnancy (RR = 3.28), maternal hypertension (RR = 3.48), convulsion during pregnancy (RR = 3.29), no prenatal care or less than 4 visits, maternal drug addiction (RR = 5.13), cigarette smoking (RR = 2.04), coffee or tea drinking during pregnancy, and repeated induced abortions (RR = 2.16).

Risk factors for hepatitis B carrier status among blood donors of the National Blood Center, Thai Red Cross Society.

A study of risk factors for hepatitis B carriers among voluntary blood donors of the National Blood Center, Thai Red Cross Society was carried out in a case-control study design during January 1989 to June 1990. Cases were 876 blood donors whose blood identified HBsAg at time of recruitment and continued positive for more than 6 months. Controls were 1,750 blood donors whose blood was free from HBsAg who came for blood donation at the same period as the cases. The ratio of cases:controls = 1:2. Self-administered questionnaires were constructed and pretested before using both cases and controls. The study revealed that the risk factors for hepatitis B among voluntary blood donors were age of less than 30 years old; low socioeconomic status (family income of less than 8,000 Baht/month); single status, especially males; male occupations of students, monks, nongovernment workers compared with government officials; female occupations of laborers, students, nongovernment workers and government officials compared with housewives. Sharing of nail clippers, used blades and tooth brushes among family members are proved to be risk factors, especially among males. In addition, sharing of used blades in barber shops proved to be a risk among males while sharing of nail clippers in beauty salons, history of ear-piercing at department stores or history of caesarean section among females could not be shown to be risk factors.(ABSTRACT TRUNCATED AT 250 WORDS)