A CORRELATIVE STUDY OF MATERNAL HAEMOGLOBIN AND BIRTH WEIGHT.

This prospective, cross sectional population study was carried out to determine the relationship between maternal haemoglobin concentration and birth weight in different socioeconomic groups in a tertiary care teaching hospital. 500 cases each from two teaching hospitals about whom information on socioeconomic status, haemoglobin concentration and birth weight was known were included in the study. This was a stratified random study based on the preselected inclusion and exclusion criteria. 149 (14.9%) women belonged to upper socioeconomic group, 119 (11.9%) to upper middle, 125 (12.5%) to lower middle, 90 (9.0%) to upper lower and 517 (51.7%) to lower group. Mean haemoglobin level was found to be lower in low socioeconomic group as compared to high socioeconomic group and was statistically significant (F value of 18.2521 & p 0.000). The lowest Hb level was 4.0g/dl and highest was 15.0g/dL Majority of pregnant women (89.3%) had their lowest haemoglobin level during the second trimester as compared to first trimester (0.8%) and third trimester (9.9%). The mean birth weight in upper socioeconomic group was 2.7508 kg, 2.7556 kg in upper middle group, 2.8802 kg in lower middle group, 2.7876 kg in upper lower group and 2.7515 in lower socioeconomic group. By analysis of variance test it was found that the mean birth weight did not vary significantly between different socioeconomic groups with an F value of 1.3398 and p value of 0.2450. The correlation analysis of haemoglobin concentration with birth weight suggested that for every rise of haemoglobin concentration by 1.0g/dl the birth weight reduced by 03839 kg (highly significant p < 0.001). In the present study there was significant inverse relationship of maternal haemoglobin concentration to birth weight Results are in agreement with the hypothesis that a higher blood viscosity is a risk factor for sub optimal placenta-perfusion.

FAILURE TO THRIVE.

Failure to thrive is a commonly encountered problem in Paediatric practice. This essentially generic term refers to children whose attained weight or rate of weight gain is significantly below that of other children of similar age and same sex. Several defining criteria have been proposed and help to differentiate true failure to thrive from other conditions causing apparent growth failure. There are numerous organic causes of failure to thrive, but non-organic failure to thrive is also an important entity and is caused by social, psychological and environmental factors. The clinical features are those of malnutrition, signs of underlying organic cause and specific manifestations of environmental/psychosocial deprivation. Indiscriminate laboratory investigations are usually non-contributory and have no role in evaluation. Management requires a multidisciplinary approach and hospitalization has a specific role. Although nutritional rehabilitation is the cornerstone of therapy, treatment of underlying factors-medical, psychological, social and environmental-should receive equally important attention. Long term physical, developmental and behavioural sequelae are known to occur in children with failure to thrive.