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A survey of low birth weight in Vancouver and resulting implications for public health programming Kendall, Perry R. W.


The literature on maternal and child health suggests that infant birth weight is the best single predictor of infant health and that the low birth weight rate of a community is a practical indicator of the perinatal health care status of that community. Two groups of Vancouver mothers were surveyed between June 1st, 1981 and November 30th, 1981. The 'case' group consisted of mothers who delivered infants weighing less than 2501 gm at birth (Low Birth Weight). The control group consisted of mothers who delivered infants weighing 2501 gm or more at birth (Non Low Birth Weight). For each low birth weight mother a non low birth weight mother was selected by time and geographic proximity. The mothers were interviewed by Community Health Nurses. Data from multiple births were excluded from the subsequent analyses. The principle hypotheses being tested were that mothers of low birth weight infants would: 1) Have a different biomedical profile; 2) Have a different sociodemographic profile; 3) Have a higher prevalence of potentially alterable behaviours that have been associated with low birth weight, than mothers of non low birth weight infants. Significant differences were found between the two groups of mothers. With regard to biomedical profiles, mothers of low birth weight infants were found to have: more illness during pregnancy (Hypertension, Epilepsy and Renal Disease); more complications of pregnancy (Toxaemia, Ante Partum, Haemorrhage and Placenta praeria); more deliveries prior to 38 weeks of gestation; more miscarriages, abortion or stillbirths in previous pregnancies; less likelihood of having gained 251b in this pregnancy. No significant differences were found for maternal age or parity. Differences found which did not reach the .05 level of significance were, previous low birth weight (all case mothers) and close interpregnancy interval (less than 12 months) for women of Chinese and Indian origins. With regard to sociodemographic profiles, no significant differences were found but some trends approaching the .05 level of significance were noted; more low birth weight babies are born to mothers who reside in the poorer East side of the city; more low birth weight babies were born to mothers of Indian origin, and fewer to mothers of Chinese origin. there is a strong suggestion that lack of support during pregnancy (defined as no live-in partner) and being a recipient of social assistance are associated with the birth of small for gestational age infants. This finding only applies to Caucasian mothers. No significant differences in English comprehension were found between case and control mothers of Chinese or Indian origin, the majority were in fact rated fair or good in English comprehension. With regard to the prevalence of potentially alterable behaviours, significant differences between case and control groups were found. Mothers of low birth weight infants were more likely to: have gained less than 25 lb during this pregnancy have smoked during this pregnancy (Caucasians only). Some trends approaching the .05 level of significance were found; mothers of low birth weight infants were less likely to attend prenatal classes and less likely, if Canadian, to have presented for physician care during the first trimester. In' this sample there was no statistical difference between Chinese and Canadian low birth weight mothers in prenatal class attendance but significant differences were found between these two groups and mothers of Indian origin. One other finding of interest was that non low birth weight Canadian mothers visit their physicians significantly more frequently than do non low birth weight mothers of Indian or Chinese origin. These findings are consistent with the literature reviewed and confirm the principle hypotheses being tested. A survey of the literature on the effectiveness of prenatal class interventions, suggests that these interventions are: a) less effective than has often been claimed b) often not designed to address factors which may adversely affect birth weight. Prenatal classes in Vancouver appear to be utilized most by those mothers who are at lowest risk for low birth weight children. Based on the findings of this study, some recommendations are made for the public health prenatal programs of the City of Vancouver. The recommendations are probably equally applicable to other jurisdictions.

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