To assess the impact of screening and intervention based on maternal height, prepregnancy weight and weight during weeks 16-19 or 24-27 in reducing adverse pregnancy outcomes (IUGR, preterm birth and assisted delivery) in developing country settings.
METHODS Decision analysis based on a recent multicentre WHO collaborative study of maternal anthropometry and pregnancy outcomes and meta-analyses of controlled clinical trials of balanced energy/protein supplementation (for IUGR and preterm birth) and support from caregivers during labour (for assisted delivery).
Subjects for the analysis comprised pregnant women from Cali.
Colombia (1989, n=4598) ; urban and rural Pune, India (1990, n=4307) ; and urban and rural Myanmar (1981-82, n=3542) followed until delivery.
RESULTS Seven to 45% of pregnant women had positive screens, with preventive fractions (PFs) ranging from 0.034 to 0.109 for IUGR, 0.027-0.082 for preterm birth and 0.011-0.105 for assisted delivery.
Screening prevention ratios (SPRs=ratios of the number of women treated to the number of cases of adverse outcome prevented) are high in all three study settings for preterm birth and assisted delivery (range 22.8-115.7) and low in settings with a high prevalence of the adverse outcome and high specificity of the anthropometric measure (India for IUGR, range 7.0-8.0). (...)
Mots-clés Pascal : Gestation, Anthropométrie, Nutrition, Hypotrophie foetale, Prématuré, Analyse décision, Dépistage, Colombie, Amérique du Sud, Amérique, Inde, Asie, Myanmar, Surveillance sanitaire, Homme, Femelle, Gestation pathologie, Foetus pathologie
Mots-clés Pascal anglais : Pregnancy, Anthropometry, Nutrition, Intrauterine growth retardation, Premature, Decision analysis, Medical screening, Colombia, South America, America, India, Asia, Myanmar, Sanitary surveillance, Human, Female, Pregnancy disorders, Fetal diseases
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0304186
Code Inist : 002B29A. Création : 27/11/1998.