RU2472446C1 - Method of predicting body weight of newborn baby - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to field of preventive medicine, in particular to pediatrics, and can be used for prevention of various forms of hypotrophy and hypertrophy of newborn babies. Medical and biological factors, nutritional status, occupational risk and qualitative indices of parents' life style in formation of physical indices of newborn babies are determined. Body weigh of newborn babies is determined by formula.

EFFECT: method makes it possible to increase reliability of prediction of newborn baby body weight due to taking into account risk factors that have impact on parents.

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Description

The invention relates to the field of preventive medicine, in particular to pediatrics, and can be used to prevent various forms of hypotrophy and hypertrophy of newborns.

The dependence of the woman’s nutrition during pregnancy and the body weight of the fetus at birth are known (V. Radzinsky et al. Interdependence of the nutrition of the mother, fetus and infant]. Healthcare of Turkmenistan. - 1990. - No. 12). However, this article does not take into account other important factors affecting the body weight of the newborn, namely the woman’s body mass index before pregnancy, working and living conditions, and lifestyle.

It is known that the formation of body mass deficiency in children of the first year of life is affected by such factors as occupational hazards, emotionally stressful work, bad habits of the mother, health status of the father (Veltishchev Yu.E. et al. Prevention and treatment of malnutrition in young children : Methodological instructions of the Ministry of Health of the USSR. - M., 1985), however, this source also does not take into account the whole complex of factors that make it possible to predict the body weight of a newborn.

A known method for predicting body mass deficiency in children born with intrauterine growth retardation by identifying traditional risk factors, characterized in that prognostically significant risk factors for developing body mass deficiency are identified, expressed by prognostic factors in points, respectively, for 6 years of age or for 7 -year-old age or for 8-year-old age, then the sum of prognostic factors is calculated, and with its value less than -13 points, the prognosis is considered favorable, and with a value of more than +13 b Allov - unfavorable (RF patent No. 2234239). The specified method allows to assess the risk of developing mass deficiency in primary school children and does not allow to predict the body weight of the newborn.

An informative indicator of intrauterine well-being is the physical development of newborns. It is known that the most resistant to diseases are children who deviate minimally from the average values of morphological characters (Brawarsky P; Stotland NE; Jackson RA; Fuentes-Afflick E; Escobar GJ; Rubashkin N; Haas JS. Pre-pregnancy and pregnancy-related factors and the risk of excessive or inadequate gestational weight gain. / Int J Gynaecol Obstet 2005 Nov; 91 (2): 125-31). Factors affecting the formation of a body mass deficit at various stages of a child’s development include: national traditions, climatic conditions, health status of mother and father, occupational hazards, working and living conditions, lifestyle. Against the background of inadequate nutrition of pregnant women and irrational eating behavior, unfavorable conditions for intrauterine development of the fetus develop. With a well-balanced diet, adaptive mechanisms can satisfy the needs of the pregnant woman and the fetus in nutrients without special additional nutritional correction. With inadequate nutrition, correction is necessary to compensate for the deficiency of certain macro- and micronutrients in the mother and fetus.

The objective of the invention is to increase the reliability of forecasting body weight of a newborn by taking into account risk factors that affect parents and, on the basis of the result, carrying out preventive measures aimed at improving the health status of the newborn.

The problem is achieved in that the method takes into account many interrelated and interdependent risk factors that can affect the body weight of the child. This model allows you to make a forecast of the body weight of the child, taking into account the content in the diets of the mother during pregnancy of animal proteins, total proteins, fats, mineral composition - sodium, potassium, calcium, phosphorus, iron, vitamins - riboflavin, niacin, vitamin C, daily calories diet, and also take into account marital status, a woman’s body mass index before pregnancy, a woman’s total work experience, mother’s working conditions, stress at work and in the family, social conditions, diet, and seniority bots father of the child, the nature of the work of the father.

The method is based on the principle of multidimensional modeling, which allows reflecting the hierarchical structure of the system of factors. This method determines the contribution of biomedical factors, nutritional status, occupational risk and qualitative indicators of the lifestyle of parents to the formation of physical parameters of newborns.

We studied the consumption of macro- and micronutrients with food in 656 pregnant women, with a gestational age of 16 to 30 weeks, at the age of 18-39, who do not have chronic diseases.

In our studies, we took into account many interrelated and interdependent risk factors that can affect the body weight of a child at birth. According to a copy of the individual card of the pregnant woman and the woman in childbirth (form No. 111 / y), as well as the results of the questionnaire of the woman during pregnancy, an information database was formed. As a result of the mathematical processing, only 21 risk factors turned out to be significantly significant:

Amount in the diet: X ₁ - animal protein (g), X ₂ - total protein (g), X ₃ - fat (g), X ₄ - sodium (mg), X ₅ - potassium (mg), X ₆ - calcium (mg), X ₇ - phosphorus (mg); X ₈ - iron (mg), X ₉ - riboflavin (mg), X ₁₀ - niacin (mg), X ₁₁ - vitamin C (mg), X ₁₂ - caloric intake (kcal), X ₁₃ - total work experience of the mother, X ₁₄ - marital status; X ₁₅ - woman's body mass index, before pregnancy; X ₁₆ - working conditions of the mother; X ₁₇ - stress in the workplace and in the family; X ₁₈ - social conditions; X ₁₉ - power mode; X ₂₀ - the work experience of the father of the child, X ₂₁ - the nature of the work of the father.

The generated forecast model (p <0.000001) with a confidence of 83% allows us to assess the degree of influence of risk factors (social, industrial, lifestyle and eating behavior), indicators of macro- and micronutrient provision of pregnant women on the health of newborns and determine the conditions for minimizing exposure.

Actual nutrition was assessed by 24-hour (daily) nutritional reproduction using an album of servings of foods and dishes. The essence of the 24-hour food polling (reproduction) method is to determine the amount of actually consumed food and dishes by means of a polling (interview), when the respondent (polled) reproduces from memory what he ate for the day preceding the polling day. The interviewer, by asking questions, asks the interviewee to remember what kind of food he took on the eve of the previous day (24 hours). The interviewer actively participates in the survey and together with the respondent gives a description of the nature and determines the amount of food taken during the previous day. The obtained characteristics and values were recorded by the interviewer in a special questionnaire form. To assess the amount of food consumed, albums with drawings of various sizes of servings of foods and dishes depicted in full size were used. An album with photos was shown to the respondent during the interview and at the end of the survey, which will help to remember what I was eating. The amount of liquid and bulk products was evaluated in familiar and familiar to the interviewee, used in the household cups, glasses, plates, spoons. As a result of the interview, the questionnaire contained information about the time of eating, the place of preparation and consumption of food, a description of the nature of the dish and product, the method of its preparation and the quantity of the product, dish (Recommendations for estimating the amount of food consumed by the 24-hour (daily) food reproduction method No. C1-19-19 / 14-17, 1996).

The information in the form was subject to further processing to obtain data on energy consumption and nutrients. The nutrient composition of the consumed rations was calculated on the basis of the reference table of the content of basic food substances and the energy value of food products edited by Prof. I.M.Skurikhin and Professor V.A. Tutelyan, taking into account the loss of nutrients during heat cooking (2005).

The 24-hour nutritional method is currently the most common method for studying human food intake due to its simplicity, ease of implementation, and affordability. When comparing the data of the 24-hour survey, good agreement with the results obtained by the weighted method was noted.

Based on the calculations, the indices X ₁ -X _{12 were} filled.

Work experience was encoded using table 1 (indices X ₁₃ , X ₂₀ ).

Table 1 Work coding Work experience The code Up to 4 years one 5-9 years old 2 10-14 years old 3 15-19 years old four 20-24 years 5 More than 25 years 6

Marital status is married - 1, not married - 2 (index X ₁₄ ).

To assess nutritional status, we determined the body mass index (BMI) of women before pregnancy. Existing medical standards for normal BMI for adult women allow a wide range of values. The BMI formula takes into account an increase in body weight with an increase in height, i.e. BMI estimates are independent of human height. Body mass index is used only at the age of 18 years and older, it does not serve as an indicator of healthy weight in children and adolescents (index X ₁₅ ).

The formula for calculating: body mass index (kg / m ² ) = body weight, kg / (height, m ² ).

Working conditions were evaluated (index X ₁₆ ):

a) no harm - 1; d) noise - 5; b) overheating - 2; e) gas contamination - 6; c) subcooling - 3; g) dust content - 7; d) vibration - 4; h) psycho-emotional stress - 8;

The presence of stressful situations at work and in the family - 1, absence - 2 (index X ₁₇ ).

Social conditions were evaluated by analyzing the family income in terms of one person (index X ₁₈ ):

a) up to 5000 rubles. - one c) 10000-15000 rub. - 3 b) 5000-10000 rubles. - 2 d) over 15,000 rubles. - four.

The diet was consistent with the number of meals:

1 time - 1; 2 times a day - 2; 3 times a day - 3; 4 times - 4; 5 or more - 5 (index X ₁₉ ).

The nature of work was evaluated (index X ₂₁ ):

a) without features - 1

b) predominantly sedentary - 2

c) mostly standing - 3

d) predominantly active - 4

e) I lift weights - 5

e) with neuro-emotional stress - 6.

After processing the data by the method of multiple regression, the following equation was obtained that describes the dependence of the body weight of the child at birth and the nutrition of the mother during pregnancy, as well as socio-economic, biomedical and other risk factors that significantly influence:

Y ₁ = 2477.41-59.63X ₁ + 82.46X ₂ + 46.1X ₃ + 0.88X ₄ -0.44X ₅ + 1.63X ₆ -5.005X ₇ -86.53X ₈ + 345.93X ₉ + 152.06X ₁₀ + 1.56X ₁₁ -3.5X ₁₂ + 493.13X ₁₃ + 834.11X ₁₄ -127.71X ₁₅ + 90.32X ₁₆ + 397.68X ₁₇ -245.04X ₁₈ + 418.51X ₁₉ -446.33X ₂₀ + 174.90X ₂₁ ,

Y ₁ - the body weight of the newborn;

X ₁ - the amount of animal protein in the diet, X ₂ - the amount of total protein in the diet, X ₃ - fats in the diet, X ₄ - sodium in the diet, X ₅ - potassium in the diet, X ₆ - calcium, X ₇ - phosphorus; X ₈ - iron, X ₉ - riboflavin, X ₁₀ - niacin, X ₁₁ - vitamin C, X ₁₂ - calorie intake, X ₁₃ - total work experience of the mother, X ₁₄ - marital status; X ₁₅ - woman's body mass index, before pregnancy; X ₁₆ - working conditions of the mother; X ₁₇ - stress in the workplace and in the family; X ₁₈ - social conditions; X ₁₉ - power mode; X ₂₀ - the work experience of the father of the child, X ₂₁ - the nature of the work of the father.

The birth weight of a baby depends on the caloric content of the mother’s diets during pregnancy, the content of both total and animal protein, fat, sodium, potassium, calcium, phosphorus, iron, vitamins B ₂ , PP, C. A significant correlation also took place between the child’s body weight at birth and the number of meals per day, the mother’s body mass index before pregnancy, the length of work and the nature of the work of the father of the child, the working conditions of the mother, the presence of stress in the workplace and in the family.

Deficiency of protein and energy in the diet of the mother, and ultimately in the "diet" of the fetus, leads to a delay in its growth and development of intrauterine malnutrition and the birth of a fetus with low body weight. Deficiency of fats in the diet, and in particular polyunsaturated fatty acids in the diet of the mother can lead to impaired functioning of the fetal nervous system, the formation of the brain. Riboflavin and niacin are involved in biological oxidation and energy metabolism, they are necessary for the construction of coenzymes of the most important redox enzymes. Vitamin C helps to reduce uterine muscles and strengthens the body’s immune system, vitamin C deficiency can lead to premature termination of pregnancy. A large amount of growing fruit needs calcium both for the growth of bones and teeth, and for the formation of the nervous system, heart and muscles. Calcium is necessary for the development of all baby tissues. Calcium deficiency can cause fetal growth retardation. A lack of calcium in the body also contributes to the development of toxicosis and neurovegetative disorders in a pregnant woman. Iron deficiency anemia during pregnancy can lead to premature birth, habitual miscarriage, weight loss of the newborn and even fetal death in severe anemia in pregnant women, especially if it manifests itself in the first half of pregnancy. In women, there is a close relationship between the weight of her own body and the body weight of the child.

Calculation example:

A 4-year student of a medical university, the gestational age is 16 weeks, body weight before pregnancy was 51 kg, height 160 cm. The nature of work and working conditions without features. Married. Her husband is a 4th year student at the Faculty of History of KSU.

X ₁ - 30 g X ₁₂ - 2100 kcal; X ₂ - 80.0 g X ₁₃ - 1 (work experience of mother 4 years); X ₃ -70 g X ₁₄ - 1 (married); X ₄ - 3000 mg; X ₁₅ - 20 (BMI = 51 / (1.6 ² )); X ₅ - 2500 mg; X ₁₆ - 1 (no harmful effects at work); X ₆ - 1000 mg; X ₁₇ - 1 (stressful situations are present); X ₇ - 1100 mg; X ₁₈ - 1 (income per family member was 5000 X ₈ - 20 mg; rub.); X ₉ - 2 mg; X ₁₉ - 4 (meal - 4 times a day); X ₁₀ - 20 mg; X ₂₀ - 1 (father's experience of 4 years); X ₁₁ - 80 mg; X ₂₁ - 1 (the nature of the father's labor activity without features).

According to the presented formula, we predict that a baby with a body weight of 3373.18 g is born.

According to a copy of the individual card of the pregnant woman and the woman in childbirth (form No. 111 / y), this woman gave birth to a child with a body weight of 3510 g. Forecast with an accuracy of 96.1%.

Thus, a combination of factors affects the body weight, and as a result, the health of the child at birth: 1) the quality and quantity of macro- and micronutrients in the mother’s diet; 2) diet; 3) biomedical characteristics of women 4) socio-economic factors; 5) production factors (working conditions, nature of work) of the mother during pregnancy, as well as the father of the child at the time of conception.

Unfavorable conditions for fetal development due to poor nutrition, exposure to risk factors at work and in the family, low quality of life of a woman, lead to a disruption in the health status of newborns, the birth of children with low morphological characteristics (with malnutrition) and functionally immature with reduced adaptive capabilities. The final prognostic indicator can be determined by any one or more weighting factors. Based on this, it is necessary to carry out specific measures and recommendations to eliminate or reduce the impact of relevant risk factors.

This method was developed and proposed as an algorithm for the diagnosis, examination and dynamic monitoring of women during pregnancy to recognize risk factors and calculate prognostic scenarios for the possible development of somatic pathology in children and is aimed at improving the health of newborns.

Claims (1)

A method for predicting the body weight of a newborn, including assessing the nutrition of the mother during pregnancy, characterized in that it further assesses the complex of socio-economic and biomedical risk factors that affect parents, while the body weight of the newborn is determined by the formula:
Y ₁ = 2477.41-59.63X ₁ + 82.46X ₂ + 46.1X ₃ + 0.88X ₄ -0.44X ₅ + 1.63X ₆ -5.005X ₇ -86.53X ₈ + 345.93X ₉ + 152.06X ₁₀ + 1.56X ₁₁ -3.5X ₁₂ + 493.13X ₁₃ + 834.11X ₁₄ -127.71X ₁₅ + 90.32X ₁₆ + 397.68X ₁₇ -245.04X ₁₈ + 418.51X ₁₉ -446.33X ₂₀ + 174.90X ₂₁ ,
where Y ₁ is the body weight of the newborn; X ₁ - the amount in the diet of animal protein (g), X ₂ - the amount of total protein in the diet (g), X ₃ - fats in the diet (g), X ₄ - sodium in the diet (mg), X ₅ - potassium diet (mg), X ₆ - calcium (mg), X ₇ - phosphorus (mg); X ₈ - iron (mg), X ₉ - riboflavin (mg), X ₁₀ - niacin (mg), X ₁₁ - vitamin C (mg), X ₁₂ - calorie intake (kcal), X ₁₃ - total maternal experience: up to 4 years - 1 point, from 5 to 9 years - 2 points, from 10 to 14 years - 3 points, from 15 to 19 years - 4 points, from 20 to 24 years - 5 points, more than 25 years - 6 points, X ₁₄ - marital status: married - 1 point, not married - 2 points; X ₁₅ - woman's body mass index, before pregnancy; X ₁₆ - working conditions of the mother during pregnancy: no harm - 1 point, overheating - 2 points, hypothermia - 3 points, vibration - 4 points, noise - 5 points, gas contamination - 6 points, dustiness - 7 points, psychoemotional loads - 8 points; X ₁₇ - stress in the workplace and in the family - 1 point, 2 points - absence; X ₁₈ - social conditions: income per family member up to 5000 rubles - 1 point, from 5000-10000 rubles - 2 points, from 10000-15000 rubles - 3 points, over 15000 rubles - 4 points; X ₁₉ - diet: 1 time per day - 1 point, 2 times - 2 points, 3 times a day - 3 points, 4 times - 4 points, 5 or more times - 5 points; X ₂₀ - work experience of the father of the child at the time of conception: up to 4 years - 1 point, from 5 to 9 years - 2 points, from 10 to 14 years - 3 points, from 15 to 19 years - 4 points, from 20 to 24 years - 5 points, more than 25 years - 6 points, X ₂₁ - the nature of the father's labor activity at the time of conception: without features - 1 point, mostly sedentary 2 points, mostly standing - 3 points, mostly active - 4 points, weight lifting - 5 points , with neuro-emotional stress - 6 points.