Low Birth Weight, and Low Ponderal Index Mediates the Association between Preeclampsia, Placenta Previa, and Neonatal Mortality

Nawsherwan; Abbas Khan; Nabila Begum; Zahoor Ahmed; Sumaira Mubarik; Ijaz Ul Haq; Ghulam Nabi; Naeem Ullah; Cuifang Fan; Suqing Wang

Low Birth Weight, and Low Ponderal Index Mediates the Association between Preeclampsia, Placenta Previa, and Neonatal Mortality

Iran J Public Health. 2020 Apr;49(4):654-662.

Authors

Nawsherwan¹, Abbas Khan², Nabila Begum³, Zahoor Ahmed⁴, Sumaira Mubarik⁵, Ijaz Ul Haq⁶, Ghulam Nabi⁷, Naeem Ullah⁸, Cuifang Fan⁹, Suqing Wang^{1

10}

Affiliations

¹ Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, Hubei, China.
² Department of Food Science, College of Food Science and Engineering, Jilin University, Changchun, China.
³ Department of Advanced Innovation Center for Food Nutrition and Human Health, Laboratory of Molecular Sensory Science, College of Food and Chemical Engineering, Beijing Technology and Business University, Beijing, China.
⁴ Department of Food Science, School of Food Science and Engineering, South China University of Technology, Guangzhou, China.
⁵ Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, Hubei, China.
⁶ Department of Food Science, College of Food and Pharmaceutical Science, Huaian, Jiangsu, China.
⁷ Key Laboratory of Animal Physiology, Biochemistry and Molecular Biology of Hebei Province, College of Life Sciences, Hebei Normal University, Shijiazhuang, China.
⁸ Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, Changchun, China.
⁹ Department of Obstetrics and Gynecology, Renmin Hospital, Wuhan University, Wuhan, Hubei, China.
¹⁰ Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Academy for Preventive Medicine, Wuhan, Hubei, China.

PMID: 32548045
PMCID: PMC7283188

Abstract

Background: A retrospective study was conducted to assess the mediation role of low birth weight, and low ponderal index between the preeclampsia, placenta previa, and neonatal mortality in the tertiary hospital of Hubei Province, China.

Methods: A total of 12772 neonatal births were included for data analysis. Birth weight, birth length, and neonatal mortality were recorded after birth. Sobel test based on mediation regression was used to evaluate the effect of mediator variables.

Results: Approximately, 383 (3%) and 409 (3.2%) women experienced preeclampsia and placenta previa respectively. After adjusting for covariates, the indirect effect of preeclampsia on neonatal mortality mediated by low birth weight and low ponderal index was [β 2.59 (95% CI: 0.74 - 4.44)], and [β 3.94 (95% CI: 1.50 - 6.38)] respectively. Moreover, the indirect effect of placenta previa on neonatal mortality mediated by the low birth weight was [β 1.74 (95% CI: 0.16 - 3.31)], and low ponderal index was [β 3.21 (95% CI: 0.95 - 5.48)]. The estimated mediation proportion between the preeclampsia and neonatal mortality accounting for possible mediation by low birth weight and low ponderal index was 44.5% and 34.5% respectively. Furthermore, 47.9% by low birth weight and 33.2% by low ponderal index mediate the association between placenta previa and neonatal mortality.

Conclusion: Low birth weight, and low ponderal index partially mediates the association between preeclampsia, placenta previa and neonatal mortality.

Keywords: Low birth weight; Low ponderal index; Neonatal mortality; Placenta previa; Preeclampsia.