Factors affecting birth outcomes in South Asian women

Abstract

This study was set out to assess the relationship between physical activity and maternal size and subsequently on birth weight. Since valid and appropriate measures for assessment of physical activity in the South Asian community are not available they have to be developed. The first part of the research is a retrospective cohort study of South Asian births in Southampton that covered a period of about thirty years. Hospital maternity records with South Asian names were extracted and routine antenatal data were linked with birth outcomes, which include birth weight, placental weight, head circumference and birth length. 2432 full term singleton births were analysed.

In univariate analysis, maternal height, weight, BMI, iron status, age, parity, length of gestation, and infant sex were identified to have an influence on birth weight. In a multivariate model, lower haemoglobin levels in late pregnancy, lower BMI in early pregnancy and being a Sikh-lndian were associated with lower birth weight. Being younger and of lower parity, which was characteristic of the Sikh-lndians could be the underlying factors for the ethnic differences. Low haemoglobin in the third trimester was associated with a high placental to birth weight ratio. The South Asian babies were about 300 g lighter at birth compared to Caucasian babies born in the same hospital, but were 400 g heavier than babies born in India. A positive energy balance, thus an increased BMI, due to changes in physical activity levels of the South Asian women since migrating to the UK, could be a contributing factor to the changes in birth weight of the South Asian babies in the UK.

In the second part of the research, we have developed and validated a physical activity questionnaire that is appropriate for use in the South Asian community. The subjects in the validation study were 57 South Asian women, aged between 17 and 55 years who were recruited through a postal invitation and by personal approach. They answered a frequency of activity questionnaire (FAQ) and a 24-hour activity recall by interview, and completed a 7-day activity diary. The correlation between energy expenditure from the FAQ and the diary was moderate (r = 0.44, p=0.001), and the correlation between the 24-hour recall was higher (r = 0.62, p=. 000). This study has shown that the FAQ, after taking account of the whole activity pattern, and the 24-hour recall can assess physical activity at group level. The FAQ and the 24-hour recall will be valid instruments to be used for future epidemiological studies to assess physical activity in South Asian populations at the group level, and the interaction of energy expenditure with birth weight.

This the first time that a physical activity questionnaire, an activity diary and the 24-hour recall has been administered in a South Asian community.

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