Date of Award

1994-12-01

Degree Name

Doctor of Nursing Science

Keywords

low birth weight, newborns, Obstetrics, nursing, women

Abstract

The problem of determining risk factors and antecedents of birth weight is multifactorial. The purpose of this study was to examine the effect of pre-pregnancy health status, prenatal care, stress, negative life style practices, nutritional status during pregnancy, and placental perfusion on the well-growness of the newborn (birth weight) in five time orderings and to examine the interaction of these variables on each other. The theoretical framework was a physiologic one centering on the effects of the proposed variables on the well-growness outcome. This prospective study used a correlational design with path analytic techniques. A sample of 160 pregnant women and their subsequent newborns was recruited from a large, urban, hospital clinic. Interviews were conducted during prenatal visits followed by chart reviews of mother and baby. Following data reduction techniques to establish independence of the variables or to form composites, the revised model had fourteen variables, namely the antecedent variables of height, height/weight, gravida/para status, life events stress and support, mediating variables of abuse, bother, smoking, pregnancy weight gain, calories, hematocrit and outcome variables of birth weight, physical maturity and neuromuscular maturity. These variables accounted for 3% of the variance in birth weight, 8% in physical maturity and 3% in neuromuscular maturity. Several of the hypotheses were partially supported. The mother's height had a direct, positive affect on physical maturity of the newborn, while the height/weight status had a direct, positive impact on the birth weight of the newborn. The height/weight status of the mother also indirectly affected the neuro-muscular maturity of the newborn through the stress variable of bother. Life stress had a direct, positive affect on abuse while support was negatively related to it and to body image (botheredness). Abuse also had a direct, positive affect on physical maturity, while body image (bother) had an indirect affect on neuro-muscular maturity through admission hematocrit. Smoking had a direct, positive affect on calorie intake but had no affect on the other proposed relationships. Lastly, admission hematocrit had a direct positive affect on neuromuscular maturity. This study needs to be repeated with a sample that would include low birth weight babies. The prospective nature of this study must be retained.

Document Type

Dissertation: Open Access

Department

Nursing

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Nursing Commons

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