Funding: The epidemiological section of this study was funded by the former Clwydian Community Trust, now renamed, Conway and Denbighshire NHS Trust. The second part of this two section study focused the investigation of low birth weight in Rhyl area, was funded by the North Wales Research Committee, Gwenfro, The Institute of Health Studies, Wrexham, North Wales. Ethical approval: The epidemiological section of the study used a meta-analysis of secondary anonymous data for which ethical approval was found to be not required. The descriptive survey section of the study received ethical approval in July 2000.
Study Aims: The aim of the first section of the study was, 1) to identify areas with the highest incidence of low birth weight births (2500kg and below) and compare these with the incidence of poverty/deprivation and, 2) to identify a focus for further study. The aim of the second section of the study was to investigate the issue of low birth weight in more depth from the perspective of experienced professionals.
Justification: Low birth weight is a major contributory factor to infant and perinatal deaths, and is known to have an influence on some major causes of ill health and death in later life. Low birth weight is one of 15 health gain targets for Wales, with a target of reducing to below 6% the percentage of low birth weight births by 2002. Since the target was set with a baseline of 7.2% in 1995, the level has deteriorated to 7.4% in 1998, Chief Medical Officers' Report, 1998 (National Assembly for Wales 1999). The evidence provided by the Barker hypothesis, (Barker 1995, 1999), concerning the foetal origins of heart disease also underpin this study.
Data set: Epidemiological section n=3586 total births in the period April 1st 1995 and August 31st 1998, (n=2778 with attributable postcode). 1) Method: A meta analysis of secondary data, by spatial analysis of low birth weight births (2500kg and below) by postcode area and correlation with deprivation measures. Findings: The study found simple correlations between low birth weight and deprivation in some areas of Denbighshire. Regression analysis, used Pearsons' Product Moment, Correlation Co-efficient, significant > r=0.2052, Jarman Index, Townsend score > r=0.3542.
Population sample: Descriptive Survey section, interviews (n=13) focus groups (n=15) 2)Method: A series of semi-structured interviews and focus group interviews to 1) elicit the professional opinion of experienced general practitioners, health visitors, community paediatricians and midwives, concerning low birth weight births, health needs and social, and environmental factors which may impact on family health in the Rhyl area. 2) To seek professional opinion concerning improvement in practice delivery/health services.
Findings: Professionals interviewed found low birth weight to be related to young teenage pregnancy and drug abuse. Professionals also identified health needs, social factors and environmental factors impacting on health, and made recommendations for improved service delivery.
The implications,what this study adds: A logical approach to investigating health need in a deprived area, using low birth weight as an indicator. The epidemiological section of study enabled an in depth investigation of low birth weight births which identified additional information to that provided by Local Authority statistics, useful in identifying small problem areas. The descriptive survey provided considerable pertinent information concerning the perceptions of experienced professionals of health need in the Rhyl area and obtained professional opinion of how practice delivery may be changed and services improved.
Back to Maternal/Infant Interventional Studies
Back to The Advancing Nursing Practice Excellence: State of the Science