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Research ArticleFamily Medicine World Perspective

Low Birth Weight Outcomes: Why Better in Cuba Than Alabama?

Yasmin Neggers and Kristi Crowe
The Journal of the American Board of Family Medicine March 2013, 26 (2) 187-195; DOI: https://doi.org/10.3122/jabfm.2013.02.120227
Yasmin Neggers
From the Department of Human Nutrition, University of Alabama, Tuscaloosa.
DrPH, RD
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Kristi Crowe
From the Department of Human Nutrition, University of Alabama, Tuscaloosa.
PhD, RD, LD
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    Figure 1.

    Trends in percentage of low birth weight (LBW) for Cuba and USA from 1960–2010. Adapted from Index Mundi8 based on data from the World Bank.8 Source: UNICEF, State of the World's Children, Child Info, and Demographic and Health Survey by Macro International, 2011.8

  • Figure 2.
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    Figure 2.

    Trends in infant mortality rate in Cuba and the U.S., 1960–2010. (Data source: World Bank, World Development Indicators.)

Tables

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    Table 1. Cuban Pregnancy Weight Gain Guidelines25
    BMI (kg/m2) at Beginning by Trimester of GestationWeekly Weight Gain (kg)
    LowModerateHigh
    Underweight (≤18.8)
        Second0.34–0.420.43–0.690.70–0.78
        Third0.26–0.340.35–0.610.62–0.70
    Normal weight (>18.8 to <25.6)
        Second0.30–0.390.40–0.660.67–0.75
        Third0.23–0.310.32–0.580.59–0.67
    Overweight (≥25.6 to <28.6)
        Second0.27–0.340.35–0.630.64–0.71
        Third0.20–0.280.29–0.530.54–0.61
    Obese (≥28.6)
        Second0.17–0.260.27–0.530.54–0.64
        Third0.15–0.230.24–0.480.49–0.56
    Cumulative Weight Gain (kg) for Trimester
    LowModerateHigh
    Underweight (≤18.8)
        Second4.42–5.465.59–8.969.10–10.14
        Third3.64–4.764.90–8.538.68–9.80
        Second and third9.45–11.3311.34–17.2817.29–19.17
    Normal weight (>18.8 to <25.6)
        Second3.90–5.075.20–8.578.71–9.75
        Third3.22–4.344.51–8.098.26–9.38
        Second and third8.64–10.5210.53–15.9315.94–18.09
    Overweight (≥25.6 to <28.6)
        Second3.51–4.424.57–8.168.32–9.23
        Third2.80–3.924.02–7.457.56–8.54
        Second and third7.56–9.449.45–14.8514.86–16.47
    Obese (≥28.6)
        Second2.21–3.383.51–6.887.02–8.32
        Third2.10–3.223.35–6.726.86–7.84
        Second and third5.40–7.557.56–12.9612.97–14.58
    • BMI, body mass index.

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    Table 2. Prenatal and Postnatal Care, Measurements, and Support Provided Through the Cuban Health Care System
    Prenatal CarePostnatal Care
    Medical VisitsFrequencyMedical VisitsFrequency
    Weeks 12–331 per monthUpon Birth—
    Weeks 34–382 per monthWeeks 2–121 per week
    Weeks ≥38WeeklyWeeks 13–521 per month
    Maternal MeasurementsInfant Measurements
    Initial BMIWeight for age
    Blood pressure (each visit)Length for age
    Weight gain and BMI (each visit after 14 weeks)Head circumference
    Ultrasound (12, 20, and 32 weeks)Vaccination (according to national schedule)
    Uterus height, abdominal circumference (each visit after 14 weeks)
    Typhus immunization (between 24 and 28 weeks)
    Blood glucose (as needed)
    Hemoglobin (as needed)
    Additional Maternal Support
    Health educationEarly and exclusive breastfeeding support
    Personal hygiene carePromotion of home-based newborn care
    Psychological support/counselingFamily planning counseling
    Nutrition counselingNutrition counseling
    Maternal vitamin & mineral
    • BMI, body mass index.

    • View popup
    Table 3. Comparison of Prenatal Supplement Provision Through the Cuban Healthcare System and the Prenatal Supplement Guidelines for Women at Risk of Deficiency According to the Institute of Medicine
    NutrientIOM RecommendationCuban Multivitamin ProvisionCuban Prenatal Supplement
    Iron30–60 mg86 mg
    Zinc15 mg
    Copper2 mg
    Calcium250 mg
    Vitamin A2500 IU2000 IU
    Vitamin C50 mg35 mg
    Vitamin D400 IU
    Folic acid400 μg0.25 mg250 μg
    Vitamin B12.5 mg
    Vitamin B21.6 mg
    Vitamin B320 mg
    Vitamin B62 mg2 mg
    Vitamin B122 μg6 μg
    • IOM, Institute of Medicine.

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The Journal of the American Board of Family     Medicine: 26 (2)
The Journal of the American Board of Family Medicine
Vol. 26, Issue 2
March-April 2013
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Low Birth Weight Outcomes: Why Better in Cuba Than Alabama?
Yasmin Neggers, Kristi Crowe
The Journal of the American Board of Family Medicine Mar 2013, 26 (2) 187-195; DOI: 10.3122/jabfm.2013.02.120227

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Low Birth Weight Outcomes: Why Better in Cuba Than Alabama?
Yasmin Neggers, Kristi Crowe
The Journal of the American Board of Family Medicine Mar 2013, 26 (2) 187-195; DOI: 10.3122/jabfm.2013.02.120227
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    • Comparing Risk Factors Associated With LBW in Cuba and Alabama
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