Secular Changes of Anthropometric Parameters in Newborns from Gracanica Area in the Period from 1998 to 2008

Abstract

SUMMARY Introduction: Growth and development of children can be observed on individual and population level. Anthropometric measures are main indicators of that development. Secular trend of anthropometric measures increase in BiH and in the world is most often observed during the adolescence period. Changes in anthropometric measures are also investigated in newborns (body length, birth weight, head circumference, upper arm circumference and others) and are correlated with different endogenous and exogenous factors. Purpose of this paper is to analyze birth weight, body length and head circumference in newborns from Gracanica area, which were born in the period from 2007 to 2008, compare them with information's collected in 1998 and 1999, and then determine eventual secular trend. Examinees and methods. Examinees were babies born in period from January 1st to December 31st 1998, and from January 1st 2007 to December 28th 2008. The method was retrospective and used information is from The Book of Protocols at the Department of Gynecology and Obstetrics, Dr M. Beganovic Hospital in Gracanica. In observed period (1998 and 1999, 2007 and 2008) more girls was born than boys (N=1801). Results: Newborns in Gracanica (2007-2008) weighted 3564 grams and female newborns weighted 3321+/-333 grams in total sample. Body length in female newborns is 55.37; and male newborns 56.32. Conclusions. Acceleration of growth of observed anthropometric parameters was established in newborns from Gracanica, in the period from 1998 to 2008 (for birth weight it is 84.96g/dec; for body length it is 1,13cm/dec and for head circumference it is 0.34cm/dec).

Secular Changes of Anthropometric Parameters in Newborns from Graanica Area in the Period from 1998 to 2008Secular Changes of Anthropometric Parameters in Newborns from Graanica Area in the Period from 1998 to 2008

Secular Changes of Anthropometric Parameters in Newborns from Graanica Area in the Period from 1998 to 2008

Jasminka Hadzihalilovic1, Sabina H. Halilovic2, Fikreta Brahimaj3, Amela Begic4, Rasima Tupkusic5, Lejla Mesalic6Faculty of Mathematics and Natural Sciences, University of Tuzla, Bosnia and Herzegovina1 Medical School Tuzla, Tuzla, Bosnia and Herzegovina2Health Center ivinice, ivinice, Bosnia and Herzegovina3Gymnasium Mea Selimovi, Tuzla, Bosnia and Herzegovina4Gymnasium Kladanj, Kladanj, Bosnia and Herzegovina5Health Center Tuzla, Tuzla, Bosnia and Herzegovina6

ORIGINAL PAPER SUMMARY

Introduction: Growth and development of children can be observed on individual and population level. Anthropometric measures are main indicators of that development. Secular trend of anthropometric measures increase in BiH and in the world is most oen observed during the adolescence period. Changes in anthropo-metric measures are also investigated in newborns (body length, birth weight, head circumference, upper arm circumference and others) and are correlated with dierent endogenous and exogenous factors. Purpose of this paper is to analyze birth weight, body length and head circumference in newborns from Graanica area, which were born in the period from 2007 to 2008, compare them with informations collected in 1998 and 1999,and then determine eventual secular trend. Examinees and methods. Examinees were babies born in period from January 1st to December 31st 1998, and from January 1st 2007 to December 28th 2008. The methodwas retrospective and used information is from The Book of Protocols at the Department of Gynecology and Obstetrics, Dr M. Beganovi Hospital in Graanica. In observed period (1998 and 1999, 2007 and 2008) more girls was born than boys (N=1801). Results: Newborns in Graanica (2007-2008) weighted 3564 grams and female newborns weighted 3321+/-333 grams in total sample. Body length in female newborns is 55.37; and male newborns 56.32. Conclusions. Acceleration of growth of observed anthropometric parameters was established in newborns from Graanica, in the period from 1998 to 2008 (for birth weight it is 84.96g/dec; for body length it is 1,13cm/dec and for head circumference it is 0.34cm/dec).

Keywords: newborns, Graanica, birth weight, body length, head circumference, percentiles

1. INTRODUCTION

Moment of birth divides the prenatal and postnatal period in the life of every organism (1,2,3). Infant is born with an average body mass of 3000 grams, body length of 47-54cm, the circumference of the head of 34-36cm, while the boys have 100 to 150 grams greater mass and are longer than girls for 1-2 cm (4,5,6). Birth weight and length of infants was determined by the genetic, hormonal and neural factors (endogenous) and a large number of exogenous factors.

Given that weight and length are in quantitative traits (polygenetically determined), these properties are inherited as a possibility to develop certain characteristics in genetically spec-ied range.

During the last century, in almost all parts of the worlds population noticed is gradually accelerated growth of various features of physical growth and development. Children in all ages are higher and heavier than their peers from less than 100, 50 and even 20 years ago (4). This phenomenon that has been

identied as growth acceleration is evident in the rapid growth (reduction of growth cycle), faster sexual maturity and increase in the body height and weight. Keyword acceleration means not only to accelerate somatic growth and evolution, but also increase the ratio of adult body, the extension of the reproductive period, the extension of life, faster fetus growth, higher birth weight and body length of infants, mental development changes, then the increase in certain organs, as well as the maturation of their functions. Acceleration trends are not necessarily present. In addition to the positive trends, and the possible negative trends of the unequal intensity in certain periods of development (secular growth changes are reversible biological process). Degree of the secular trend is specic to each population. Within it are hidden temporal, regional and social dierences. The specicity of the external environment requires development of proper standards of physical development for children and youth, which is due to the secular trend renewed ev-

ery 10 years. Only in this manner we can evaluate the signicance of secular trends of growth and development in a particular population.

The aim of this paper is to analyze anthropometric characteristics (birth weight, body length and head circumference) of infants from the area of Gracanica, born in the period 19981999 and compare with children born in 2007 and 2008 in order to determine the secular trend.

2. EXAMINEES AND METHODS

Analysis of anthropometric parameters (birth weight, body length and head circumference) and their secular trend was performed on a sample of 1801 newborns from the area of Gracanica. Processed data are from the 1998 and 1999. As one sub-sample (N = 986, hereinafter referred to as rst period) and from 2007 and 2008 as a second sub-sample (N = 815; hereinafter second period) with which comparison is carried out. Data were taken from the book of the protocol of the Department of newborn, gynecology and obstetrics Public Institute General Hospital Dr. M. Beganovic in Gracanica. Between the data from both time periods there is a distance of a decade in which it was possible to calculate the secular trend for the observed parameters. The analysis included all live births in single and twin pregnancy. The sample of infants is not complete, because a small number of births are performed in parallel in university Clinical Center Tuzla (about a hundred a year) and a small number of women which birth at home. The existence of the secular trend is calculated on the total sample of live births of both genders.

3. RESULTS

Majority of mothers originates from Gracanica (average 25%), and the rest are mothers from 13 surrounding villages such as Klokotnica, D. Orahovica, Lukavica, Malesici, Stjepan Polje and other. Data from the protocols show that in the hospital in Gracanica (for a period of 11 years of keeping records of birth) were born a total of 4820 infants (Figure 1). Figure 1 show that the number of newborns decreased until 2002, then increases until 2006 and decreasing until 2008 when the lowest number of births is recorded (341).

Women in Gracanica, as in most

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271

years of keeping records of birth) were born a total of 4820 infants (Figure 1). Figure 1 show

that the number of newborns decreased until 2002, then increases until 2006 and decreasing

until 2008 when the lowest number of births is recorded (341).

Figure 1. Number of live born infants in period 1998-2008 in Gracanica

Secular Changes of Anthropometric Parameters in Newborns from Graanica Area in the Period from 1998 to 2008

2008 is 3564grama. Secular trend is expressed by decades (every 10 years) and for the birth weight of boys is 91.81 g/ dec, which means that in 10 years the average birth weight of male newborns increased by 91.81 grams (for each year by 9.18 grams; Figure 2). For girls the trend is slightly smaller and is 78.1 g / dec (birth weight in 1998 Xsr = 3339 grams, and in 2008

cm / dec (0.11 cm in one year, Table 4, Figure 3) Boys in all analyzed years are signicantly longer than girls (t -test, Table 5). The average length of the body of girls is 55.80 cm, and boys 56.72 cm.

Circumference of the head also shows a slight acceleration, which is more pronounced in female than in male gender. Circumference of the head in the period 1998-2008, increased to 0.27 cm which is 0.24 cm / dec in boys and for girls were 0.44 cm / dec (Table 5, Figure 4). Here, as well as for the birth weight and body length there is a slight positive secular trend. The total increase for both is 0.35 cm for 11 years,

600

500

508 478

424 429

367 390

472

392

464

555

341

400

Broj

300

200

100

0

1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

Kalendarska godina

Figure 1. Number of live born infants in period 1998-2008 in

Gracanica

Women in Gracanica, as in most European countries are planning a family with two children,

and to have a third child decides only 11.44% (206 women). There is negligible small number

of women with fourth or five children (Table 1). Number of women who give birth to a third

child also decreased since 1998 (73 women) by 2008 (30 women; Fig. 1).

European countries are planning a family with two children, and to have a third child decides only 11.44% (206 women). There is negligible small number of women with fourth or ve children (Table 1). Number of women who give birth to a third child also decreased since 1998 (73 women) by 2008 (30 women; Fig. 1).

The age structure of mothers shows that the youngest mother was 15 years old and the oldest 44 years. Young mothers (up to age 25 years) were more frequent in the rst period than in the second one (Table 2). Today more often are the mothers of the infants in age groups from 25 to 35 years than 10 years ago. The average age of mothers was 26.30 years.

Secular trend. Acceleration of growth in anthropometric parameters was monitored in the total sample (all live births in Gracanica). In Figure 2 and Table 4 can be seen that the birth weight of male and female infants is in a slight increase for a period of last 11 years (1998-2008). Birth weight of boys in 1998 was 3463 grams, and in

Table 3. Birth weight according to years and gender

Years Gender N Xsr Med Xmin Xmax Range SD SE 1998. 242 3.463 3490 1450 4620 3170 449 28.85

266 3.339 3325 2220 4550 2330 415 25.47 (+) 508 3.398 3370 1450 4620 3170 436 19.33 1998.(+) t-test=3.23 df=506 p=0.00 1999. 226 3.458 3500 2040 4660 2620 456 30.30

253 3.347 3360 2000 4810 2810 429 26.97 (+) 479 3.399 3400 2000 4810 2810 445 20.32 1999.(+) t-test=2.74 df=477 p=0.01 2007. 228 3.542 3535 2150 4790 2640 429 28.43

245 3.334 3350 2000 4330 2330 415 26.54 (+) 473 3.434 3430 2000 4790 2790 434 19.97 2007.(+) t-test=5.36 df=471 p=0.00 2008. 170 3.564 3565 1800 4770 2970 429 32.90

171 3.425 3380 2150 4670 2520 436 33.33 (+) 341 3.494 3460 1800 4770 2970 437 23.68 2008.(+) t-test=2.97 df=339 p=0.00

Birthorder 1998. 1999. 2007. 2008. Total:

N % N % N % N % N %1 174 34.25 156 32.57 212 44.82 135 39.59 677 37.59 2 251 49.41 243 50.73 213 45.03 171 50.15 878 48.75 3 73 14.37 60 12.53 43 9.09 30 8.80 206 11.44 4 7 1.38 14 2.92 3 0.63 5 1.47 29 1.61 5 2 0.39 4 0.84 2 0.42 0 - 8 0.44 6 1 0.20 1 0.21 0 - 0 - 2 0.11 7 0 - 0 - 0 - 0 - - -8 0 - 0 - 0 - 0 - - -9 0 - 0 - 0 - 0 - - -10 0 - 1 0.21 0 - 0 - 1 0.05 Total: 508 100.00 479 100.00 473 100.00 341 100.00 1801 100.00 Table 1. Birth order within baseline according to years

1998. 1999. 2007 2008 Total:Age N % N % N % N % N % 15<=x<20 31 6.10 55 11.48 30 6.34 32 9.38 148 8.22 20<=x<25 177 34.84 181 37.79 148 31.29 112 32.84 618 34.31 25<=x<30 184 36.22 159 33.19 177 37.42 130 38.12 650 36.09 30<=x<35 88 17.32 57 11.90 89 18.82 56 16.42 290 16.10 35<=x<40 27 5.31 20 4.18 28 5.92 10 2.93 85 4.72 40<=x<45 1 0.20 7 1.46 1 0.21 1 0.29 10 0.55

508 100 479 100 473 100 341 100 1801 100 Table 2. Age of the mothers according to years

and 0.34 cm / dec. The average volume of the head girl today in Gracanica is 35.06 cm and 35.53 cm in boys.

4. DISCUSSION

Number of live births in Gracanica in the observed time period varies, for the last 2 years (2007 and 2008) it decreases. Analyzing anthropometric characteristics of infants from the Rijeka, Prpic et al. (8) also found a trend of decline in the number of births since 2000. Reduced number of births in our population can be related to the poor socio-economic status of the population, the general poverty, lack of society

3.600

Sekularni trend 1998-2008

3.550

3.500

Poroajna teina (g)

3.450

3.400

3.350

3.300

3.250

3.200

1998

1999

2007

2008

3.463

3.458

3.543

3.565

3.339

3.347

3.334

3.426

(+)

3.398

3.399

3.435

3.495

Kalendarske godine

Xsr = 3425 grams). Secular trend for both genders together is 84.96 g / dec. Male infants in the rst and second period are significantly heavier than female infants (t-test, Table 3).

Female infants are today longer than those from the 1998 by 1.1 cm, and the secular trend is 1.0 cm / dec. The total increase in body length for the past 11 years in boys is 1.24 cm or 1.13

Figure 2. Birth weight of the infants from Gracanica in both time periods

Female infants are today "longer" than those from the 1998 by 1.1 cm, and the secular trend is

1.0 cm / dec. The total increase in body length for the past 11 years in boys is 1.24 cm or 1.13

cm / dec (0.11 cm in one year, Table 4, Figure 3) Boys in all analyzed years are significantly

"longer" than girls (t -test, Table 5). The average length of the body of girls is 55.80 cm, and

Figure 2. Birth weight of the infants from Gracanica in both time periods

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2007.(+) t-test=5.44 df=471 p=0.00 2008. 170 56.72 57 48 64 16 2.69 0.21

171 55.80 56 49 61 12 2.54 0.19 (+) 341 56.26 56 48 64 16 2.65 0.14 2008.(+) t-test=3.25 df=339 p=0.00

Secular Changes of Anthropometric Parameters in Newborns from Graanica Area in the Period from 1998 to 2008

average birth weight of male infants is 3535 grams and body length 51.66 cm. Birth weight of female infants in Gracanica in 2008 is Xsr = 3425 grams, and body length of 55.80 cm. Girls in Nova Bila have nearly equal average birth weight (3450 grams) as female infants in Gracanica. The average body length of female infants in Gracanica is about

5cm longer than the body length of girls from Nova Bila (50.89 cm). Infants of both genders from Gracanica was about 5 cm longer than infants from Nova Bila, which can be explained by dierent genetic potential, and (possible) errors in the methodology of measuring body length of infants.

The most important factors that lead to the acceleration of growth in anthropometric parameters include the improvement of general living conditions (among which the most important is diet), the less ill children and increased possibilities for new combina-

57,00

Sekularni trend 1998-2008

56,50

56,00

Duina tijela (cm)

55,50

55,00

54,50

54,00

53,50

53,00

1998

1999

2007

2008

Figure 3. Body length of the

infants from Gracanica in both

time periods

Circumference of the head also shows a slight acceleration, which is more pronounced in female than in male gender. Circumference of the head in the period 1998-2008, increased to 0.27 cm which is 0.24 cm / dec in boys and for girls were 0.44 cm / dec (Table 5, Figure 4). Here, as well as for the birth weight and body length there is a slight positive secular trend. The total increase for both is 0.35 cm for 11 years, and 0.34 cm / dec. The average volume of the head girl today in Gracanica is 35.06 cm and 35.53 cm in boys.

Table 5.Head circumference according to years and gender (descriptive statistics and t-test)

N Xsr Med Xmin Xmax Range SD SE Years Gender

1998. 242 35.26 35 28 39 11 1.34 0.09

266 34.58 35 31 38 7 1.25 0.08 (+) 508 34.91 35 28 39 11 1.34 0.06 1998. +) t-test=5.85 df=506 p=0.00 1999. 226 35.03 35 31 39 8 1.28 0.09

253 34.45 34 30 38 8 1.20 0.08 (+) 479 34.72 35 30 39 9 1.27 0.06 1999.(+) t-test=5.13 df=477 p=0.00 2007. 228 35.54 36 31 38 7 1.30 0.09

245 34.90 35 32 38 6 1.23 0.08 (+) 473 35.21 35 31 38 7 1.30 0.06 2007.(+) t-test=5.53 df=471 p=0.00 2008. 170 35.53 36 3.6 38 34.4 2.77 0.21

171 35.06 35 33 38 5 1.13 0.09 (+) 341 35.29 35 3.6 38 34.4 2.12 0.11 2008.(+) t-test=2.06 df=339 p=0.04

55,48

55,17

56,71

56,72

54,70

54,36

55,41

55,80

(+)

55,07

54,74

56,04

56,26

Kalendarske godine

Figure 3. Body length of the infants from Gracanica in both time periods

Years Gender N Xsr Med Xmin Xmax Range SD SE 1998. 242 3.463 3490 1450 4620 3170 449 28.85

266 3.339 3325 2220 4550 2330 415 25.47 (+) 508 3.398 3370 1450 4620 3170 436 19.33 1998.

(+) t-test=3.23 df=506 p=0.001999. 226 3.458 3500 2040 4660 2620 456 30.30

253 3.347 3360 2000 4810 2810 429 26.97 (+) 479 3.399 3400 2000 4810 2810 445 20.32 1999.

(+) t-test=2.74 df=477 p=0.012007. 228 3.542 3535 2150 4790 2640 429 28.43

245 3.334 3350 2000 4330 2330 415 26.54 (+) 473 3.434 3430 2000 4790 2790 434 19.97 2007.

(+) t-test=5.36 df=471 p=0.002008. 170 3.564 3565 1800 4770 2970 429 32.90

171 3.425 3380 2150 4670 2520 436 33.33 (+) 341 3.494 3460 1800 4770 2970 437 23.68 2008.

(+) t-test=2.97 df=339 p=0.00

Table 3. Birth weight according to years and gender

care to raise birth rate and other factors that are crucial for family planning. In relation with this trend also reduced is the number of third child birth, so that in the rst period there was 133 third born, and in second 73 children, which is approximately one-half less.

Age of mothers from Gracanica also shifts toward older age, as can be seen from the table 3. Gali (2) states that the medical treatment of pregnant women classified as old pregnant after 25 years of age. In the past ten years, Croatia has a distinctive downward trend of births by women in younger age groups. These trends are in the USA and developed countries also clearly present for longer time period. According to data from the Croatian Institute for Public Health about the number of mothers younger than 20 years was reduced by 34% compared to 10 years ago, the number of mothers older than 35 years increased by 5% compared to 10 years ago. These trends are more pronounced in Slovenia, and are typical for other European countries (3).

Segregur (9,10) examining the inuence of body weight and BMI of pregnant women on pregnancy outcome in Virovitica found that most pregnant women were at age from 20 to 29 years (66.5%) and the minority in the group of more than 40 years of age (2.0%). At the same time it was determined that the average life span of pregnant women was 26.25 + / -5.62 years. The average life span for all mothers was 27.48 years in Nova Bila for the period since 1999 to 2003 (1)). The average age of mothers in Gracanica today is 26.30 years.

The average birth weight for boys in 2008 in Gracanica is 3564 grams and length 56.72 cm. Bilobrk-Josipovic (2005) in Nova Bila found that the

Years Gender N Xsr Med Xmin Xmax Range SD SE 1998. 242 55.48 56 41 65 24 2.97 0.19

266 54.70 55 47 62 15 2.61 0.16 (+) 508 55.07 55 41 65 24 2.81 0.12 1998.

(+) t-value=3.13 df=506 p=0.001999. 226 55.17 56 47 62 15 2.72 0.18

253 54.36 55 45 61 16 2.73 0.17 (+) 479 54.74 55 45 62 17 2.75 0.13 1999.

(+) t-value=3.25 df=477 p=0.002007. 228 56.71 57 50 63 13 2.65 0.18

245 55.41 56 48 62 14 2.56 0.16 (+) 473 56.04 56 48 63 15 2.68 0.12 2007.

(+) t-test=5.44 df=471 p=0.002008. 170 56.72 57 48 64 16 2.69 0.21

171 55.80 56 49 61 12 2.54 0.19 (+) 341 56.26 56 48 64 16 2.65 0.14 2008.

(+) t-test=3.25 df=339 p=0.00Table 4. Body length according to years and gender (descriptive statistics and t-test)

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Secular Changes of Anthropometric Parameters in Newborns from Graanica Area in the Period from 1998 to 2008

N Xsr Med Xmin Xmax Range SD SE Years Gender1998. 242 35.26 35 28 39 11 1.34 0.09

266 34.58 35 31 38 7 1.25 0.08 (+) 508 34.91 35 28 39 11 1.34 0.06 1998.

+) t-test=5.85 df=506 p=0.001999. 226 35.03 35 31 39 8 1.28 0.09

253 34.45 34 30 38 8 1.20 0.08 (+) 479 34.72 35 30 39 9 1.27 0.06 1999.

(+) t-test=5.13 df=477 p=0.002007. 228 35.54 36 31 38 7 1.30 0.09

245 34.90 35 32 38 6 1.23 0.08 (+) 473 35.21 35 31 38 7 1.30 0.06 2007.

(+) t-test=5.53 df=471 p=0.002008. 170 35.53 36 3.6 38 34.4 2.77 0.21

171 35.06 35 33 38 5 1.13 0.09 (+) 341 35.29 35 3.6 38 34.4 2.12 0.11 2008.

(+) t-test=2.06 df=339 p=0.04Table 5.Head circumference according to years and gender (descriptive statistics and t-test)

tions of genes as a resultof increased migrationand the appearance of alarger number of heterozygote for genes with acertain degree of dominance control growth.

The basic model of thesecular trend is not fully understood. Increase inthe number of heterozygote in the population results in strongeroffspring (heterosis effects) and thus partiallyexplain the positive secular trend. There is nodirect evidence that this is a causal mechanism, so that environmental factors likely to be the main cause of the secular changes (7,9). In the period of 10 years in Gracanica determined is a positive secular trend for birth weight, length and circumference of the head.

5. CONCLUSIONS

Based on the above we can conclude the existence of acceleration of growth of the observed anthropometric parameters, and a mild positive secular trend among the newborns from Gracanica in period from 1998 until 2008. For

the secular trend in birth weight = 84.96 g / dec, body length = 1.13 cm / dec, head circumference = 0.34 cm / dec. Male infants in both time periods are significantly heavier, longer and have a signicantly greater circumference of the head than the female infants.

Maternal age structure is changing and increasingly shifts toward older age.

Number of women who decide to have a 3rd child is decreasing since 1998 to 2008.

In order to further study the growth and development as well

as possibility for comparison of anthropometric parameters of newborns and children during the growth and development in a particular geographic area, it is necessary to make in Bosnia and Herzegovina unique methodology to create national standards that dier from the standards recommended by WHO. Development of anthropometric standards to own population of infants is a prerequisite for quality care for the children, especially when it comes to detecting fetal growth disorders.

REFERENCES

1. Bilobrk-Josipovi J. Perinatalna zbivanja u rodilitu bolnice u Novoj Bili u razdoblju od 1999. do 2003.godine. Gynaecol Perinatol, 2005; 14(4): 183-7.

2. Gali Misir L, i Grguri J: http://lijecnickivjesnik.hlz.hr/

3. Gali B. Stigma ili potovanje? Reproduktivni status ena u Hrvatskoj i ire. Revija za sociologiju, 2006; 37(3-4): 149-64..

4. Hadiselimovi R. Bioantropologija. Priorodno-matematiki fakultet Univeziteta u Sarajevu, 2005.

5. H a d i s e l i m o v i R . i L e l o S . Bioantropoloki praktikum. Prirodnomatematiki fakultet Univerziteta u Sarajevu, 2000.

6. Ninkovi D. Medicinska genetika. Zavod za udbenike i nastavna sredstva, Beograd, 2000.

7. Malina RM. Research on secular trends in auxology. Anthropologische Anzeiger, 1990; 48: 20917.

8. Prpi I, Krajina R, Radi J, Petrovi O, Mamula O, Haller H, Badari K, i Vukeli-aruni A. Porodna teina i duljina novoroenadi roene u klinikom bolnikom centru Rijeka. Gynaecol Perinatol, 2007; 16(3): 136-143..

9. Susanne C. Living conditions and secular trend. J Hum Evol, 1985; 14: 35770.

10. egregur J.Utjecaj tjelesne teine, indeksa ztjelesne teine i prirasta tjelesne teine u trudnica na ishod trudnoe. Gynaecol Perinatol, 2008; 17(1): 9-14.

Corresponding author: Jasminka Hadzihalilovic, PhD. Faculty of mathematics and natural sciences, University of Tuzla, Tuzla; BiH. E-mail:[email protected].

35,80

Sekularni trend 1998-2008

35,60

35,40

35,20

Obim glave (cm)

35,00

34,80

34,60

34,40

34,20

34,00

33,80

1998

1999

2007

2008

35,26

35,03

35,54

35,53

34,58

34,45

34,90

35,06

(+)

34,91

34,72

35,21

35,29

Kalendarske godine

Figure 4. Head circumference of

the infants in Gracanica in both

time periods

4. DISCUSSION

Number of live births in Gracanica in the observed time period varies, for the last 2 years (2007 and 2008) it decreases. Analyzing anthropometric characteristics of infants from the Rijeka, Prpic et al also found a trend of decline in the number of births since 2000. Reduced number of births in our population can be related to the poor socio-economic status of the population, the general poverty, lack of society care to raise birth rate and other factors that are crucial for family planning. In relation with this trend also reduced is the number of third child birth, so that in the first period there was 133 third born, and in second 73 children, which is approximately one-half less.

Age of mothers from Gracanica also shifts toward older age, as can be seen from the table 3. Gali (2006) states that the medical treatment of pregnant women classified as "old pregnant" after 25 years of age. "In the past ten years, Croatia has a distinctive downward trend of births by women in younger age groups. These trends are in the USA and developed countries also clearly present for longer time period. According to data from the Croatian Institute for Public Health about the number of mothers younger than 20 years was reduced by 34% compared to 10 years ago, the number of mothers older than 35 years increased by 5% compared to 10 years ago. These trends are more pronounced in Slovenia, and are typical for other European countries "(Gali, 2006).

Segregur (2008) examining the influence of body weight and BMI of pregnant women

Figure 4. Head circumference of the infants in Gracanica in both time periods

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