Low birth weight of institutional births in Cambodia: Analysis of the Demographic and Health Surveys 2010-2014

Risk factors of children's low birth weight and infant mortality in Bangladesh: Evidence from binary logistic regression and Cox PH models

Background

Low birth weight is recognized as a pivotal risk factor affecting child survival and growth. Although Bangladesh has made commendable progress in public health, an infant mortality rate of 38 per 1000 live births and a 16% prevalence of low birth weight remain significant concerns compared to other developing countries. This situation poses a significant challenge for the formulation of future health policies in Bangladesh. As a result, this study aims to identify potential risk factors contributing to low birth weight and infant mortality among children in Bangladesh.

Methods

The data is extracted from the 2014 Bangladesh Demographic and Health Survey. The response variables are infant mortality and low birth weight. In the bivariate analysis, Log-rank tests and Chi-square tests of independence were conducted. Cox proportional hazards and binary logistic regression models were utilized to determine the impact of risk factors on infant mortality and low birth weight.

Results

This study identified several significant factors associated with children's low birth weight, including wealth index, parental education, birth order, twin births, mother's body mass index, and child sex. Additionally, wealth index, parental education, twin status, media exposure, birth order, antenatal care visits, prenatal care assistance, and low birth weight were identified as potential risk factors for infant mortality in Bangladesh.

Conclusion

This study revealed that maternal and child characteristics, along with knowledge about child health care during pregnancy, can potentially reduce the risk of low birth weight and infant mortality among children in Bangladesh. To improve child health and survival, policymakers should prioritize community-based health education programs, and encourage parents to seek healthcare information from institutional medical facilities during pregnancy and after birth.

Child anemia in Cambodia: A descriptive analysis of temporal and geospatial trends and logistic regression-based examination of factors associated with anemia in children

Anemia in children remains a public health concern in many resource-limited countries. To better understand child anemia in Cambodia, we examined temporal and geospatial trends of childhood anemia and used logistic regression to analyze its association with individual and household characteristics using data from the Cambodia Demographic and Health Surveys for 2005, 2010, and 2014. The prevalence of childhood anemia decreased from 62.2% in 2005 to 56.6% in 2014. The prevalence of childhood anemia was highest in Pursat (84.3%) for 2005, Kampong Thom (67%) for 2010, and Preah Vihear and Steung Treng (68.6%) for 2014. After adjusting for other variables, factors positively associated with childhood anemia included having a mother who was anemic (adjusted odds ratio (AOR) = 1.77, 95% CI: 1.58-1.97); being male vs. female (AOR = 1.20, 95% CI: 1.07-1.33), underweight (AOR = 1.24, 95% CI: 1.14-1.57), or stunted (AOR = 1.24, 95% CI: 1.09-1.41); or having had a recent episode of fever (AOR = 1.16, 95% CI: 1.03-1.31). Children were less likely to have anemia if they were older than 12 months. They were also less likely to have anemia if they were from a wealthier household (AOR = 0.64; 95% CI: 0.50-0.84) or had taken medications for intestinal parasites (AOR = 0.86; 95% CI: 0.89-0.93). These associations were generally consistent across time and space. Public health interventions and policies to alleviate anemia should be prioritized to address these factors across geospatial divides. Anemia remains highly prevalent among children aged 6-59 months in Cambodia.

Prevalence and correlates of low birth weight in India: findings from national family health survey 5

BACKGROUND

Childhood mortality and morbidity has become a major public health issue in low-middle-income countries. However, evidence suggested that Low birth weight(LBW) is one of the most important risk factors for childhood deaths and disability.This study is designed to estimate the prevalence of low birth weight (LBW) in India and to identify maternal correlates associated with LBW.

METHODS

Data has been taken from National Family Health Survey 5 (2019-2021) for analysis. 149,279 women belonging to reproductive age group (15-49) year who had last recent most delivery preceding the NFHS-5 survey.

RESULTS

Mother's age, female child, birth interval of less than 24 months, their low educational level, low wealth index, rural residence, lack of insurance coverage, women with low BMI, anaemia, and no ANC visits during pregnancy are predictors that contribute to LBW in India. After adjusting for covariates, smoking and alcohol consupmtion is strongly correlated with LBW.

CONCLUSION

Mother's age, educational attainment and socioeconomic status of living has a highly significant with LBW in India. However, consumption of tobacco and cigarrettes are also associated with LBW.

Association between inadequate prenatal care and low birth weight of newborns in Peru: Evidence from a peruvian demographic and health survey

Objective

To assess the association between inadequate prenatal care (IPNC) and Low birth weight (LBW) in newborns of singleton gestation mothers in Peru.

Methods

We performed a secondary analysis of data from the 2019 Demographic and Health Survey. We included a total of 10,186 women of reproductive age (15 - 49 years) who had given birth to a singleton child in the last 5 years. The dependent variable was LBW (< 2500 g). The independent variables were IPNC (inadequate: when at least one of the IPNC components was absent [number of PNC visits ≥ 6, first PNC visit during the first trimester, compliance with PNC visit contents, and PNC visits provided by trained health personnel]) and each of its components. We evaluated the association using logistic regression models to estimate crude odds ratios and adjusted odds ratios (aOR) and their respective 95% confidence intervals (95% CI).

Results

We found that approximately six out of 100 live births had LBW and that seven out of 10 women had received IPNC. We observed that receiving IPNC (aOR: 1.39; 95% CI: 1.09 - 1.77) and having less than six prenatal control visits (aOR: 3.20; 95% CI: 2.48 - 4.13) were associated with higher odds of LBW regardless of the mother's age, educational level, occupation, wealth, region, rural origin, ethnicity, sex of the newborns, and place of delivery. While, regarding to the other PNC components, first prenatal control in the first trimester (aOR: 0.99; 95% CI: 0.76 - 1.28) and compliance with prenatal control contents (aOR: 1.07; 95% CI: 0.86 - 1.34), they were associated with lower and higher odds of LBW, respectively, regardless of the same adjustment variables, but it was not statistically significant.

Conclusions

IPNC and having less than six PNC visits were associated with higher odds of LBW. Therefore, it is very important to implement strategies that ensure access to quality prenatal care is necessary to reduce the consequences of LBW.

Maternal Characteristics and Socio-Economic Factors as Determinants of Low Birth Weight in Indonesia: Analysis of 2017 Indonesian Demographic and Health Survey (IDHS)

Although low birth weight (LBW) is still a major health problem in Indonesia, studies about determinants of LBW with large sample sizes are still limited. This study aimed to examine the association between LBW and maternal characteristics, as well as socio-economic backgrounds in Indonesia. A secondary analysis of 2017 Indonesian Demographic and Health Survey (IDHS) was conducted, specifically using the questionnaires for women of childbearing age. A bivariate chi-square analysis and a multivariate logistic regression analysis were performed. As many as 6.7% of infants were born with LBW. In terms of maternal characteristics, women who gave birth to twins were 20.30 times more likely to have infants with LBW (p < 0.001). Women with birth intervals of <24 and ≥24 months were likely to have LBW infants (p < 0.05). Complications during pregnancy were also associated with LBW (1.99 times higher than women with no complications) (p < 0.001). In terms of socio-economic factors, women with higher education and higher wealth index were less likely to give birth to infants with LBW. Additionally, marital status and type of residence were also significantly associated with a higher risk of LBW. In conclusion, LBW was associated with maternal characteristics and socio-economic backgrounds among women of childbearing age in Indonesia, including twin births, birth interval, and pregnancy complications as well as educational attainment, wealth index, marital status, and type of residence.

Determinant factors of low birth weight in Indonesia: Findings from the 2017 Indonesian demographic and health survey

BACKGROUND

Low birth weight (LBW) is still a significant problem in Indonesia because it affects the growth and development of infants. It is also one of the factors that increase the risk of developing chronic disease later in life.

PURPOSE

The study aimed to analyse the determinants of LBW in Indonesia.

METHODS

This cross-sectional analytic study used secondary data from the 2017 Indonesian Demographic and Health Survey (IDHS). Data on the maternal factors (maternal age, frequency of antenatal care (ANC) visits, education, and maternal smoking status), children's birth order, and socio-demographic factors of the 14,239 respondents were examined. The association between LBW and the independent variables was analysed using bivariate analysis with a chi-square test (X²), followed by multivariate analysis in the form of binary logistic regression.

RESULTS

LBW was identified in 960 infants (6.74%). Fewer than four ANC visits [AOR = 1.86; 95% CI = 1.44-2.42], uneducated mothers [AOR = 2.09; 95% CI = 1.00-4.37], and mothers who finished only primary school [AOR = 1.45; 95% CI = 1.05-2.00] were significantly associated with the incidence of LBW.

CONCLUSIONS

This study revealed that the frequency of ANC visits was a dominant factor in the incidence of LBW.

PRACTICE IMPLICATION

To reduce LBW in Indonesia, the government must increase ANC visits through health promotion programmes and maintain ANC facilities and quality.

Lived experiences of women with low birth weight infants in the Solomon Islands: A descriptive qualitative study

Every year, around 20 million women worldwide give birth to low birth weight (LBW) infants, with majority of these births occurring in low-and middle-income countries, including the Solomon Islands. Few studies have explored the pregnancy lived experience of women who deliver LBW infants. The aim of the study is to understand the lived experience of women in the Solomon Islands who gave birth to LBW infants by exploring their personal (socio-demographic and health), behavioural, social and environmental contexts. We used a qualitative descriptive approach and purposely selected 18 postnatal women with LBW infants in the Solomon Islands for an in-depth interview. All data were analysed using thematic analysis in NVivo. We identified six themes reported as being related to LBW: health issues, diet and nutrition, substance use, domestic violence, environmental conditions and antenatal care. Our findings suggest that women in the Solomon Islands are exposed to various personal, behavioural, social and environmental risk factors during pregnancy that can impact birth outcomes, particularly LBW. We recommend further research should be redirected to look at the factors/themes identified in the interviews.

Underweight and early childhood caries among young children in rural Cambodia: a pilot study

Objectives

To investigate the association between underweight and early childhood caries (ECC) among children aged one to three years in rural Cambodia.

Materials and methods

A total of 200 Cambodian children aged one to three years at several villages in Kampong Cham province participated in this study. The children whose Z scores were below two and three standard deviations were considered as moderately-underweight and severely-underweight. Children whose mid-upper arm circumstance (MUAC) was below 12.5 cm, were regarded as having malnutrition. ECC was recorded following the WHO guidelines. Associated factors were obtained through interviews with caregivers.

Results

33.5% and 7.0% of the children were identified as being moderately-underweight and severely-underweight, respectively. The prevalence of ECC was 61.5%. ECC was significantly associated with children being moderately-underweight (P < 0.05). The prevalence of ECC was higher prevalence of those who with severely-underweight, although significant differences were not observed (P = 0.054). Logistic regressions showed that those with low birth weight (OR = 2.57; 95% CI = 1.03–6.40) and malnutrition (OR = 4.71; 95% CI = 1.08–20.62) were likely to be moderately-underweight and severely-underweight, whereas those who with ECC had more moderately-underweight, although it was not significant (OR = 2.21; 95% CI = 0.97–5.00). Those with low birth weight (OR = 10.68; 95% CI = 2.95–38.65) and ECC (OR = 6.67; 95% CI = 1.02–43.61) were likely to be severely-underweight.

Conclusion

The findings of this study suggest that low birth weight, malnutrition and ECC were associated factors of underweight in this population.

Trends and Determinants of Small Birth Weight in Ethiopia: Further Analysis of Ethiopian Demographic and Health Surveys

Background

Globally, Low Birth Weight (LBW) prevalence is estimated to be 14.6%. It is a major cause of neonatal mortality in developing countries including Ethiopia. Despite extensive institution-based studies in Ethiopia, there is no comprehensive study using countrywide data. Thus, this study aimed to investigate trends and determinants of Small Birth Weight (SBW) among under-five children in Ethiopia.

Methods

Under-five children data from 2000, 2005, 2011, and 2016 Ethiopian Demographic and Health Surveys (EDHS) were used. However, only 2787 children were weighed at birth and used for analysis in this study. Descriptive statistics and the logistic regression model were used to determine trends and determinants of SBW respectively.

Results

The prevalence of SBW increased from 7.0% (95% CI; 3.1–10.0) to 13.2% (95% CI; 11.4–15.0) between 2000 and 2016. The odds of SBW increased by being a female child (AOR 1.50; 95% CI [1.07–2.09]), mother's with partner occupation of agriculture (AOR 1.54; 95% CI [1.05–2.26]) and mothers who did not know their partner's occupation (AOR 7.35; 95% CI [1.96–27.48]). However, infants born to mothers with primary (AOR 0.43; 95% CI [0.29–0.65]), secondary (AOR 0.30; 95% CI [0.16–0.55]) and higher (AOR 0.55; 95% CI [0.31–0.97]) educational status versus no education and grandmultiparous mothers (OR 0.39; 95% CI [0.19–0.78]) versus primiparous had lower odds of SBW.

Conclusion

In Ethiopia, during the survey period, there was an increment in prevalence of SBW, and maternal related factors were significant determinants. Therefore, empowering mothers through education and improving the socioeconomic status of the household can be one strategy to reduce SBW.

Birthweight data completeness and quality in population-based surveys: EN-INDEPTH study

BACKGROUND

Low birthweight (< 2500 g) is an important marker of maternal health and is associated with neonatal mortality, long-term development and chronic diseases. Household surveys remain an important source of population-based birthweight information, notably Demographic and Health Surveys (DHS) and UNICEF's Multiple Indicator Cluster Surveys (MICS); however, data quality concerns remain. Few studies have addressed how to close these gaps in surveys.

METHODS

The EN-INDEPTH population-based survey of 69,176 women was undertaken in five Health and Demographic Surveillance System sites (Matlab-Bangladesh, Dabat-Ethiopia, Kintampo-Ghana, Bandim-Guinea-Bissau, IgangaMayuge-Uganda). Responses to existing DHS/MICS birthweight questions on 14,411 livebirths were analysed and estimated adjusted odds ratios (aORs) associated with reporting weighing, birthweight and heaping reported. Twenty-eight focus group discussions with women and interviewers explored barriers and enablers to reporting birthweight.

RESULTS

Almost all women provided responses to birthweight survey questions, taking on average 0.2 min to answer. Of all babies, 62.4% were weighed at birth, 53.8% reported birthweight and 21.1% provided health cards with recorded birthweight. High levels of heterogeneity were observed between sites. Home births and neonatal deaths were less likely to be weighed at birth (home births aOR 0.03(95%CI 0.02-0.03), neonatal deaths (aOR 0.19(95%CI 0.16-0.24)), and when weighed, actual birthweight was less likely to be known (aOR 0.44(95%CI 0.33-0.58), aOR 0.30(95%CI 0.22-0.41)) compared to facility births and post-neonatal survivors. Increased levels of maternal education were associated with increases in reporting weighing and knowing birthweight. Half of recorded birthweights were heaped on multiples of 500 g. Heaping was more common in IgangaMayuge (aOR 14.91(95%CI 11.37-19.55) and Dabat (aOR 14.25(95%CI 10.13-20.3) compared to Bandim. Recalled birthweights were more heaped than those recorded by card (aOR 2.59(95%CI 2.11-3.19)). A gap analysis showed large missed opportunity between facility birth and known birthweight, especially for neonatal deaths. Qualitative data suggested that knowing their baby's weight was perceived as valuable by women in all sites, but lack of measurement and poor communication, alongside social perceptions and spiritual beliefs surrounding birthweight, impacted women's ability to report birthweight.

CONCLUSIONS

Substantial data gaps remain for birthweight data in household surveys, even amongst facility births. Improving the accuracy and recording of birthweights, and better communication with women, for example using health cards, could improve survey birthweight data availability and quality.