Trends of proximate low birth weight and associations among children under-five years of age: Evidence from the 2016 Ethiopian demographic and health survey data

Birth weight and nutritional status in school-age children from Boane city, Mozambique

BACKGROUND

Birth weight is considered an important marker of inadequate maternal nutrition, and it is a critical indicator of the newborn's health and development.

OBJECTIVE

This study evaluated the influence of low birth weight (LBW) on body composition in 7-10-year-old school children from Boane City-Mozambique.

METHODS

A total of 220 children (female = 122 and male = 98) were divided into two groups according to their birth weight (LBW, n = 41; and normal birth weight, NBW, n = 179). Anthropometric indicators of nutritional status were analyzed by the indices weight-for-age, height-for-age, BMI-for-age, and weight-for-height.

RESULTS

LBW children showed reduced skinfolds, and weight-for-height when compared to NBW children. Birth weight was positively associated with all anthropometric variables, except for BMI, which was not associated with any other variable. The r2 value ranged from .09 (weight-for-age) to .72 (height-for-age). For body composition variables, older children had higher fat mass (β = .26; 95% CI = 0.05-0.48) and fat-free mass (β = 1.10; 95% CI = 0.71-1.48), and boys had lower fat percentage (β = -3.49; 95% CI = -4.35 to -2.65) and fat mass (β = -.92; 95% CI = -1.31 to -0.55) than girls. Birth weight was also positively associated with fat-free mass.

CONCLUSION

LBW seems to influence some growth indicators of children living in Boane, however, current environmental factors seem to weaken this association. Our results suggest that public policies involving healthy nutrition and physical activity can reverse the effects of low weight in children from Boane.

Development and evaluation of a kangaroo mother care implementation model in South Ethiopia

AIM

To develop a model for increasing the coverage of kangaroo mother care (KMC), which involved ≥8 h of skin-to-skin contact per day and exclusive breastfeeding, for small babies with birth weight < 2000 g in South Ethiopia.

METHODS

A mixed methods study was conducted between June 2017 and January 2019 at four hospitals and their catchment areas. Iterative cycles of implementation, program learning and evaluation were used to optimise KMC implementation models. The study explored the community-facility continuum of care and assessed the proportion of neonates with a birth weight less than 2000 g receiving effective KMC.

RESULTS

Three KMC implementation models were tested with Model 2 being the final version. This model included enhanced identification of home births, improved referral linkages, immediate skin-to-skin care initiation in facilities and early contact after discharge. These improvements resulted in 86% coverage of effective facility-based KMC initiation for eligible babies. The coverage was 81.5% at discharge and 57.5% 7 days after discharge. The mean age of babies at KMC initiation was 8.2 days (SD = 5.7).

CONCLUSION

The study found that the KMC implementation model was feasible and can lead to substantial population-level KMC coverage for small babies.

Prevalence and Factors Associated With Low Birth Weight in the Solomon Islands: Evidence From the 2015 Solomon Islands Demographic and Health Survey data

Low birth weight (LBW) has contributed to more than 80% of under-5 deaths worldwide, most occurring in low- and middle-income countries. We used the 2015 Solomon Islands Demographic and Health Survey data to identify the prevalence and risks associated with LBW in the Solomon Islands. Low birth weight prevalence estimated was 10%. After adjustment for potential confounders, we found the risk of LBW for women with a history of marijuana and kava use was 2.6 times, adjusted relative risk (aRR) 2.64 at a 95% confidence interval [0.64, 10.95] and 2.5 times [aRR: 2.50 (0.63, 9.88)] than among unexposed women, respectively. Polygamous relationship, no antenatal care, decision-making by another person were 84% [aRR: 1.84 (1.15, 2.93)], 73% [aRR: 1.73 (0.96, 3.13)], and 73% [aRR: 1.73 (0.96, 3.13)] than among unexposed women, respectively. We also found that 10% and 4% of LBW cases in the Solomon Islands were attributable to a household of more than 5 members and tobacco and cigarette use history. We concluded that LBW in the Solomon Islands relied more on behavioral risk factors, including substance use and health and social risk factors. We recommended further study on kava use and its impact on pregnancy and LBW.

Policy to Decrease Low Birth Weight in Indonesia: Who Should Be the Target?

The study aimed to analyze the target of the policy to decrease low birth weight (LBW) in Indonesia. This cross-sectional study used a sample of live births in last five years preceding the survey of birth weight. Data collection took place from July to September 2017. The weighted sample size was 17,848 participants. The variables analyzed included residence, age, marital status, education, employment, parity, and wealth. The study employed binary logistic regression in the final stage to determine the target of policy regarding LBW. The results showed that women in urban areas were 1.200 times more likely to deliver babies with LBW than women in rural areas. All age groups were less likely to deliver babies with LBW than those aged 45-49. The study also found all marital statuses had a lower likelihood of providing babies with LBW than those who had never been in a marriage. Women of all education levels had a greater risk of giving birth to babies with LBW than women with higher education levels. Unemployed women had 1.033 times more chances of delivering babies with LBW than employed women. Primiparous women were 1.132 times more likely to give birth to babies with LBW than multiparous women. Overall, the women in all wealth status categories had a higher probability of delivering babies with LBW than the wealthiest groups. The study concluded that policymakers should target women who live in urban areas, are old, have never been married, have low education, and are unemployed, primiparous, and poor to decrease LBW cases in Indonesia.

Secular trends of birth weight and its associations with obesity and hypertension among Southern Chinese children and adolescents

OBJECTIVES

The association of low or high birth weight (L/HBW) with obesity and hypertension in childhood remains unclear. We aimed to identify the secular trend of birth weight distribution and its relationship to obesity and hypertension in Southern Chinese children and adolescents.

METHODS

6,561 individuals (6-17-year-old) were enrolled by multistage cluster sampling to observed the trend of birth weight distribution and its associated factors. 1,218 were further selected by group matching to investigate the correlation between birth weight and obesity or hypertension.

RESULTS

Between 1997 and 2008, a significant decline in the LBW rate and no significant change in the HBW rate was found. LBW was associated with maternal BMI<18 kg/m² (OR1.79, 95% CI 1.08-2.97) during pregnancy, while maternal BMI between 25.0 and 27.9 kg/m² (OR1.62, 95% CI 1.04-2.52) and paternal BMI>28 kg/m² (OR1.64, 95% CI 1.02-2.63) during pregnancy were associated with HBW. The prevalence of obesity was significantly higher with HBW than normal birth weight (NBW) or LBW (16.73, 6.25 and 5.50%, respectively). The prevalence rates of suspected hypertension were 1.62, 1.25 and 1.49% among LBW, NBW and HBW, respectively (p>0.05). LBW decreased the risks of childhood overweight (OR0.31, 95% CI 0.18-0.54), but had no effect on suspected hypertension. HBW increased the risks of childhood obesity (OR2.19, 95% CI 1.50-3.20), but decreased the risks of suspected hypertension (OR0.22, 95% CI 0.09-0.58).

CONCLUSIONS

HBW was positively associated with childhood obesity, and parental BMIs management might be one of the measurements to control birth weight to lessen childhood obesity.

The effect of maternal anaemia on low birth weight among newborns in Northwest Ethiopia

Low birth weight is an indicator of maternal-related multifactorial problems such as malnutrition, illness, and work overload. As a result, low birth weight is associated with maternal anaemia, and both of them were significant public health issues in developing nations. Low birth weight and anaemia are caused by insufficient nutrient intake, which is especially severe during pregnancy. So, this study aimed to assess the effect of maternal anaemia during the late trimester on low birth weight among newborns in Northwest Ethiopia. A systematic random sampling technique was used to select 211 participants for the primary data collection. Face-to-face interviews were used to collect data, while blood samples were collected using standard operating procedures. For further analysis, the data file was imported into Stata version 16 (MP) software. The binary logistic regression model was used to investigate significant factors related to low birth weight. Finally, the statistical significance of the variables was determined using a p value of ≤ 0.05. The prevalence of anaemia among pregnant women in the late trimester and newborns was 34 (16.11%, 95% CI: 11.42, 21.78) and 64 (30.33%, 95% CI: 24.20, 37.01), respectively. The mean ± standard deviation of the newborn babies' weight was 3.19 ± 0.49 kg. The proportion of low birth weight among newborns was 26 (12.32%, 95% CI: 8.20, 17.53%). The independent effect of anaemia on low birth weight was 4.19 times while all other factors were constant (COR = 4.19, 95% CI: 1.70, 10.30). Maternal educational status [unable to read and write (AOR = 10.94, 95% CI: 1.74, 68.58) and attained secondary education (AOR = 8.06, 95% CI: 1.53, 42.36)], and maternal anaemia (AOR = 3.51, 95% CI: 1.29, 9.55) were associated with low birth weight after adjusting with all other variables. In this study, the proportion of low birth weight was high. Here, maternal anaemia alone had a significant independent role in the development of low birth weight. Maternal education status and anaemic conditions were associated with low birth weight among newborns. Early detection and treatment of maternal anaemia during pregnancy is crucial with the usual nutritional-related care.

Machine learning algorithms for predicting low birth weight in Ethiopia

Background

Birth weight is a significant determinant of the likelihood of survival of an infant. Babies born at low birth weight are 25 times more likely to die than at normal birth weight. Low birth weight (LBW) affects one out of every seven newborns, accounting for about 14.6 percent of the babies born worldwide. Moreover, the prevalence of LBW varies substantially by region, with 7.2 per cent in the developed regions and 13.7 per cent in Africa, respectively. Ethiopia has a large burden of LBW, around half of Africa. These newborns were more likely to die within the first month of birth or to have long-term implications. These are stunted growth, low IQ, overweight or obesity, developing heart disease, diabetes, and early death. Therefore, the ability to predict the LBW is the better preventive measure and indicator of infant health risks.

Method

This study implemented predictive LBW models based on the data obtained from the Ethiopia Demographic and Health Survey 2016. This study was employed to compare and identify the best-suited classifier for predictive classification among Logistic Regression, Decision Tree, Naive Bayes, K-Nearest Neighbor, Random Forest (RF), Support Vector Machine, Gradient Boosting, and Extreme Gradient Boosting.

Results

Data preprocessing is conducted, including data cleaning. The Normal and LBW are the binary target category in this study. The study reveals that RF was the best classifier and predicts LBW with 91.60 percent accuracy, 91.60 percent Recall, 96.80 percent ROC-AUC, 91.60 percent F1 Score, 1.05 percent Hamming loss, and 81.86 percent Jaccard score.

Conclusion

The RF predicted the occurrence of LBW more accurately and effectively than other classifiers in Ethiopia Demographic Health Survey. Gender of the child, marriage to birth interval, mother’s occupation and mother’s age were Ethiopia’s top four critical predictors of low birth weight in Ethiopia.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12911-022-01981-9.

Perinatal mortality and its predictors in Kersa Health and Demographic Surveillance System, Eastern Ethiopia: population-based prospective study from 2015 to 2020

OBJECTIVE

Perinatal mortality is an important outcome indicator for newborn care and directly mirrors the quality of prenatal, intra partum and newborn care. Therefore, this study was aimed at estimating perinatal mortality and its predictors in Eastern Ethiopia using data from Kersa Health and Demographic Surveillance System (KHDSS).

DESIGN, SETTINGS AND PARTICIPANTS

An open dynamic cohort design was employed among pregnant women from 2015 to 2020 at KHDSS. A total of 19 687 women were observed over the period of 6 years, and 29 719 birth outcomes were registered.

OUTCOME MEASURES

Perinatal mortality rate was estimated for each year of cohort and the cumulative of 6 years. Predictors of perinatal mortality are identified.

RESULTS

From a total of 29 306 births 783 (26.72 deaths per 1000 births; 95% CI 24.88 to 28.66) deaths were occurred during perinatal period. Rural residence (adjusted OR (AOR)=3.43; 95% CI 2.04 to 5.76), birth weight (low birth weight, AOR=3.98; 95% CI 3.04 to 5.20; big birth weight, AOR=2.51; 95% CI 1.76 to 3.57), not having antenatal care (ANC) (AOR=1.67; 95% CI 1.29 to 2.17) were associated with higher odds of perinatal mortality whereas the parity (multipara, AOR=0.46; 95% CI 0.34 to 0.62; grand multipara, AOR=0.31; 95% CI 0.21 to 0.47) was associated with lower odds of perinatal mortality.

CONCLUSIONS

The study revealed relatively high perinatal mortality rate. Place of residence, ANC, parity and birth weight were identified as predictors of perinatal mortality. Devising strategies that enhance access to and utilisations of ANC services with due emphasis for rural residents, primipara mothers and newborn with low and big birth weights may be crucial for reducing perinatal mortality.

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.

Survival Status and Predictors of Mortality Among Low Birthweight Neonates Admitted in Amhara Region Referral Hospitals of Ethiopia: Retrospective Follow-Up Study

Background

Being born with low birthweight is a major determinant of perinatal, neonatal, and infant survival. Even though low birthweight-related neonatal mortality is high, there is an information gap regarding the survival status of low birthweight neonates and their predictors of mortality in Ethiopia.

Objective

This study was conducted to assess the survival status and predictors of mortality among low birthweight neonates admitted to Amhara region referral hospitals in Ethiopia.

Methods and Materials

A retrospective follow-up study was conducted on randomly selected low birthweight neonates admitted to the Amhara region referral hospital between January 01-2017 and December 30-2018. Data were entered into Epi-data 4.4.2.1 and exported to Stata 14 for cleaning and analysis. A cox regression model was used to analyze the data. Tables, charts, and text were used to report the results.

Results

This study revealed that 35.2% of participants died with incidence rates of 37.86 per 1000 person-day observations (95%CI: 31.79-45.10). Sepsis (AHR:1.72(95% CI: 1.05-2.81), respiratory distress (AHR: 2.03 (95% CI:1.36-3.03), necrotizing enterocolitis (AHR: 2.47 (95% CI: 1.17-5.20), congenital anomalies (AHR:2.37 (95% CI: 1.36-4.13), extreme low birth weight (AHR:2.62 (95% CI:1.54-4.44) and prematurity (AHR: 2.55 (95% CI:1.10-5.92) were independent predictors of mortality.

Conclusion

Sepsis, respiratory distress, necrotizing enterocolitis, congenital anomalies, extremely low birth weight, and premature birth were the independent predictors of mortality. Therefore, it is better for all stakeholders to focus more on the early diagnosis and management of low birth weight neonates with the factors associated with mortality.