Mother's perception of size at birth is a weak predictor of low birth weight: Evidence from Nepal Demographic and Health Survey

Accuracy of Mothers' Perception of Birth Size to Predict Birth Weight Data in Bangladesh

OBJECTIVES

The prevalence of low birth weight (LBW) is an important indicator of child health and wellbeing. However, in many countries, decisions regarding care and treatment are often based on mothers' perceptions of their children's birth size due to a lack of objective birth weight data. Additionally, birth weight data that is self-reported or recorded often encounters the issue of heaping. This study assesses the concordance between the perceived birth size and the reported or recorded birth weight. We also investigate how the presence of heaped birth weight data affects this concordance, as well as the relationship between concordance and various sociodemographic factors.

METHODS

We examined 4,641 birth records reported in the 2019 Bangladesh Multiple Indicator Cluster Survey. The sensitivity-specificity analysis was performed to assess perceived birth size's ability to predict LBW, while Cohen's Kappa statistic assessed reliability. We used the kernel smoothing technique to correct heaping of birth weight data, as well as a multivariable multinomial logistic model to assess factors associated with concordance.

RESULTS

Maternally-perceived birth size exhibited a low sensitivity (63.5%) and positive predictive value (52.6%) for predicting LBW, but a high specificity (90.1%) and negative predictive value (93.4%). There was 86.1% agreement between birth size and birth weight-based classifications (Kappa = 0.49, indicating moderate agreement). Smoothed birth weight data did not improve agreement (83.4%, Kappa = 0.45). Of the sociodemographic factors, early marriage was positively associated with discordance (i.e., overestimation).

CONCLUSIONS

An important consideration when calculating the LBW prevalence is that maternally perceived birth size is not an optimal proxy for birth weight. Focus should be placed on encouraging institutional births and educating community health workers and young mothers about the significance of measuring and recording birth weight.

Synergistic associations of antenatal care visits and iron-folic acid supplementation with low birth weight: a pooled analysis of national surveys from six south Asian countries

BACKGROUND

The prevalence of low birth weight (LBW) has remained high (24.9%) in the South Asian region with a significant impact on newborn survival. This region bears nearly 40% of global burden of LBW. While antenatal care (ANC) and iron-folic acid supplementation independently have been considered effective for improving maternal and newborn outcomes, the evidence on the combined effect of these two supplements on LBW is lacking. This study aimed to examine the synergistic association of ANC and iron-folic acid supplementation on LBW in the South Asian region using pooled data from six South Asian countries.

METHODS

Nationally representative surveys from Nepal, India, Bangladesh, Pakistan, Maldives, and Afghanistan were included in the study. Birth weight and the prevalence of LBW for singleton last-born children were reported using descriptive statistics. The association between LBW and ANC visits and the interaction between iron-folic acid consumption and ANC were examined using multiple logistic regression.

RESULTS

The mean birth weight in the region was 2841.8 g with an LBW prevalence of 17.1%. Country-specific prevalence ranged from 11.4% in Nepal to 22.4% in Pakistan. Not attending ANC visits (adjusted odds ratio (AOR): 1.24; 95% confidence interval (CI): 1.16, 1.34) and not consuming iron-folic acid (AOR: 1.14; 95% CI: 1.08, 1.21) were significantly associated with a higher likelihood of LBW. Furthermore, jointly, having < 4 ANC visits and < 180 days of iron-folic acid supplementation was associated with a higher likelihood (AOR: 1.29; 95% CI: 1.22, 1.36) of having LBW compared to those who had  ≥ 4 ANC visits and ≥ 180 days of iron-folic acid consumption after controlling for key confounding factors.

CONCLUSIONS

The current study provides important evidence on the synergy between ANC visits and iron-folic acid consumption during pregnancy to capitalize on the existing national maternal health programs in the South Asian region, including low-and middle-income countries for positive foetal outcomes.

Accuracy of Syrain Refugee Mothers' Perceptions of Newborn's Birth Size: Insights from a National Survey in Turkey

This study aims to assess the accuracy of maternally perceived birth size and its associated factors among the Syrian refugees in Turkey, using the data from 2018 Turkey Demographic and Health Survey Syrian Migrant Sample (TDHS-SM-18). The study includes information on the last-born child, singleton pregnancies, births in healthcare facilities, children under 5 living with their mothers, with recorded birth weight (n = 969). The study categorizes the mother's perception of size into three groups : compatible, overestimated, and underestimated. Various factors, including sociodemographic characteristics, financial aspects, maternal characteristics, and child characteristics, are considered as explanatory variables. The analysis employs a complex sample multiple logistic regression model. The findings reveal that the majority of mothers accurately perceive the birth size, but 17.1% of them do not. Maternal factors such as region of residence, literacy, occupation, age at birth, and child factors such as birth order, birth interval, gender, and birth weight are identified as associated factors with maternal misperception. This study provides valuable insights into the accuracy of maternally perceived birth size and sheds light on the factors influencing this perception among Syrian refugee mothers in Turkey.