1
|
Tikmani SS, Mårtensson T, Roujani S, Feroz AS, Seyfulayeva A, Mårtensson A, Brown N, Saleem S. Exploring gestational age, and birth weight assessment in Thatta district, Sindh, Pakistan: Healthcare providers' knowledge, practices, perceived barriers, and the potential of a mobile app for identifying preterm and low birth weight. PLoS One 2024; 19:e0299395. [PMID: 38603767 PMCID: PMC11008874 DOI: 10.1371/journal.pone.0299395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 02/09/2024] [Indexed: 04/13/2024] Open
Abstract
INTRODUCTION Reliable methods for identifying prematurity and low birth weight (LBW) are crucial to ending preventable deaths in newborns. This study explored healthcare providers' (HCPs) knowledge, practice, perceived barriers in assessing gestational age and birth weight and their referral methods for preterm and LBW infants. The study additionally assessed the potential of using a mobile app for the identification and referral decision of preterm and LBW. METHODS This qualitative descriptive study was conducted in Thatta District, Sindh, Pakistan. Participants, including doctors, nurses, lady health visitors, and midwives, were purposefully selected from a district headquarter hospital, and private providers in the catchment area of Global Network's Maternal and Newborn Health Registry (MNHR). Interviews were conducted using an interview guide after obtaining written informed consent. Audio recordings of the interviews were transcribed and analyzed using NVIVO® software with an inductive approach. RESULTS The HCPs had extensive knowledge about antenatal and postnatal methods for assessing gestational age. They expressed a preference for antenatal ultrasound due to the perceived accuracy, though accept practical barriers including workload, machine malfunctions, and cost. Postnatal assessment using the Ballard score was only undertaken sparingly due to insufficient training and subjectivity. All HCPs preferred electronic weighing scales for birth weight Barriers encountered included weighing scale calibration and battery issues. There was variation in the definition of prematurity and LBW, leading to delays in referral. Limited resources, inadequate education, and negative parent past experiences were barriers to referral. Foot length measurements were not currently being used. While mobile apps are felt to have potential, unreliable electricity supply and internet connectivity are barriers. CONCLUSION The HCPs in this study were knowledgeable in terms of potential tools, but acknowledged the logistical and parental barriers to implementation.
Collapse
Affiliation(s)
- Shiyam Sunder Tikmani
- Department of Women’s & Children’s Health, Global Health & Migration Unit, Uppsala University, Uppsala, Sweden
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Thomas Mårtensson
- Department of Women’s & Children’s Health, Global Health & Migration Unit, Uppsala University, Uppsala, Sweden
| | - Sana Roujani
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Anam Shahil Feroz
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada
| | - Ayshe Seyfulayeva
- National School of Public Health, The NOVA University of Lisbon, Lisbon, Portugal
| | - Andreas Mårtensson
- Department of Women’s & Children’s Health, Global Health & Migration Unit, Uppsala University, Uppsala, Sweden
| | - Nick Brown
- Department of Women’s & Children’s Health, Global Health & Migration Unit, Uppsala University, Uppsala, Sweden
| | - Sarah Saleem
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| |
Collapse
|
2
|
Maniragaba VN, Atuhaire LK, Rutayisire PC. Modeling the Risk Factors of Undernutrition among Children below Five Years of Age in Uganda Using Generalized Structural Equation Models. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1926. [PMID: 38136128 PMCID: PMC10742231 DOI: 10.3390/children10121926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 12/24/2023]
Abstract
INTRODUCTION The prevalence of undernutrition among children below five years of age, in Uganda and the world over, remains very high. About 45% of all global deaths among children below five years of age are attributed to undernutrition. A number of studies using different statistical approaches affirm this effect, yet some factors indicate the influence of other factors within the system. This study, therefore, uses a method that demonstrates how different variables feed into each other. AIM The aim of this study was to establish the major factors associated with an increased likelihood of undernutrition and the paths showing how these risk factors influence undernutrition. METHODS Data from the Uganda Demographic and Health Survey (UDHS, 2016) were used for this study. A sample of 4530 children, whose age, height, and weight measurements were recorded, was considered for this study. Additionally, the study used generalized structural equation models to identify the multifaceted natures and paths of the risk factors that influence undernutrition among children below five years of age. The study relied on the UNICEF 2020 conceptual framework to identify and analyze the direct and indirect effects of these risk factors of undernutrition. RESULTS From the perspective of a male child, having a perceived small size at birth, a low birth weight, being breastfed for less than 6 months, having no formal education from mothers, limited income-generating opportunities, a low wealth status, and notable episodes of diarrhea were among the key factors associated with an increased likelihood of undernutrition. The identified paths were as follows: (i) Having no education, as this was associated with limited working opportunities and a low income, which increases the likelihood of low household wealth status, hence increasing the chances of undernutrition. (ii) Exposure to a rural setting was associated with an increased likelihood of undernutrition through association with poor and or low employment levels within the rural areas. (iii) A shorter duration of breastfeeding was associated with children in urban areas, resulting in an increased likelihood of undernutrition. (iv) Children aged between 6 and 47 months had a higher likelihood of undernutrition. CONCLUSIONS An approach that addresses and recognizes all these factors at different levels, along the established paths, should be implemented to effectively reduce undernutrition among children below five years of age.
Collapse
Affiliation(s)
- Vallence Ngabo Maniragaba
- African Center of Excellence in Data Science, College of Business and Economic, University of Rwanda, Kigali P.O. Box 3248, Rwanda;
| | - Leonard K. Atuhaire
- School of Statistical Methods, College of Management Sciences, Makerere University, Kampala P.O. Box 7072, Uganda;
| | - Pierre Claver Rutayisire
- African Center of Excellence in Data Science, College of Business and Economic, University of Rwanda, Kigali P.O. Box 3248, Rwanda;
| |
Collapse
|
3
|
Diamond-Smith NG, Epstein A, Zlatnik MG, Treleaven E. The association between timing in pregnancy of drought and excess rainfall, infant sex, and birthweight: Evidence from Nepal. Environ Epidemiol 2023; 7:e263. [PMID: 37840861 PMCID: PMC10569756 DOI: 10.1097/ee9.0000000000000263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/26/2022] [Accepted: 06/26/2023] [Indexed: 10/17/2023] Open
Abstract
Background Past research on the impact of climatic events, such as drought, on birth outcomes has primarily been focused in Africa, with less research in South Asia, including Nepal. Existing evidence has generally found that drought impacts birthweight and infant sex, with differences by trimester. Additionally, less research has looked at the impact of excess rain on birth outcomes or focused on the impact of rainfall extremes in the preconception period. Using data from a large demographic surveillance system in Nepal, combined with a novel measure of drought/excess rainfall, we explore the impact of these on birthweight by time in pregnancy. Methods Using survey data from the 2016 to 2019 Chitwan Valley Study in rural Nepal combined with data from Climate Hazards InfraRed Precipitation with Station, we explored the association between excess rainfall and drought and birthweight, looking at exposure in the preconception period, and by trimester of pregnancy. We also explore the impact of excess rainfall and drought on infant sex and delivery with a skilled birth attendant. We used multilevel regressions and explored for effect modification by maternal age. Results Drought in the first trimester is associated with lower birthweight (β = -82.9 g; 95% confidence interval [CI] = 164.7, -1.2) and drought in the preconception period with a high likelihood of having a male (odds ratio [OR] = 1.41; 95% CI = 1.01, 2.01). Excess rainfall in the first trimester is associated with high birthweight (β = 111.6 g; 95% CI = 20.5, 202.7) and higher odds of having a male (OR = 1.48; 95% CI = 1.02, 2.16), and in the third trimester with higher odds of low birth weight (OR = 2.50; 95% CI = 1.40, 4.45). Conclusions Increasing rainfall extremes will likely impact birth outcomes and could have implications for sex ratios at birth.
Collapse
Affiliation(s)
- Nadia G. Diamond-Smith
- Department of Epidemiology and Biostatistics and Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California
| | - Adrienne Epstein
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
| | - Marya G. Zlatnik
- Division of Maternal Fetal Medicine, Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology, & Reproductive Sciences, University of California, San Francisco, San Francisco, California
| | - Emily Treleaven
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| |
Collapse
|
4
|
Adjei-Gyamfi S, Musah B, Asirifi A, Hammond J, Aryee PA, Miho S, Aiga H. Maternal risk factors for low birthweight and macrosomia: a cross-sectional study in Northern Region, Ghana. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:87. [PMID: 37644518 PMCID: PMC10464333 DOI: 10.1186/s41043-023-00431-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 08/14/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Abnormal birthweights are critical public health challenges accountable for most non-communicable diseases and perinatal mortalities. Regardless of the myriad of mixed evidence on maternal factors responsible for abnormal birthweight globally, most of these findings are attained from urban and rural settings. This study serves as one of the key pieces of evidence in view of the increasing prevalence of abnormal birthweight particularly in some parts of semi-rural Ghana. The study, therefore, aims to estimate the prevalence of abnormal birthweight and identify some possible maternal risk factors for abnormal birthweight in Northern Ghana. METHODS A retrospective cross-sectional study was conducted in Savelugu municipality from February-March 2022. A total of 356 mothers aged 16-46 years, having a neonate and attending postnatal care service, were recruited as study participants. Data were collected from maternal and child health record books and through structured interviews. To identify the maternal risk factors for abnormal birthweight, chi-square/Fischer's exact test and multinomial logistic regression were employed as bivariate and multivariate analyses, respectively, at 95% confidence level. RESULTS Prevalence rates of low birthweight and macrosomia were 22.2% and 8.7%, respectively. Maternal anaemia in first trimester (AOR 3.226; 95% CI 1.372-7.784) and third trimester (AOR 23.94; 95% CI 7.442-70.01) of gestation was strong predictors for low birthweight. Mothers belonging to minority ethnic groups (AOR 0.104; 95% CI 0.011-0.995); mothers who had ≥ 8 antenatal care visits (AOR 0.249; 95% CI 0.103-0.602); and mothers having neonates whose birth length > 47.5 cm (AOR 0.271; 95% CI 0.113-0.651) had reduced odds for low birthweight. Alternatively, mothers with gestational weeks ≥ 42 (AOR 23.21; 95% CI 4.603-56.19) and mothers from the richest households (highest socioeconomic homes) (AOR 14.25; 95% CI 1.638-23.91) were more likely to birth to macrosomic infants. CONCLUSION The prevalence rates of low birthweight and macrosomia were relatively high. Anaemia in the first and third trimesters was strong determinants of low birthweight. Being minority ethnic group, frequency of antenatal visits, and childbirth length reduced the risk of low-weight births. Advanced gestational age and socioeconomic status of mothers were also predictors of macrosomia. Hence, nutrition counselling, community health education, and promotion of lifestyle improvement coupled with strengthening of health service delivery are recommended interventions.
Collapse
Affiliation(s)
- Silas Adjei-Gyamfi
- School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4, Sakamoto, Nagasaki City, 852-8523, Japan.
- Savelugu Municipal Hospital, Ghana Health Service, P.O. Box 45, Savelugu, Northern Region, Ghana.
| | - Bashiru Musah
- Savelugu Municipal Hospital, Ghana Health Service, P.O. Box 45, Savelugu, Northern Region, Ghana
| | - Abigail Asirifi
- Seventh Day Adventist Hospital, Christian Health Association of Ghana, P.O. Box 24, Wiamoase, Ashanti Region, Ghana
| | - John Hammond
- Central Regional Health Directorate, Ghana Health Service, P.O. Box 63, Cape Coast, Central Region, Ghana
| | - Paul Armah Aryee
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, P.O. Box TL 1883, Tamale, Northern Region, Ghana
| | - Sato Miho
- School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4, Sakamoto, Nagasaki City, 852-8523, Japan
| | - Hirotsugu Aiga
- School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4, Sakamoto, Nagasaki City, 852-8523, Japan
| |
Collapse
|
5
|
Engdaw GT, Tesfaye AH, Feleke M, Negash A, Yeshiwas A, Addis W, Angaw DA, Engidaw MT. Effect of antenatal care on low birth weight: a systematic review and meta-analysis in Africa, 2022. Front Public Health 2023; 11:1158809. [PMID: 37441651 PMCID: PMC10335749 DOI: 10.3389/fpubh.2023.1158809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/25/2023] [Indexed: 07/15/2023] Open
Abstract
Background Risk identification, as well as the prevention and management of diseases associated with pregnancy or other conditions that may occur concurrently, is the essential component of ANC. Method The observational follow-up and cross-sectional studies on the effect of antenatal care on low birth weight in Africa were conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Five computerized bibliographic databases: Google Scholar, PubMed, Scopus, Cochrane Library, and Hinari Direct were searched for published studies written in English till May 2022. The risk of bias assessment tools developed by the Joanna Briggs Institute for cross-sectional and observational follow-up research was used, and the caliber of each included study was assessed. Seven papers were included, with a total of 66,690 children participating in the study. Results Seven studies met the selection criteria. Prenatal care and low birth weight were linked in four of the seven studies included in the review. The pooled odd ratio for low birth weight in the random-effects model was 0.46 (95% CI: 0.39, 0.53). The pooled odds ratio for low birth weight was 0.21 (95% CI: 0.19, 0.22) and 0.21 (95% CI: 0.19, 0.22), respectively, among pregnant women who had no antenatal care follow-up and those who had antenatal care follow up. Conclusion Women who attended at least one antenatal care appointment were more likely than their counterparts to have a baby of normal weight. Interventions to reduce low birth weight in Africa should focus on providing adequate antenatal care and quality healthcare services to women with low socioeconomic status.
Collapse
Affiliation(s)
- Garedew Tadege Engdaw
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Amensisa Hailu Tesfaye
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Maru Feleke
- Amhara Regional Health Beauro, Wogera Primary Hospital, Northwest, Ethiopia
| | - Aragaw Negash
- Amhara Regional Health Beauro, Wogera Primary Hospital, Northwest, Ethiopia
| | - Amanuel Yeshiwas
- Amhara Regional Health Beauro, Wogera Primary Hospital, Northwest, Ethiopia
| | - Wabiw Addis
- Amhara Regional Health Beauro, Wogera Primary Hospital, Northwest, Ethiopia
| | - Dessie Abebaw Angaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melaku Tadege Engidaw
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| |
Collapse
|
6
|
Sindiani A, Awadallah E, Alshdaifat E, Melhem S, Kheirallah K. The relationship between maternal health and neonatal low birth weight in Amman, Jordan: a case-control study. J Med Life 2023; 16:290-298. [PMID: 36937486 PMCID: PMC10015569 DOI: 10.25122/jml-2022-0257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 01/30/2023] [Indexed: 03/21/2023] Open
Abstract
This study aimed to examine the relationship between maternal health during pregnancy and low birth weight (LBW), as well as the impact of COVID-19 on the socio-economic status of pregnant women and its effect on LBW. The study was conducted in Amman, Jordan, and included 2260 mothers who visited Abu-Nusair comprehensive health center between January and December 2020. A matched case-control design was used with 72 cases and 148 controls selected for data collection through medical records and face-to-face interviews. Results showed that factors such as a monthly income of 400 JD or less, living with an extended family, exposure to passive smoking, maternal weight gain of 6-10 kg, maternal anemia, maternal hypertension, delivery by cesarean section, and previous history of LBW newborns were positively associated with an increased risk of LBW. Conversely, factors such as a monthly income above 700 JD, living with a core family, daily intake of iron, calcium, and vitamin D, prenatal visits, healthy food intake, and planning for pregnancy were associated with a lower risk of LBW. COVID-19 infection and its effects on work, family finances, antenatal care visits, and food supply were also positively linked with LBW. In conclusion, socioeconomic status, maternal health, COVID-19, and its impacts were significant risk factors for LBW.
Collapse
Affiliation(s)
- Amer Sindiani
- Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
- Corresponding Author: Amer Sindiani, Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan. E-mail:
| | - Ekram Awadallah
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Eman Alshdaifat
- Department of Obstetrics and Gynecology, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Shatha Melhem
- Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Khalid Kheirallah
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| |
Collapse
|
7
|
Toolan M, Barnard K, Lynch M, Maharjan N, Thapa M, Rai N, Lavender T, Larkin M, Caldwell DM, Burden C, Manandhar DS, Merriel A. A systematic review and narrative synthesis of antenatal interventions to improve maternal and neonatal health in Nepal. AJOG GLOBAL REPORTS 2022; 2:100019. [PMID: 35252905 PMCID: PMC8883503 DOI: 10.1016/j.xagr.2021.100019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
8
|
Mishra PS, Sinha D, Kumar P, Srivastava S, Bawankule R. Newborn low birth weight: do socio-economic inequality still persist in India? BMC Pediatr 2021; 21:518. [PMID: 34798861 PMCID: PMC8603541 DOI: 10.1186/s12887-021-02988-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 11/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The incidence of preterm birth and subsequent low birth weight (LBW) are vital global public health issues. It contributes to high infant and child mortality in the early stages of life and later on in adult life; it increases the risk for non-communicable diseases. The study aims to understand the socio-economic status-related inequality for LBW among children in India. It hypothesises that there is no association between the socio-economic status of the household and the newborn's LBW in India. METHODS The study utilised data from the fourth round of the National Family Health Survey, a national representative cross-sectional survey conducted in 2015-16 (N = 127,141). The concentration index (CCI) and the concentration curve (CC) measured socio-economic inequality in low birth status among newborns. Wagstaff decomposition further analysed key contributors in CCI by segregating significant covariates. RESULTS About 18.2% of children had low birth weight status. The value of concentration was - 0.05 representing that low birth weight status is concentrated among children from lower socio-economic status. Further, the wealth quintile explained 76.6% of the SES related inequality followed by regions of India (- 44%) and the educational status of mothers (43.4%) for LBW among children in India. Additionally, the body mass index of the women (28.4%), ante-natal care (20.8%) and residential status (- 15.7%) explained SES related inequality for LBW among children in India. CONCLUSION Adequate attention should be given to the mother's nutritional status. Awareness of education and usage of health services during pregnancy should be promoted. Further, there is a need to improve the coverage and awareness of the ante-natal care (ANC) program. In such cases, the role of the health workers is of utmost importance. Programs on maternal health services can be merged with maternal nutrition to bring about an overall decline in the LBW of children in India.
Collapse
Affiliation(s)
- Prem Shankar Mishra
- Population Research Centre, Institute for Social and Economic Change, Bengaluru, Karnataka 560072 India
| | - Debashree Sinha
- Department of Development Studies, International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - Pradeep Kumar
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - Shobhit Srivastava
- Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| | - Rahul Bawankule
- Department of Public Health & Mortality Studies, International Institute for Population Sciences, Mumbai, Maharashtra 400088 India
| |
Collapse
|
9
|
Ahmed MS. Mapping the prevalence and socioeconomic predictors of low birth weight among Bangladeshi newborns: evidence from the 2019 Multiple Indicator Cluster Survey. Int Health 2021; 14:485-491. [PMID: 34347870 PMCID: PMC9450642 DOI: 10.1093/inthealth/ihab048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/27/2021] [Accepted: 07/22/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Low birth weight (LBW) remains a global concern for childhood morbidity and mortality. This study examined the socioeconomic factors associated with LBW among Bangladeshi newborns and drew a district-level prevalence map. METHODS Data were extracted from the 2019 Multiple Indicator Cluster Survey for Bangladesh. Multivariate logistic regression was used to identify the predictors of LBW. RESULTS The prevalence of LBW among Bangladeshi newborns was found to be 14.5%. Overall, the Eastern and South-Eastern regions had a higher burden of LBW. Mothers' educational status, mode of delivery, wealth index quintile of the household and area were identified as independent predictors of newborns' LBW. Mothers who completed primary and secondary education grades had a 1.6- and 1.3-fold higher possibility of having an LBW baby compared with those who completed higher secondary or higher educational grades (adjusted OR=1.62 and 1.32, 95% CI 1.21 to 2.18 and 1.06 to 1.65, respectively). Children belonging to the poorest households and residing in urban areas had a 1.4-fold higher likelihood of being LBW (p<0.05). CONCLUSIONS This study indicates that LBW is still highly prevalent in Bangladesh. Immediate public health action is required in the highly prevalent regions identified in this study.
Collapse
Affiliation(s)
- Md Sabbir Ahmed
- Department of Community Health and Hygiene, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Dumki, Patuakhali-8602, Bangladesh
| |
Collapse
|
10
|
Patel S, Verma NR, Padhi P, Naik T, Nanda R, Naik G, Mohapatra E. Retrospective analysis to identify the association of various determinants on birth weight. J Family Med Prim Care 2021; 10:496-501. [PMID: 34017777 PMCID: PMC8132747 DOI: 10.4103/jfmpc.jfmpc_1493_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/29/2020] [Accepted: 10/12/2020] [Indexed: 11/04/2022] Open
Abstract
Objectives: LBW is the strong determinant of neonatal morbidity and mortality with a global prevalence of nearly 15%. India's prevalence, though not yet established, ranges from 16-30% and influenced by maternal nutritional status, antenatal care and associated maternal morbidity. Hence, the study was aimed to determine the influencing parameters for occurrence of LBW. Study Design: A retrospective observational study conducted for all live newborns delivered in a tertiary care centre during the study period of twenty four months. Methods: Data from institutional medical record section was recorded on predesigned questionnaire from a total of 1216 newborns. Results: The percentage of LBW was found to be 27.55% (335/1216) with a proportion of LBW to NBW babies was approximately 1:3. The occurrence of LBW was significantly higher in babies of anemic mothers (59.39%, P < 0.0001), young mothers (30.39%, P < 0.01), mothers with parity ≥ 3 (35.71%, P < 0.05), those with <3 ANC check-up (56.88%, P < 0.0001) and those with premature delivery (71.57%, P < 0.0001). Maternal anemia (OR 4.7, 95%CI 3.4-6.7, P < 0.001); ANC with <3 visits (OR 2.2, 95%CI 1.4-3.4, P < 0.01) and prematurity (OR 7.6, 95%CI 5.1-11.2, P < 0.0001) were considered as independent risk factor for LBW. Significant association of neonatal complications was found with LBW babies (OR 1.6, 95%CI 1.1-2.5, P < 0.05). Conclusions: Inadequate antenatal care, maternal anemia and other maternal illness causing premature delivery are considered critical determinants for LBW and thus associated with high neonatal mortality and morbidity. Continued focus for improving the overall maternal health status would lead to lowering burden of LBW.
Collapse
Affiliation(s)
- Suprava Patel
- Associate Professor, Department of Biochemistry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Neha R Verma
- Senior Resident, Department of Biochemistry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Phalguni Padhi
- Assistant Professor, Department of Pediatrics, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Tripty Naik
- Assistant Professor, Department of Pediatrics, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Rachita Nanda
- Additional Professor, Department of Biochemistry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Gitismita Naik
- Senior Resident, Department of Community and Family Medicine, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Eli Mohapatra
- Professor, Department of Biochemistry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| |
Collapse
|
11
|
Wu T, Niu J, Yin X, Zhao C, Huang X, Wang X. China's antenatal care promoting early childhood development: evidence from a cross-sectional survey. Ann N Y Acad Sci 2021; 1493:90-101. [PMID: 33455003 DOI: 10.1111/nyas.14559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 12/05/2020] [Accepted: 12/17/2020] [Indexed: 11/30/2022]
Abstract
The Chinese government has established a three-tier maternal care system covering the entire country and providing integrated antenatal care (ANC) for pregnancies. This study aimed to analyze the direct and indirect effects of ANC services on early childhood development. A community-based cross-sectional survey was conducted for mothers' ANC visits and assessments of early childhood development in Shanxi and Guizhou provinces, China. A total of 1660 mother-child dyads were included in current analyses: 29.2% of mothers did not receive any ANC (ANC1), 23.3% of mothers received ANC three or fewer times (ANC2), and 47.5% of mothers received ANC four or more times (ANC3). Children whose mothers received ANC services had a significantly lower risk of overall developmental delay (OR = 0.60, 95% CI: 0.44-0.81 for ANC2; and OR = 0.44, 95% CI: 0.34-0.59 for ANC3) and social-emotional developmental delay (OR = 0.68, 95% CI: 0.49-0.94 for ANC3). Furthermore, a significant pathway relationship mediated by maternal depression and nurturing care was found between ANC and developmental delay. This study showed ANC services significantly reduced the risk of developmental delay in offspring. We also suggest that a nationwide ANC system can be a good delivery platform for scaled-up early childhood development interventions.
Collapse
Affiliation(s)
- Tianchen Wu
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Jieqiong Niu
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Xiaohan Yin
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Chunxia Zhao
- Section of Health, Nutrition, and Water, Environment and Sanitation, The United Nations Children's Fund in China Office, Beijing, China
| | - Xiaona Huang
- Section of Health, Nutrition, and Water, Environment and Sanitation, The United Nations Children's Fund in China Office, Beijing, China
| | - Xiaoli Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China.,Key Laboratory of Reproductive Health, National Health Commission, Beijing, China
| |
Collapse
|
12
|
Liyew AM, Sisay MM, Muche AA. Spatial distribution and factors associated with low birth weight in Ethiopia using data from Ethiopian Demographic and Health Survey 2016: spatial and multilevel analysis. BMJ Paediatr Open 2021; 5:e000968. [PMID: 34036183 PMCID: PMC8103935 DOI: 10.1136/bmjpo-2020-000968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 04/01/2021] [Accepted: 04/17/2021] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE This study aimed to assess the spatial distribution, individual and community-level factors associated with low birth weight in Ethiopia. METHOD Secondary data analysis was conducted using the 2016 Ethiopian Demographic and Health Survey data. A total of 2110 neonates were included in this study. Spatial autocorrelation analysis was conducted to assess the spatial clustering of LBW. Besides, the spatial scan statistics and ordinary kriging interpolation were done to detect the local level clusters and to assess predicted risk areas, respectively. Furthermore, a multilevel logistic regression model was fitted to determine individual and community-level factors associated with LBW. Finally, most likely clusters with log-likelihood ratio (LLR), relative risk and p value from spatial scan statistics and adjusted OR (AOR) with 95% CI for multilevel logistic regression model were reported. RESULTS LBW was spatially clustered in Ethiopia. Primary (LLR=11.57; p=0.002) clusters were detected in the Amhara region. Neonates within this spatial window had a 2.66 times higher risk of being LBW babies as compared with those outside the window. Besides, secondary (LLR=11.4; p=0.003; LLR=10.14, p=0.0075) clusters were identified at southwest Oromia, north Oromia, south Afar and southeast Amhara regions. Neonates who were born from severely anaemic (AOR=1.40, 95% CI (1.03 to 2.15)), and uneducated (AOR=1.90, 95% CI (1.23 to 2.93)) mothers, those who were born before 37 weeks of gestation (AOR=5.97, 95% CI (3.26 to 10.95)) and women (AOR=1.41, 95% CI (1.05 to 1.89)), had significantly higher odds of being LBW babies. CONCLUSION The high-risk areas of LBW were detected in Afar, Amhara and Oromia regions. Therefore, targeting the policy interventions in those hotspot areas and focusing on the improvement of maternal education, strengthening anaemia control programmes and elimination of modifiable causes of prematurity could be vital for reducing the LBW disparity in Ethiopia.
Collapse
Affiliation(s)
- Alemneh Mekuriaw Liyew
- Department of Epidemiology and Biostatistics, Institute of Public Health College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Malede Mequanent Sisay
- Department of Epidemiology and Biostatistics, Institute of Public Health College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Achenef Asmamaw Muche
- Department of Epidemiology and Biostatistics, Institute of Public Health College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
13
|
Spatial Pattern and Associated Factors of ANC Visits in Ethiopia: Spatial and Multilevel Modeling of Ethiopian Demographic Health Survey Data. Adv Prev Med 2020; 2020:4676591. [PMID: 32922999 PMCID: PMC7453231 DOI: 10.1155/2020/4676591] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 07/29/2020] [Accepted: 08/01/2020] [Indexed: 11/18/2022] Open
Abstract
Background Although there is an increase in having antenatal care (ANC), still many women lack recommended ANC contacts in Ethiopia. Therefore, this study was aimed at determining spatial patterns and associated factors of not having ANC visits using the Ethiopian Demographic and Health Survey (EDHS) 2016 data. Methods A two-stage stratified cluster sampling technique was employed based on EDHS data from January 18 to June 27, 2016. A total of 7,462 women were included in the study. ArcGIS version 10.7 software was used to visualize the spatial distribution. The Bernoulli model was applied using Kilduff SaTScan version 9.6 software to identify significant purely spatial clusters for not having ANC visits in Ethiopia. A multivariable multilevel logistic regression model was used to identify individual- and community-level determinants of not having antenatal care. Model comparison was checked using the likelihood test and goodness of fit was assessed by the deviance test. Results The primary clusters' spatial window was located in Somalia, Oromia, Afar, Dire Dawa, and Harari regions with the log-likelihood ratio (LLR) of 133.02, at p < 0.001 level of significance. In this study, Islam religion (adjusted odds ratio (AOR) = 0.7 with 95% confidence interval (CI) (0.52,0.96)), mother education being primary (AOR = 0.59, 95% CI (0.49,0.71)), distance from health facility being a big problem (AOR = 0.76, CI (0.65,0.89)), second birth order (AOR = 1.35, CI (1.03, 1.76)), richer wealth index (AOR = 0.65, CI (0.51,0.82)), rural residence (AOR = 2.38, CI (1.54,3.66)), and high community media exposure (AOR = 0.68, CI (0.52,0.89)) were determinants of not having antenatal care in Ethiopia. Conclusion The spatial distribution of ANC in Ethiopia is non-random. A higher proportion of not having ANC is found in northeast Amhara, west Benishangul Gumuz, Somali, Afar, north, and northeast SNNPR. On the other hand, a low proportion of not having ANC was found in Tigray, Addis Ababa, and Dire Dawa. In Ethiopia, not having antenatal care is affected by both individual- and community-level factors. Prompt attention by the Federal Ministry of Health is compulsory to improve ANC especially in rural residents, uneducated women, poor households, and regions like Oromia, Gambella, and Somalia.
Collapse
|
14
|
Bater J, Lauer JM, Ghosh S, Webb P, Agaba E, Bashaasha B, Turyashemererwa FM, Shrestha R, Duggan CP. Predictors of low birth weight and preterm birth in rural Uganda: Findings from a birth cohort study. PLoS One 2020; 15:e0235626. [PMID: 32658895 PMCID: PMC7357758 DOI: 10.1371/journal.pone.0235626] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 06/18/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Approximately 20.5 million infants were born weighing <2500 g (defined as low birthweight or LBW) in 2015, primarily in low- and middle-income countries (LMICs). Infants born LBW, including those born preterm (<37 weeks gestation), are at increased risk for numerous consequences, including neonatal mortality and morbidity as well as suboptimal health and nutritional status later in life. The objective of this study was to identify predictors of LBW and preterm birth among infants in rural Uganda. METHODS Data were derived from a prospective birth cohort study conducted from 2014-2016 in 12 districts across northern and southwestern Uganda. Birth weights were measured in triplicate to the nearest 0.1 kg by trained enumerators within 72 hours of delivery. Gestational age was calculated from the first day of last menstrual period (LMP). Associations between household, maternal, and infant characteristics and birth outcomes (LBW and preterm birth) were assessed using bivariate and multivariable logistic regression with stepwise, backward selection analyses. RESULTS Among infants in the study, 4.3% were born LBW (143/3,337), and 19.4% were born preterm (744/3,841). In multivariable analysis, mothers who were taller (>150 cm) (adjusted Odds Ratio (aOR) = 0.42 (95% CI = 0.24, 0.72)), multigravida (aOR = 0.62 (95% CI = 0.39, 0.97)), or with adequate birth spacing (>24 months) (aOR = 0.60 (95% CI = 0.39, 0.92)) had lower odds of delivering a LBW infant Mothers with severe household food insecurity (aOR = 1.84 (95% CI = 1.22, 2.79)) or who tested positive for malaria during pregnancy (aOR = 2.06 (95% CI = 1.10, 3.85)) had higher odds of delivering a LBW infant. In addition, in multivariable analysis, mothers who resided in the Southwest (aOR = 0.64 (95% CI = 0.54, 0.76)), were ≥20 years old (aOR = 0.76 (95% CI = 0.61, 0.94)), with adequate birth spacing (aOR = 0.76 (95% CI = 0.63, 0.93)), or attended ≥4 antenatal care (ANC) visits (aOR = 0.56 (95% CI = 0.47, 0.67)) had lower odds of delivering a preterm infant; mothers who were neither married nor cohabitating (aOR = 1.42 (95% CI = 1.00, 2.00)) or delivered at home (aOR = 1.25 (95% CI = 1.04, 1.51)) had higher odds. CONCLUSIONS In rural Uganda, severe household food insecurity, adolescent pregnancy, inadequate birth spacing, malaria infection, suboptimal ANC attendance, and home delivery represent modifiable risk factors associated with higher rates of LBW and/or preterm birth. Future studies on interventions to address these risk factors may be warranted.
Collapse
Affiliation(s)
- Jorick Bater
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Jacqueline M. Lauer
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts, United States of America
- USAID Feed the Future Innovation Lab for Nutrition at Tufts University, Boston, Massachusetts, United States of America
| | - Shibani Ghosh
- USAID Feed the Future Innovation Lab for Nutrition at Tufts University, Boston, Massachusetts, United States of America
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University, Boston, Massachusetts, United States of America
| | - Patrick Webb
- USAID Feed the Future Innovation Lab for Nutrition at Tufts University, Boston, Massachusetts, United States of America
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University, Boston, Massachusetts, United States of America
| | - Edgar Agaba
- USAID Feed the Future Innovation Lab for Nutrition at Tufts University, Boston, Massachusetts, United States of America
| | - Bernard Bashaasha
- Department of Agribusiness and Natural Resource Economics, Makerere University, Kampala, Uganda
| | | | - Robin Shrestha
- USAID Feed the Future Innovation Lab for Nutrition at Tufts University, Boston, Massachusetts, United States of America
| | - Christopher P. Duggan
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts, United States of America
- USAID Feed the Future Innovation Lab for Nutrition at Tufts University, Boston, Massachusetts, United States of America
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| |
Collapse
|
15
|
Bhattarai HK, Khanal P, Khanal V, Regmi K, Paudel NR, Dhakal L, Singh S. Factors associated with child health service delivery by female community health volunteers in Nepal: findings from a national survey. BMC Health Serv Res 2020; 20:561. [PMID: 32560690 PMCID: PMC7304139 DOI: 10.1186/s12913-020-05424-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 06/11/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nepal has made a significant improvement in child survival in the last few decades and the involvement of female community health volunteers (FCHVs) has been crucial in such achievement. While there have been many studies on child health in Nepal however, rarely explored the status and factors associated with the child health service provided by these volunteers. This study aimed to identify the factors associated with the child health service delivery by FCHVs. METHODS A national survey was conducted in 2014 in Nepal that included 4302 FCHVs using the structured questionnaire across the 13 geopolitical domains of the country. Factors associated with the use of child health services was examined using Chi-square test (χ2) followed by logistic regression. RESULTS Overall, 62.6% of FCHVs provided at least one child health service. Those FCHVs who utilized money from the FCHV fund, conducted health mothers' group meeting, involved in local committees and those who supported antenatal care and outreach clinics related activities had higher odds of providing child health services. Similarly, FCHVs equipped with the stock of Cotrimoxazole tablet, Zinc tablet, Oral Rehydration Salt packets were more likely to provide child health services. The province-wise analysis showed that FCHVs from Province 5 and Sudur Paschim Province were more likely to provide child health services compared to their counterparts from province 1. Technology-wise, FCHVs who were using mobile were more likely to provide child health services. CONCLUSIONS FCHVs are important human resource in providing child health services in Nepal. To improve child health service delivery by FCHVs; availability of key commodities, involvement of FCHVs in regular health mothers' group meeting, use of mobile phone, involvement in other public health programs and social networks, and utilization of the FCHV fund need to be taken into consideration.
Collapse
Affiliation(s)
- Hari Krishna Bhattarai
- JSI Research and Training Institute Inc., Kathmandu, Nepal
- Nepal Development Society, Bharatpur, Nepal
| | - Pratik Khanal
- Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | | | - Kiran Regmi
- Former Secretary of the Ministry of Health and Population, Principal Investigator of the FCHV survey 2014, Kathmandu, Nepal
| | | | | | | |
Collapse
|
16
|
Maternal folic acid supplementation and more prominent birth weight gain in twin birth compared with singleton birth: a cross-sectional study in northwest China. Public Health Nutr 2020; 23:2973-2982. [PMID: 32301402 DOI: 10.1017/s1368980019004580] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate the association of folic acid (FA) supplementation with birth weight, the risk of small for gestational age (SGA) and low birth weight (LBW) in singleton and twin pregnancy. DESIGN A population-based cross-sectional survey. SETTING Twenty counties and ten districts in Shaanxi Province of northwestern China, 2013. PARTICIPANTS 28 174 pregnant women with their infants, covering 27 818 single live births and 356 twin live births. RESULTS The prevalence of FA supplementation in singletons and twins was 63·9 and 66·3 %. The mean birth weight was 3267 (sd 459·1) g, 2525 (sd 534·0) g and 2494 (sd 539·5) g; the prevalence of SGA was 14·3, 51·4 and 53·4 %; the prevalence of LBW was 3·4, 42·4 and 46·6 % among singleton, twin A and twin B, respectively. Compared with non-users, women with FA supplementation were (β 17·3, 95 % CI 6·1, 28·4; β 166·3, 95 % CI 69·1, 263·5) associated with increased birth weight, lower risk of SGA (OR 0·85, 95 % CI 0·80, 0·92; OR 0·45, 95 % CI 0·30, 0·68) and LBW (OR 0·82, 95 % CI 0·71, 0·95; OR 0·50, 95 % CI 0·33, 0·75) in singletons and twins, and more prominent effects in twins. Moreover, there were significant interactions between FA supplementation and plurality on birth weight, SGA and LBW. CONCLUSIONS The present study suggests the association of periconceptional 0·4 mg/d FA supplementation with increased birth weight and reduced risk of SGA and LBW in both singletons and twins, and this association may be more prominent in twins.
Collapse
|
17
|
Predictors of Low Birth Weight at Lumbini Provincial Hospital, Nepal: A Hospital-Based Unmatched Case Control Study. Adv Prev Med 2020; 2020:8459694. [PMID: 32274216 PMCID: PMC7136760 DOI: 10.1155/2020/8459694] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 03/04/2020] [Indexed: 01/23/2023] Open
Abstract
Background Low birth weight (LBW) is defined as the birth weight of live born infants below 2500 g, regardless of gestational age. It is a public health problem caused by factors that are potentially modifiable. The purpose of this study was to determine the socioeconomic, obstetric, and maternal factors associated with LBW in Lumbini Provincial Hospital, Nepal. Methods The study was conducted using case control study design with 1 : 2 case control ratio. A total of 105 cases and 210 controls were taken in this study. Data were entered on Epi data software version 3.1 and exported to Statistical Package for Social Science (SPSS) software version 25 for analysis. Characteristics of the sample were described using mean and standard deviation. Bivariate analysis was done to assess the association between dependent and independent variables. The ultimate measure of association was odds ratio. Variables found to be associated with bivariate analysis were entered into a multivariable logistic regression model to identify predictors of LBW. Results The mean age of the participants was 25.98 years with ±4.40 standard deviation. Mothers with literate educational background (AOR 0.32, 95% CI 0.13–0.81), housewife (AOR 2.63, 95% CI 1.11–6.20), vaginal mode of delivery (AOR 0.45, 95% CI 0.25–0.82), gestational age <37 weeks (AOR 2.51, 95% CI 1.15–5.48), history of LBW (AOR 5.12, 95% CI 1.93–13.60), and maternal weight <50 kilograms (AOR 2.23, 95% CI 1.23–4.02) were significantly associated with LBW. Conclusion Educational and occupational status, mode of delivery, gestational age, maternal weight, and history of LBW were found to be independent predictors of LBW. There is need of developing coordination with education sector for increasing educational status of mothers and adolescent girls. Social determinants of health need to be considered while developing interventional programs. Similarly, interventional programs need to be developed considering identified predictors of low birth weight.
Collapse
|
18
|
Molina-García L, Hidalgo-Ruiz M, Cámara-Jurado AM, Fernández-Valero MJ, Delgado-Rodríguez M, Martínez-Galiano JM. Newborn Health Indicators Associated with Maternal Age during First Pregnancy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3448. [PMID: 31533243 PMCID: PMC6765882 DOI: 10.3390/ijerph16183448] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 09/12/2019] [Accepted: 09/14/2019] [Indexed: 12/19/2022]
Abstract
Delaying motherhood is becoming increasingly common, raising questions of the possible influence that maternal age may have on newborn health. Therefore, the objective of this study was to determine the association between maternal age and different newborn health parameters. An observational study was conducted in Spain on primiparous women and their infants. Data were collected on newborn health variables, breastfeeding, and different clinical practices that are beneficial for child health and development. Crude and adjusted mean differences were calculated along with the standard error of the mean. A total of 373 women and their children participated. In terms of early commencement skin-to-skin contact, the mean age of women that did skin-to-skin contact was 29.95 ± 0.31 years compared to 31.49 ± 0.66 years in those that did not (p = 0.042). In terms of other newborn parameters, such as preterm birth, health problems or complications, or the need for hospital admission, these were more frequent in the oldest group of mothers, but the differences found were not significant (p > 0.05). Hence, indicators of newborn morbidity were not found to be significantly associated with maternal age; however, beneficial practices such as early commencement skin-to-skin contact were found to be significantly associated with maternal age.
Collapse
Affiliation(s)
| | | | | | | | - Miguel Delgado-Rodríguez
- Department of Health Sciences, University of Jaen, 23071 Jaen, Spain.
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain.
| | - Juan Miguel Martínez-Galiano
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain.
- Department of Nursing, Campus de Las Lagunillas s/n, Edificio B3, University of Jaen, 23071 Jaen, Spain.
| |
Collapse
|