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Mfipa D, Hajison PL, Mpachika-Mfipa F. Predictors of low birthweight and comparisons of newborn birthweights among different groups of maternal factors at Rev. John Chilembwe Hospital in Phalombe district, Malawi: A retrospective record review. PLoS One 2024; 19:e0291585. [PMID: 39208326 PMCID: PMC11361679 DOI: 10.1371/journal.pone.0291585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 08/16/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Birthweight has an impact on newborn's future health outcomes. Maternal factors, including age, delivery mode, HIV status, gestational age, parity and obstetric complications (preeclampsia or eclampsia [PE], antepartum hemorrhage [APH] and sepsis), however, have been shown as risk factors of low birthweight (LBW) elsewhere. For data-guided interventions, we aimed to identify predictors of LBW and compare newborn birthweights between different groups of maternal factors at Rev. John Chilembwe Hospital in Phalombe district, Malawi. METHODS Using a retrospective record review study design, we extracted data from maternity registers of 1244 women and their newborns from October, 2022 to March, 2023. Data were skewed. Median test was used to compare median birthweights. Chi-square or Fisher's exact tests were used to compare proportions of LBW among different groups of maternal factors. Multivariable logistic regression with stepwise, forward likelihood method was performed to identify predictors of LBW. RESULTS Median birthweight was 2900.00g (interquartile range [IQR]: 2600.00g to 3200.00g). Prevalence of LBW was 16.7% (n = 208). Proportions of LBW infants were higher in women with PE, APH, including women with sepsis than controls (10 [47.6%] of 21 vs 7 [58.3%] of 12 vs 191 [15.8%] of 1211, p < .001). Lower in term and postterm than preterm (46 [5.5%] of 835 vs 2 [3.7%] of 54 vs 160 [45.1%] of 355, p < .001). The odds of LBW infants were higher in preterm than term (AOR = 13.76, 95%CI: 9.54 to 19.84, p < .001), women with PE (AOR = 3.88, 95%CI: 1.35 to 11.18, p = .012), APH, including women with sepsis (AOR = 6.25, 95%CI: 1.50 to 26.11, p = .012) than controls. CONCLUSION Prevalence of LBW was high. Its predictors were prematurity, PE, APH and sepsis. Interventions aimed to prevent these risk factors should be prioritized to improve birthweight outcomes.
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Affiliation(s)
- Dumisani Mfipa
- Agency for Scientific Research and Training, Lilongwe, Malawi
| | - Precious L. Hajison
- Preluha Consultancy, Zomba, Malawi
- Pediatric and Child Health Association, Blantyre, Malawi
| | - Felistas Mpachika-Mfipa
- Department of Nursing, Phalombe District Health Office, Phalombe, Malawi
- Centre for Reproductive Health, Kamuzu University of Health Sciences, Chichiri, Blantyre, Malawi
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Lat C, Murila F, Wamalwa D. Prevalence and factors associated with low birth weight among newborns in South Sudan. Afr Health Sci 2023; 23:149-158. [PMID: 38357135 PMCID: PMC10862565 DOI: 10.4314/ahs.v23i3.19] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
Background WHO estimates that that 13% of babies are delivered low birth weight in Sub-Saharan Africa. Infants with LBW have a twenty times greater risk of dying than infants weighing more than 2500 grams. The neonatal mortality rates in South Sudan is 40 per 1000 live births. LBW significantly contributes to neonatal mortality rates. Objectives The study aimed at determining the prevalence and factors associated with LBW among newborns. Methods This was a cross-sectional descriptive study conducted at three hospitals. Completed data on all live births was collected using a structured questionnaire. Univariate and multivariate logistic regression analysis was applied for factors associated with LBW. Adjusted odds ratio with 95% confidence interval was applied and a P value <0.05 was considered statistically significant. Results We retrieved records of 11845 birth cohorts. The prevalence of LBW among newborns was 11.4%. The prevalence of LBW at Aweil, Juba and Bor was 13.3%, 9.8% and 8.8% respectively. Maternal age less than 20 years and 35 years and above, multigravidity, GA <37 weeks, male sex and multiple pregnancy were significantly associated with LBW. Conclusion The prevalence of LBW in infants was 11.4%. Associated factors were, maternal age, GA <37 weeks, multigravidity, male sex and multiple pregnancy.
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Affiliation(s)
- Chol Lat
- University of Nairobi College of Health Sciences, Department of Paediatrics and Child Health
| | - Florence Murila
- University of Nairobi College of Health Sciences, Department of Paediatrics and Child Health
| | - Dalton Wamalwa
- University of Nairobi College of Health Sciences, Department of Paediatrics and Child Health
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Wulandari F, Mahmudiono T, Rifqi MA, Helmyati S, Dewi M, Yuniar CT. Maternal Characteristics and Socio-Economic Factors as Determinants of Low Birth Weight in Indonesia: Analysis of 2017 Indonesian Demographic and Health Survey (IDHS). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13892. [PMID: 36360771 PMCID: PMC9654396 DOI: 10.3390/ijerph192113892] [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: 08/30/2022] [Revised: 10/23/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
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.
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Affiliation(s)
- Fatqiatul Wulandari
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Trias Mahmudiono
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Mahmud Aditya Rifqi
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Siti Helmyati
- Department of Health Nutrition, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
| | - Mira Dewi
- Department of Community Nutrition, Faculty of Human Ecology, IPB University, Bogor 16680, Indonesia
| | - Cindra Tri Yuniar
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Institut Teknologi Bandung, Bandung 40132, Indonesia
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Pregnancy as a Fundamental Determinant of Child Health: a Review. Curr Nutr Rep 2022; 11:457-485. [PMID: 35789475 DOI: 10.1007/s13668-022-00416-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE OF REVIEW Maternal conditions and exposures during pregnancy including over- and undernutrition are associated with poor childbirth outcomes, growth, development and chronic childhood diseases. We examined contemporary pregnancy-related determinants of child health. RECENT FINDINGS While maternal undernutrition remains a major contributor to low birth weight, maternal obesity affects foetal growth, birth weight, survival and is associated with childhood obesity, asthma and autistic spectrum disorders. Emerging evidence suggests that epigenetic changes, the prenatal microbiome and maternal immune activation (MIA), a neuroinflammatory process induced by diet and other exposures cause foetal programming resulting in these chronic childhood diseases. Maternal diet is potentially a modifiable risk factor for controlling low birth weight, obesity and chronic disease in childhood. Further studies are warranted to refine guidance on dietary restriction and physical activity during pregnancy and determine how MIA and prenatal microbiota can be applied to control childhood diseases arising from programming.
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Epuitai J, Woolley KE, Bartington SE, Thomas GN. Association between Wood and Other Biomass Fuels and Risk of Low Birthweight in Uganda: A Cross-Sectional Analysis of 2016 Uganda Demographic and Health Survey Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4377. [PMID: 35410058 PMCID: PMC8999071 DOI: 10.3390/ijerph19074377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 11/29/2022]
Abstract
In utero exposure to household air pollution (HAP) from polluting cooking fuels has been linked to adverse pregnancy outcomes including low birthweight (LBW). No previous study in Uganda has attempted to investigate the association between the different types of biomass cooking fuels and LBW. This study was conducted to investigate the association between wood and other biomass cooking fuel use with increased risk of LBW, using the 2016 Uganda Demographic and Health Survey for 15,270 live births within five years prior to interview. LBW, defined as birthweight of <2500 g, was estimated from maternal recall and health cards. Association between household exposure to the different solid biomass cooking fuels and LBW was determined using multivariable logistic regression. Biomass cooking fuels were used in 99.6% of the households, with few (0.3%) using cleaner fuels and 0.1% with no cooking, while the prevalence of LBW was 9.6% of all live-births. Although the crude analysis suggested an association between wood fuel use and LBW compared to other biomass and kerosene fuel use (AOR: 0.82; 95% CI: 0.67−1.00), after adjusting for socio-demographic and obstetric factors, no association was observed (AOR: 0.94; 95% CI: 0.72−1.22). LBW was significantly more likely among female neonates (AOR: 1.32 (95% CI: 1.13−1.55) and neonates born to mothers living in larger households (AOR: 1.03; 95% CI: 1.00−1.07). LBW was significantly less likely among neonates delivered at term (AOR: 0.39; 95% CI: 0.31−0.49), born to women with secondary or tertiary level of education (AOR: 0.80; 95% CI: 0.64−1.00), living in households with a higher wealth index (AOR: 0.69; 95% CI: 0.50−0.96), Eastern (AOR: 0.76; 95% CI:0.59−0.98) and Northern (AOR: 0.75; 95% CI: 0.57−0.99) regions. The study findings suggest inconclusive evidence regarding the association between the use of wood compared to other biomass and kerosene cooking fuels and risk of LBW. Given the close observed association between socioeconomic status and LBW, the Ugandan government should prioritize public health actions which support female education and broader sustainable development to improve household living standards in this setting.
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Affiliation(s)
- Joshua Epuitai
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (J.E.); (K.E.W.); (S.E.B.)
- Department of Nursing, Faculty of Health Sciences, Busitema University, Mbale P.O. Box 1460, Uganda
| | - Katherine E. Woolley
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (J.E.); (K.E.W.); (S.E.B.)
| | - Suzanne E. Bartington
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (J.E.); (K.E.W.); (S.E.B.)
| | - G. Neil Thomas
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; (J.E.); (K.E.W.); (S.E.B.)
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Outcomes and Disease Spectrum of LBW Neonates in a Secondary Health Facility. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:9974636. [PMID: 35126962 PMCID: PMC8813240 DOI: 10.1155/2022/9974636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 12/23/2021] [Accepted: 01/10/2022] [Indexed: 11/18/2022]
Abstract
Globally, 30 million low birth weight (LBW) babies are born every year and 95% of them are from developing countries. LBW neonates are at a high risk of mortality, morbidity, and long-term disability. The objective of this study is to investigate outcomes and disease spectrum among low birth weight neonates. This is a prospective, observational study conducted on 540 neonates admitted in the Mother and Child Hospital, Akure, Ondo State, Nigeria, from 2017 to 2018. Questionnaire, interview, clinical, and diagnostic procedures were used as research tools. There were 137 low birth weight (LBW) neonates, with the mean mothers’ age of 31.92 ± 6.60. Of the 540 neonates, 69 (50.4%) and 68 (49.6%) were term and preterm, respectively. There were 64 female neonates (46.7%) and 73 male neonates (53.3%). The mean weight of the neonates was 1.82 ± 0.44 kg, and mean number of days on admission was 6.42 ± 6.75 days. Neonatal sepsis (NNS) was the highest morbidity 51 (37.2%) among the LBW neonates, followed by prematurity 47 (34.4%) and neonatal jaundice (NNJ) 18 (13.1%). Sex (χ2 = 3.584,
), mode of delivery (χ2 = 4.669,
), and gestational age (χ2 = 3.904,
) were not a significant determinant of outcome among LBW neonates. Men were 2.36 times more likely to be preterm (OR = 2.36, 95% CL = 1.01–5.54,
) among LBW neonates. Outcomes of LBW neonates who were delivered by SVD were not significant compared to preterm delivered by CS (OR = 0.46, 95% CL = 0.13–1.65,
). Sixty percent (60%) of the mothers had Prolonged Rupture of Membranes (PROM). Morbidities such as hypothermia (72.2%), apnoea (63.6%), haemorrhagic disease of the newborn (HDN) (66.7%), and respiratory distress syndrome (RDS) (66.7%) were more observed with preterm LBW neonates. Importance of qualitative antenatal care (ANC) should be emphasized; anticipation and prevention of LBW births can help mitigate some of the problems they are prone to.
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Maulinda F, Handayani D, Wongkaren TS. The effect of age at first marriage on the incidence of labor complications and babies with low birth weight in Indonesia. CHILD HEALTH NURSING RESEARCH 2022; 27:127-136. [PMID: 35004503 PMCID: PMC8650910 DOI: 10.4094/chnr.2021.27.2.127] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 02/01/2021] [Accepted: 03/21/2021] [Indexed: 12/01/2022] Open
Abstract
Purpose This study investigated the effect of a woman's age at first marriage (AFM) on the incidence of labor complications and babies with low birth weight (LBW). Methods This study used data from the 2017 Indonesian Demographic and Health Survey (IDHS) on women aged 15-49 years who gave birth to their first child within the previous 5 years. Data analysis was conducted using binary logistic regression for labor complications and the binomial probit method for the incidence of LBW. Results The analysis showed that AFM affected the likelihood of childbirth complications and LBW babies. An increase in AFM tended to reduce the risk of childbirth complications, although poor economic conditions increased the risk of complications in mothers with a higher AFM. In addition, a low or high AFM increased the chances of delivering a baby with LBW. Conclusion A low AFM was associated with an increased likelihood of women experiencing birth complications when delivering their first child and delivering babies with LBW, underscoring the importance of delaying childbirth until a more mature age.
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Affiliation(s)
| | - Dwini Handayani
- Assistant Professor, Faculty of Economics and Business, Universitas Indonesia, Depok, Indonesia
| | - Turro S Wongkaren
- Director, Lembaga Demografi, Faculty of Economics and Business, Universitas Indonesia, Depok, Indonesia
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Kaforau LS, Tessema GA, Bugoro H, Pereira G, Jancey J. Lived experiences of women with low birth weight infants in the Solomon Islands: A descriptive qualitative study. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0001008. [PMID: 36962868 PMCID: PMC10022132 DOI: 10.1371/journal.pgph.0001008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/04/2022] [Indexed: 12/12/2022]
Abstract
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.
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Affiliation(s)
- Lydia S Kaforau
- Curtin School of Population Health, Curtin University, Perth, Australia
- School of Nursing and Allied Health Sciences, Solomon Islands National University, Honiara, Solomon Islands
| | - Gizachew A Tessema
- Curtin School of Population Health, Curtin University, Perth, Australia
- School of Public Health, The University of Adelaide, South Australia, Australia
| | - Hugo Bugoro
- School of Nursing and Allied Health Sciences, Solomon Islands National University, Honiara, Solomon Islands
| | - Gavin Pereira
- Curtin School of Population Health, Curtin University, Perth, Australia
- Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, Oslo, Norway
- enAble Institute, Curtin University, Perth, Australia
| | - Jonine Jancey
- Curtin School of Population Health, Curtin University, Perth, Australia
- enAble Institute, Curtin University, Perth, Australia
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Bilal JA, Rayis DA, AlEed A, Al-Nafeesah A, Adam I. Maternal Undernutrition and Low Birth Weight in a Tertiary Hospital in Sudan: A Cross-Sectional Study. Front Pediatr 2022; 10:927518. [PMID: 35799688 PMCID: PMC9253371 DOI: 10.3389/fped.2022.927518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 05/24/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The World Health Organization set a Global Nutrition Target of a 30% reduction in LBW by 2025. Maternal malnutrition/undernutrition is among the most important modifiable risk factors for impaired fetal growth. This study investigates the effect of maternal undernutrition on LBW in Sudan. METHODS A cross-sectional study was conducted at Saad Abuelela Hospital in Khartoum, Sudan, from May to October 2020. The sociodemographic and obstetric data of the women were gathered via questionnaire, and their mid-upper arm circumference (MUAC) was measured. Maternal undernutrition was defined as a MUAC of <23 cm. RESULTS In total, 1,505 pairs of pregnant women and their newborns were enrolled in the study. The medians [interquartile (IQR)] of the age, parity, and gestational age were 27.0 (9.0) years, 1.0 (3.0), and 38.0 (2.0) weeks, respectively. The median (IQR) of the birth weight was 3,028.0 (690.0) g. Of the 1,505 participants, 182 (12.1%) delivered LBW infants. Multivariate logistic regression showed that MUAC [adjusted odds ratio (AOR) = 0.91, 95% confidence interval (CI) = 0.87-0.96] and gestational age (AOR = 0.79, 95% CI = 0.73-0.85) were negatively associated with LBW. The level of antenatal care <2 visits (AOR = 2.10, 95% CI = 1.30-3.57) was associated with LBW. Women with undernutrition were at a higher risk of delivering LBW infants (AOR = 1.66, 95% CI = 1.09-2.53). CONCLUSION LBW is a health problem in Sudan, and women with undernutrition were at a higher risk of delivering LBW infants.
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Affiliation(s)
- Jalal A Bilal
- Department of Pediatrics, College of Medicine, Shaqra University, Shaqra, Saudi Arabia
| | - Duria A Rayis
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Ashwaq AlEed
- Department of Pediatrics, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia.,Department of Pediatrics, College of Medicine, Qassim University, Buraydah, Saudi Arabia
| | - Abdullah Al-Nafeesah
- Department of Pediatrics, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia
| | - Ishag Adam
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia
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Berhe K, Weldegerima L, Gebrearegay F, Kahsay A, Tesfahunegn A, Rejeu M, Gebremariam B. Effect of under-nutrition during pregnancy on low birth weight in Tigray regional state, Ethiopia; a prospective cohort study. BMC Nutr 2021; 7:72. [PMID: 34782014 PMCID: PMC8594154 DOI: 10.1186/s40795-021-00475-7] [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: 05/12/2021] [Accepted: 10/06/2021] [Indexed: 01/09/2023] Open
Abstract
Background Under-nutrition during pregnancy affects birth outcomes and neonatal outcomes. Worldwide, 20.5 million children were low birth weight, mainly in poor countries. However, there is no longitudinal-based evidence on the effect of under-nutrition during pregnancy on birth weight in Tigray regional state. Therefore, this study aimed at investigating the effect of under-nutrition during pregnancy on low birth weight in Tigray regional state. Methods We conducted a prospective cohort study among consecutively selected 540 pregnant women attending antenatal care in hospitals from October 2019 to June 2020. Pregnant women with mid upper arm circumference (MUAC) < 23 cm were exposed and those with MUAC≥23 cm were unexposed. Data on socio-demographic, diet, hygiene and anthropometry measurements were collected using pretested and structured questionnaires. SPSS version 25 was used for analysis. A log-binomial model was used to estimate the adjusted risk ratio and its 95%CI of the risk factors for low birth weight. Multi-collinearity was checked using the variance inflation factor (VIF) at a cut-off point of 8 and there was no multi-collinearity. Result The overall incidence of low birth weight was 14% (95%CI: 11.1, 17.4%). The incidence of low birth weight was 18.4 and 9.8% among the exposed and unexposed women, respectively. The difference in low birth weight incidence between the exposed and unexposed groups was statistically significant (p-value = 0.006). The risk factors of low birth weight were maternal illiteracy (ARR: 1.8, 95%CI: 1.01, 3.3), low monthly family income < 50 US Dollar (ARR: 1.6, 95%CI: 1.07, 2.2), lack of latrine utilization (ARR: 0.47, 95%CI: 0.28, 0.78), and diet diversity score < 5 (ARR: 1.9, 95%CI: 1.05, 2.61). Conclusion Low birth weight was significantly higher among the exposed pregnant women. Maternal illiteracy, low monthly income, lack of latrine utilization, and low DDS were risk factors of low birth weight. It is then important to strengthen nutritional assessment and interventions during pregnancy, with a special attention for illiterate, and low monthly income pregnant women. Again, there has to be a promotion of latrine utilization and consumption of diversified diets.
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Affiliation(s)
- Kidanemaryam Berhe
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia.
| | - Lemlem Weldegerima
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Freweini Gebrearegay
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Amaha Kahsay
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Afewerki Tesfahunegn
- Department of Epidemiology, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Mehammedseid Rejeu
- Department of Maternity and Reproductive Health Nursing, School of Nursing, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
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Lingani M, Zango SH, Valéa I, Valia D, Sanou M, Samandoulougou SO, Robert A, Tinto H, Dramaix M, Donnen P. Magnitude of low birthweight in malaria endemic settings of Nanoro, rural Burkina Faso: a secondary data analysis. Sci Rep 2021; 11:21332. [PMID: 34716389 PMCID: PMC8556330 DOI: 10.1038/s41598-021-00881-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/15/2021] [Indexed: 12/02/2022] Open
Abstract
Low birthweight (LBW) is a worldwide problem that particularly affects developing countries. However, limited information is available on its magnitude in rural area of Burkina Faso. This study aimed to estimate the prevalence of low birthweight and to identify its associated factors in Nanoro health district. A secondary analysis of data collected during a cross-sectional survey was conducted to assess the prevalence of low birthweight in Nanoro health and demographic surveillance system area (HDSS). Maternal characteristics extracted from antenatal care books or by interview, completed by malaria diagnosis were examined through a multi-level logistic regression to estimate odd-ratios of association with low birthweight. Significance level was set at 5%. Of the 291 neonates examined, the prevalence of low birthweight was 12%. After adjustment for socio-demographic, obstetric and malaria prevention variables, being primigravid (OR = 8.84, [95% CI: 3.72-21.01]), or multigravid with history of stillbirth (OR = 5.03, [95% CI: 1.54-16.40]), as well as the lack of long-lasting insecticide treated bed net use by the mother the night preceding the admission for delivery (OR = 2.5, [95% CI: 1.1-5.9]) were significantly associated with neonate low birthweight. The number of antenatal visits however did not confer any direct benefit on birthweight status within this study area. The prevalence of low birthweight was high in the study area and represents an important public health problem in Burkina Faso. In light of these results, a redefinition of the content of the antenatal care package is needed.
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Affiliation(s)
- Moussa Lingani
- École de Santé Publique, Université Libre de Bruxelles, Route de Lennik 808, CP594, 1070, Bruxelles, Belgique.
- Institut de Recherche en Sciences de la Santé/Direction Régionale du Centre Ouest (IRSS/DRCO), BP 218, 11, Nanoro, Burkina Faso.
| | - Serge H Zango
- Epidemiology and Biostatistics Research Division, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Clos Chapelle-aux-Champs 30, B1.30.13, 1200, Brussels, Belgique
- Institut de Recherche en Sciences de la Santé/Direction Régionale du Centre Ouest (IRSS/DRCO), BP 218, 11, Nanoro, Burkina Faso
| | - Innocent Valéa
- Institut de Recherche en Sciences de la Santé/Direction Régionale du Centre Ouest (IRSS/DRCO), BP 218, 11, Nanoro, Burkina Faso
| | - Daniel Valia
- Institut de Recherche en Sciences de la Santé/Direction Régionale du Centre Ouest (IRSS/DRCO), BP 218, 11, Nanoro, Burkina Faso
| | - Maïmouna Sanou
- Institut de Recherche en Sciences de la Santé/Direction Régionale du Centre Ouest (IRSS/DRCO), BP 218, 11, Nanoro, Burkina Faso
| | - Sékou O Samandoulougou
- Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute Research Center, Quebec City, QC, G1V 4G5, Canada
| | - Annie Robert
- Epidemiology and Biostatistics Research Division, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Clos Chapelle-aux-Champs 30, B1.30.13, 1200, Brussels, Belgique
| | - Halidou Tinto
- Institut de Recherche en Sciences de la Santé/Direction Régionale du Centre Ouest (IRSS/DRCO), BP 218, 11, Nanoro, Burkina Faso
| | - Michèle Dramaix
- École de Santé Publique, Université Libre de Bruxelles, Route de Lennik 808, CP594, 1070, Bruxelles, Belgique
| | - Philippe Donnen
- École de Santé Publique, Université Libre de Bruxelles, Route de Lennik 808, CP594, 1070, Bruxelles, Belgique
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Zango SH, Lingani M, Valea I, Samadoulougou OS, Bihoun B, Lankoande D, Donnen P, Dramaix M, Tinto H, Robert A. Association of malaria and curable sexually transmitted infections with pregnancy outcomes in rural Burkina Faso. BMC Pregnancy Childbirth 2021; 21:722. [PMID: 34706705 PMCID: PMC8549350 DOI: 10.1186/s12884-021-04205-6] [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: 03/01/2021] [Accepted: 10/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malaria and curable sexually transmitted infections (STIs) are severe infections associated with poor pregnancy outcomes in sub-Saharan countries. These infections are responsible for low birth weight, preterm birth, and miscarriage. In Burkina Faso, many interventions recommended by the World Health Organization were implemented to control the impact of these infections. After decades of intervention, we assessed the impact of these infections on pregnancy outcomes in rural setting of Burkina Faso. METHODS Antenatal care and delivery data of pregnant women attending health facilities in 2016 and 2017 were collected in two rural districts namely Nanoro and Yako, in Burkina Faso. Regression models with likelihood ratio test were used to assess the association between infections and pregnancy outcomes. RESULTS During the two years, 31639 pregnant women received antenatal care. Malaria without STI, STI without malaria, and their coinfections were reported for 7359 (23.3%), 881 (2.8 %), and 388 (1.2%) women, respectively. Low birth weight, miscarriage, and stillbirth were observed in 2754 (10.5 %), 547 (2.0 %), and 373 (1.3 %) women, respectively. Our data did not show an association between low birth weight and malaria [Adjusted OR: 0.91 (0.78 - 1.07)], STIs [Adjusted OR: 0.74 (0.51 - 1.07)] and coinfection [Adjusted OR: 1.15 (0.75 - 1.78)]. Low birth weight was strongly associated with primigravidae [Adjusted OR: 3.53 (3.12 - 4.00)]. Both miscarriage and stillbirth were associated with malaria [Adjusted OR: 1.31 (1.07 - 1.59)], curable STI [Adjusted OR: 1.65 (1.06 - 2.59)], and coinfection [Adjusted OR: 2.00 (1.13 - 3.52)]. CONCLUSION Poor pregnancy outcomes remained frequent in rural Burkina Faso. Malaria, curable STIs, and their coinfections were associated with both miscarriage and stillbirth in rural Burkina. More effort should be done to reduce the proportion of pregnancies lost associated with these curable infections by targeting interventions in primigravidae women.
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Affiliation(s)
- Serge Henri Zango
- Pôle d'Epidémiologie et biostatistique, Université catholique de Louvain (UCLouvain), Institut de Recherche Expérimentale et Clinique (IREC), Clos Chapelle-aux-Champs, 30 bte B1.30.13, 1200, Brussels, Belgique. .,Institut de Recherche en Sciences de la Santé, Direction Régionale du Centre Ouest (IRSS/DRCO), Nanoro, Burkina Faso. .,Centre MURAZ, Institut National de Santé Publique (INSP), Bobo-Dioulasso, Burkina Faso.
| | - Moussa Lingani
- Institut de Recherche en Sciences de la Santé, Direction Régionale du Centre Ouest (IRSS/DRCO), Nanoro, Burkina Faso.,École de santé publique, Université Libre de Bruxelles, CP594, route de Lennik 808, 1070, Bruxelles, Belgique
| | - Innocent Valea
- Institut de Recherche en Sciences de la Santé, Direction Régionale du Centre Ouest (IRSS/DRCO), Nanoro, Burkina Faso.,Centre MURAZ, Institut National de Santé Publique (INSP), Bobo-Dioulasso, Burkina Faso
| | - Ouindpanga Sekou Samadoulougou
- Pôle d'Epidémiologie et biostatistique, Université catholique de Louvain (UCLouvain), Institut de Recherche Expérimentale et Clinique (IREC), Clos Chapelle-aux-Champs, 30 bte B1.30.13, 1200, Brussels, Belgique
| | - Biebo Bihoun
- Pôle d'Epidémiologie et biostatistique, Université catholique de Louvain (UCLouvain), Institut de Recherche Expérimentale et Clinique (IREC), Clos Chapelle-aux-Champs, 30 bte B1.30.13, 1200, Brussels, Belgique.,Institut de Recherche en Sciences de la Santé, Direction Régionale du Centre Ouest (IRSS/DRCO), Nanoro, Burkina Faso
| | - Diagniagou Lankoande
- Institut de Recherche en Sciences de la Santé, Direction Régionale du Centre Ouest (IRSS/DRCO), Nanoro, Burkina Faso
| | - Phillipe Donnen
- École de santé publique, Université Libre de Bruxelles, CP594, route de Lennik 808, 1070, Bruxelles, Belgique
| | - Michele Dramaix
- École de santé publique, Université Libre de Bruxelles, CP594, route de Lennik 808, 1070, Bruxelles, Belgique
| | - Halidou Tinto
- Institut de Recherche en Sciences de la Santé, Direction Régionale du Centre Ouest (IRSS/DRCO), Nanoro, Burkina Faso.,Centre MURAZ, Institut National de Santé Publique (INSP), Bobo-Dioulasso, Burkina Faso
| | - Annie Robert
- Pôle d'Epidémiologie et biostatistique, Université catholique de Louvain (UCLouvain), Institut de Recherche Expérimentale et Clinique (IREC), Clos Chapelle-aux-Champs, 30 bte B1.30.13, 1200, Brussels, Belgique
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Ojima WZ, Olawade DB, Awe OO, Amusa AO. Factors Associated with Neonatal Mortality among Newborns Admitted in the Special Care Baby Unit of a Nigerian Hospital. J Trop Pediatr 2021; 67:6344870. [PMID: 34363078 DOI: 10.1093/tropej/fmab060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND With Nigeria being one of the countries with the highest neonatal mortality rate globally, identifying the risk factors associated with neonatal mortality is essential as we strive to proffer sustainable solutions. AIM This retrospective hospital-based survey aimed to bridge this gap by evaluating the trends and risk factors associated with neonatal mortality in a teaching hospital in Southwestern Nigeria. METHODS Records of newborns admitted at the special care baby unit from January 2018 to December 2019 (n = 1098) were accessed, and available data were extracted. Descriptive analysis and inferential statistics were performed at 0.05 level of significance. RESULTS The mortality rate was determined to be 16.9% (inborn babies- 12.9% and out-born babies- 22.3%), with 83.3% of the newborns dying within the first week. Some of the factors associated with neonatal mortality were proximity of newborns' mothers home to the hospital [p = 0.041; Odds Ratio (OR) = 0.670; 95% Confidence Interval (CI) = 0.455-0.985], maturity of the baby at delivery (p < 0.001; OR = 0.514; CI = 0.358-0.738), place of delivery-inborn or out-born (p < 0.001; OR = 0.515; CI = 0.375-0.709), place of delivery-in a hospital or a non-hospital setting (p = 0.048; OR = 0.633; CI = 0.401-0.999), and baby's weight (p < 0.001; CI = -0.684 to -0.411). CONCLUSION Findings from the study indicate that newborns delivered at home, traditional birth attendant centres or hospitals without essential healthcare facilities have a higher mortality risk. This suggests that measures to improve the accessibility of pregnant women to essential healthcare services are a prerequisite to reducing the neonatal mortality rate in Nigeria.
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Affiliation(s)
- Wada Zechariah Ojima
- Division of Sustainable Development, College of Science and Engineering, Hamad Bin Khalifa University, Doha 34110, Qatar.,Department of Environmental Health Sciences, University of Ibadan, Ibadan, Oyo State 200212, Nigeria
| | - David Bamidele Olawade
- Center for Population and Reproductive Health, University of Ibadan, Ibadan, Oyo State 200212, Nigeria.,Department of Environmental Health Sciences, University of Ibadan, Ibadan, Oyo State 200212, Nigeria
| | - Olabisi O Awe
- School of Midwifery, Ekiti State University Teaching Hospital, Ado-Ekiti 360281, Nigeria
| | - Aminat Opeyemi Amusa
- Department of Medicine and Surgery, University of Ibadan, Ibadan, Oyo State 200212, Nigeria
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Tamirat KS, Sisay MM, Tesema GA, Tessema ZT. Determinants of adverse birth outcome in Sub-Saharan Africa: analysis of recent demographic and health surveys. BMC Public Health 2021; 21:1092. [PMID: 34098914 PMCID: PMC8186187 DOI: 10.1186/s12889-021-11113-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 05/23/2021] [Indexed: 01/18/2023] Open
Abstract
Background More than 75% of neonatal deaths occurred in the first weeks of life as a result of adverse birth outcomes. Low birth weight, preterm births are associated with a variety of acute and long-term complications. In Sub-Saharan Africa, there is insufficient evidence of adverse birth outcomes. Hence, this study aimed to determine the pooled prevalence and determinants of adverse birth outcomes in Sub-Saharan Africa. Method Data of this study were obtained from a cross-sectional survey of the most recent Demographic and Health Surveys (DHS) of ten Sub-African (SSA) countries. A total of 76,853 children born five years preceding the survey were included in the final analysis. A Generalized Linear Mixed Models (GLMM) were fitted and an adjusted odds ratio (AOR) with a 95% Confidence Interval (CI) was computed to declare statistically significant determinants of adverse birth outcomes. Result The pooled prevalence of adverse birth outcomes were 29.7% (95% CI: 29.4 to 30.03). Female child (AOR = 0.94, 95%CI: 0.91 0.97), women attended secondary level of education (AOR = 0.87, 95%CI: 0.82 0.92), middle (AOR = 0.94,95%CI: 0.90 0.98) and rich socioeconomic status (AOR = 0.94, 95%CI: 0.90 0.99), intimate-partner physical violence (beating) (AOR = 1.18, 95%CI: 1.14 1.22), big problems of long-distance travel (AOR = 1.08, 95%CI: 1.04 1.11), antenatal care follow-ups (AOR = 0.86, 95%CI: 0.83 0.86), multiparty (AOR = 0.88, 95%CI: 0.84 0.91), twin births (AOR = 2.89, 95%CI: 2.67 3.14), and lack of women involvement in healthcare decision-making process (AOR = 1.10, 95%CI: 1.06 1.13) were determinants of adverse birth outcomes. Conclusion This study showed that the magnitude of adverse birth outcomes was high, abnormal baby size and preterm births were the most common adverse birth outcomes. This finding suggests that encouraging antenatal care follow-ups and socio-economic conditions of women are essential. Moreover, special attention should be given to multiple pregnancies, improving healthcare accessibilities to rural areas, and women’s involvement in healthcare decision-making. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11113-z.
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Affiliation(s)
- Koku Sisay Tamirat
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia.
| | - Malede Mequanent Sisay
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Zemenu Tadesse Tessema
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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15
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Tessema ZT, Tamirat KS, Teshale AB, Tesema GA. Prevalence of low birth weight and its associated factor at birth in Sub-Saharan Africa: A generalized linear mixed model. PLoS One 2021; 16:e0248417. [PMID: 33705473 PMCID: PMC7951905 DOI: 10.1371/journal.pone.0248417] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 02/26/2021] [Indexed: 11/18/2022] Open
Abstract
Background Low birth weight (LBW) is one of the major determinants of perinatal survival, infant morbidity, and mortality, as well as the risk of developmental disabilities and illnesses in future lives. Though studies were conducted to assess the magnitude and associated factors of low birth weight, most of the studies were at a single center and little information on the regional level. Hence, this study assessed the prevalence and associated factors of low birth weight in Sub-Saharan countries. Method This study was based on secondary data sources from 35 Sub-Saharan countries’ Demography and Health Survey (DHS). For this study, we used the Kids Record (KR file) data set. In the KR file, all under-five children who were born in the last five years preceding the survey in the selected enumeration area who had birth weight data were included for the study. To identify determinants of low birth weight multivariable mixed-effect logistic regression model fitted. Adjusted Odds Ratios (AOR) with a 95% Confidence Interval (CI) and p-value ≤0.05 in the multivariable model were used to declare significant factors associated with low birth weight at birth. Result The pooled prevalence of newborn babies’ low birth weight measured at birth in Sub-Saharan Africa was 9.76% with (95% CI: 9.63% to 9.89%). Female child, women not participated in healthcare decision making, and wider birth intervals, divorced/ separated women, and twin pregnancies associated with increased occurrences of low birth weight, while some level of woman and husband education, antenatal care visits, older maternal age, and multiparity associated with reduced occurrence low birth weight. Conclusion This study revealed that the magnitude of low birth weight was high in sub-Saharan Africa countries. Therefore, the finding suggests that more emphasis is important for women with a lack of support, multiples, and healthcare decision-making problems.
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Affiliation(s)
- Zemenu Tadesse Tessema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Koku Sisay Tamirat
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Tshinzobe JCK, Ngaya DK. [Case-control study of factors associated with low birth weight at the Kingasani Hospital Center, Kinshasa (Democratic Republic of Congo)]. Pan Afr Med J 2021; 38:94. [PMID: 33889260 PMCID: PMC8035683 DOI: 10.11604/pamj.2021.38.94.16099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 05/08/2020] [Indexed: 11/15/2022] Open
Abstract
Introduction l´insuffisance pondérale à la naissance est considérée comme l´un des plus importants indicateurs de chances de survie d´un nouveau-né et un risque majeur de morbidité, de mortalité périnatale et infantile. L´objectif de cet article est d´étudier les facteurs associés à l´insuffisance pondérale à la naissance au Centre Hospitalier de Kingasani, à Kinshasa. Méthodes une étude rétrospective de type cas-témoins a été réalisée. Les informations sur les parturientes et leurs enfants nés du 1er janvier au 31 décembre 2016 ont été collectées dans le registre de la maternité du Centre Hospitalier Kingasani. Quatre cent cinquante-huit (458) cas (moins de 2500 grammes) ont été comparés aux 458 témoins (2500-4000 grammes). L´analyse multivariée a été faite à l´aide de la régression logistique binaire pour identifier les facteurs associés au faible poids de naissance. Résultats en 2016, 3451 naissances vivantes ont été enregistrées et la prévalence de l´insuffisance pondérale a été estimée à 13,27%. Il a été trouvé, dans l´analyse bivariée, que la parité, le terme de grossesse, le type de grossesse et le sexe du nouveau-né sont des variables significativement associées à l´insuffisance pondérale à la naissance. Après ajustement sur les variables intégrées dans l´analyse multivariée, la parité, le terme de grossesse et le type de grossesse sont demeurés significativement associées à l´insuffisance pondérale à la naissance. Conclusion de ces résultats, nous suggérons la promotion des études intégrant tous les paramètres impliqués dans la survenue de l´insuffisance pondérale à la naissance pour suivre l´évolution régulière de ce problème et des facteurs associés.
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Affiliation(s)
- Jean Claude Kaka Tshinzobe
- Institut Supérieur des Techniques Médicales de Kinshasa, Section Santé Communautaire, Kinshasa, République Démocratique du Congo
| | - Denise Kwango Ngaya
- Centre Hospitalier Kingasani, Service de Maternité, Kinshasa, République Démocratique du Congo
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Roberman J, Emeto TI, Adegboye OA. Adverse Birth Outcomes Due to Exposure to Household Air Pollution from Unclean Cooking Fuel among Women of Reproductive Age in Nigeria. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E634. [PMID: 33451100 PMCID: PMC7828613 DOI: 10.3390/ijerph18020634] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/01/2021] [Accepted: 01/08/2021] [Indexed: 11/16/2022]
Abstract
Exposure to household air pollution (HAP) from cooking with unclean fuels and indoor smoking has become a significant contributor to global mortality and morbidity, especially in low- and middle-income countries such as Nigeria. Growing evidence suggests that exposure to HAP disproportionately affects mothers and children and can increase risks of adverse birth outcomes. We aimed to quantify the association between HAP and adverse birth outcomes of stillbirth, preterm births, and low birth weight while controlling for geographic variability. This study is based on a cross-sectional survey of 127,545 birth records from 41,821 individual women collected as part of the 2018 Nigeria Demographic and Health Survey (NDHS) covering 2013-2018. We developed Bayesian structured additive regression models based on Bayesian splines for adverse birth outcomes. Our model includes the mother's level and household characteristics while correcting for spatial effects and multiple births per mother. Model parameters and inferences were based on a fully Bayesian approach via Markov Chain Monte Carlo (MCMC) simulations. We observe that unclean fuel is the primary source of cooking for 89.3% of the 41,821 surveyed women in the 2018 NDHS. Of all pregnancies, 14.9% resulted in at least one adverse birth outcome; 14.3% resulted in stillbirth, 7.3% resulted in an underweight birth, and 1% resulted in premature birth. We found that the risk of stillbirth is significantly higher for mothers using unclean cooking fuel. However, exposure to unclean fuel was not significantly associated with low birth weight and preterm birth. Mothers who attained at least primary education had reduced risk of stillbirth, while the risk of stillbirth increased with the increasing age of the mother. Mothers living in the Northern states had a significantly higher risk of adverse births outcomes in 2018. Our results show that decreasing national levels of adverse birth outcomes depends on working toward addressing the disparities between states.
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Affiliation(s)
- Jamie Roberman
- Public Health & Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia; (J.R.); (T.I.E.)
| | - Theophilus I. Emeto
- Public Health & Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia; (J.R.); (T.I.E.)
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia
| | - Oyelola A. Adegboye
- Public Health & Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia; (J.R.); (T.I.E.)
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD 4811, Australia
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Prevalence and factors associated with antenatal care service access among Indigenous women in the Chittagong Hill Tracts, Bangladesh: A cross-sectional study. PLoS One 2020; 15:e0244640. [PMID: 33373416 PMCID: PMC7771700 DOI: 10.1371/journal.pone.0244640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 12/15/2020] [Indexed: 11/19/2022] Open
Abstract
Background Prevalence of accessing antenatal care (ANC) services among Indigenous women in the Chittagong Hill Tracts (CHT) is unknown. This study aims to estimate the prevalence of accessing ANC services by Indigenous women in the CHT and identify factors associated with knowledge of, and attendance at, ANC services. Methods Using a cross-sectional design three Indigenous groups in Khagrachari district, CHT, Bangladesh were surveyed between September 2017 and February 2018. Indigenous women within 36 months of delivery were asked about attending ANC services and the number who attended was used to estimate prevalence. Socio-demographic and obstetric characteristics were used to determine factors associated with knowledge and attendance using multivariable logistic regression techniques adjusted for clustering by village; results are presented as odds ratios (OR), adjusted OR, and 95% confidence intervals (CI). Results Of 494 indigenous women who met the inclusion criteria in two upazilas, 438 participated (89% response rate) in the study, 75% were aged 16–29 years. Sixty-nine percent were aware of ANC services and the prevalence of attending ANC services was 53% (n = 232, 95%CI 0.48–0.58). Half (52%; n = 121) attended private facilities. Independent factors associated with knowledge about ANC were age ≥30 years (OR 2.2, 95%CI 1.1–4.6), monthly household income greater than 20,000 Bangladeshi Taka (OR 3.4, 95%CI 1.4–8.6); knowledge of pregnancy-related complications (OR 3.6, 95%CI 1.6–8.1), knowledge about nearest health facilities (OR 4.3, 95%CI 2.1–8.8); and attending secondary school or above (OR 4.8, 95%CI 2.1–11). Independent factors associated with attending ANC services were having prior knowledge of ANC benefits (OR 7.7, 95%CI 3.6–16), Indigenous women residing in Khagrachhari Sadar subdistrict (OR 6.5, 95%CI 1.7–25); and monthly household income of 20,000 Bangladeshi Taka or above (OR 2.8, 95%CI 1.1–7.4). Conclusion Approximately half of Indigenous women from Chittagong Hill Tracts Bangladesh attended ANC services at least once. Better awareness and education may improve ANC attendance for Indigenous women. Cultural factors influencing attendance need to be explored.
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Fayehun O, Asa S. Abnormal birth weight in urban Nigeria: An examination of related factors. PLoS One 2020; 15:e0242796. [PMID: 33232372 PMCID: PMC7685448 DOI: 10.1371/journal.pone.0242796] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 11/10/2020] [Indexed: 11/19/2022] Open
Abstract
There is a knowledge gap on abnormal birth weight in urban Nigeria where specific community contexts can have a significant impact on a child's health. Abnormal birth weight, classified into low birth weight and high birth weight, is often associated with adverse health outcomes and a leading risk for neonatal morbidity and mortality. The study used datasets from the birth recode file of 2013 and 2018 Nigeria Demographic and Health Survey (NDHS); a weighted sample of pooled 9,244 live births by 7,951 mothers within ten years (2008-2018) in urban Nigeria. The effects of individual, healthcare utilization and community-level variables on the two abnormal birth weight categories were explored with a multinomial logistic regression models using normal birth weight as a reference group. In urban Nigeria, the overall prevalence of ABW was 18.3%; high birth weight accounted for the majority (10.7%) of infants who were outside the normal birth weight range. Predictors of LBW were community (region), child characteristic (the type of birth) and household (wealth index) while that of HBW were community (regions), child characteristics (birth intervals and sex), maternal characteristic (education) and healthcare utilization (ANC registration). LBW was significantly more prevalent in the northern part while HBW was more common in the southern part of urban Nigeria. This pattern conforms to the expected north-south dichotomy in health indicators and outcomes. These differences can be linked to suggested variation in regional exposure to urbanization in Nigeria.
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Affiliation(s)
| | - Soladoye Asa
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ife, Nigeria
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Hua W, Yuwen W, Simoni JM, Yan J, Jiang L. Parental readiness for hospital discharge as a mediator between quality of discharge teaching and parental self-efficacy in parents of preterm infants. J Clin Nurs 2020; 29:3754-3763. [PMID: 32644290 DOI: 10.1111/jocn.15405] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/28/2020] [Accepted: 06/21/2020] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To examine the extent to which parental readiness for hospital discharge mediates the relationship between quality of discharge teaching and parental self-efficacy in parents of preterm infants. BACKGROUND Parental readiness for hospital discharge and self-efficacy should be considered to establish whether preterm infants and their families are prepared for the discharge. High-quality discharge teaching could facilitate a smooth discharge transition. However, little is known about how quality of discharge teaching influences parental readiness for hospital discharge and self-efficacy. DESIGN This was a descriptive cross-sectional study of 202 parents with preterm infants in a tertiary hospital in Eastern China. METHODS The key variables of interest were measured using the Chinese versions of the Quality of Discharge Teaching Scale, Readiness for Hospital Discharge Scale-Parent Form, and Preterm Parenting and Self-Efficacy Checklist. Path analyses were conducted to test the mediation models. STROBE checklist was used to compile the study's report. RESULTS Parental readiness for discharge (overall and knowledge dimension) partially mediated the relationship between the quality of discharge teaching and parental self-efficacy. The two dimensions (content received and delivery) of quality of discharge teaching positively influenced parental self-efficacy by improving parental readiness for discharge. CONCLUSIONS Parental readiness for hospital discharge, especially the knowledge dimension, was an important factor in quality of discharge teaching's association with self-efficacy in parents of preterm infants. Improving the quality of discharge teaching could increase parental readiness for discharge and thus promote parental self-efficacy. RELEVANCE TO CLINICAL PRACTICE Improving discharge instructions is essential to help parents of preterm infants prepare for the transition to home care. Assessing readiness and confidence at an early stage and continuing to do so throughout the hospital stay may provide additional ways for nurses to identify parents' knowledge gaps and to provide tailored interventions at more opportune times before hospital discharge.
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Affiliation(s)
- Wenzhe Hua
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | - Weichao Yuwen
- Nursing and Healthcare Leadership, University of Washington Tacoma, Tacoma, WA, USA
| | - Jane M Simoni
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Jie Yan
- Neonatology Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liping Jiang
- Chief Nursing Officer, Department of Nursing, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Falcão IR, Ribeiro-Silva RDC, de Almeida MF, Fiaccone RL, Dos S Rocha A, Ortelan N, Silva NJ, Paixao ES, Ichihara MY, Rodrigues LC, Barreto ML. Factors associated with low birth weight at term: a population-based linkage study of the 100 million Brazilian cohort. BMC Pregnancy Childbirth 2020; 20:536. [PMID: 32928144 PMCID: PMC7491100 DOI: 10.1186/s12884-020-03226-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 09/01/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Factors associated with low birth weight at term (TLBW), a proxy for intrauterine growth restriction (IUGR), are not well-elucidated in socioeconomically vulnerable populations. This study aimed to identify the factors associated with TLBW in impoverished Brazilian women. METHODS Records in the 100 Million Brazilian Cohort database were linked to those in the National System of Information on Live Births (SINASC) to obtain obstetric, maternal, birth and socioeconomic data between 2001 and 2015. Multivariate logistic regression was performed to investigate associations between variables of exposure and TLBW. RESULTS Of 8,768,930 term live births analyzed, 3.7% presented TLBW. The highest odds of TLBW were associated with female newborns (OR: 1.49; 95% CI: 1.47-1.50), whose mothers were black (OR: 1.20; 95% CI: 1.18-1.22), had a low educational level (OR: 1.57; 95% CI: 1.53-1.62), were aged ≥35 years (OR: 1.44; 95% CI: 1.43-1.46), had a low number of prenatal care visits (OR: 2.48; 95% CI: 2.42-2.54) and were primiparous (OR: 1.62; 95% CI: 1.60-1.64). Lower odds of TLBW were found among infants whose mothers lived in the North, Northeast and Center-West regions of Brazil compared to those in the South. CONCLUSION Multiple aspects were associated with TLBW, highlighting the need to comprehensively examine the mechanisms underlying these factors, especially in more vulnerable Brazilian populations, in order to contribute to the elaboration of health policies and promote better conditions of life for poor and extremely poor mothers and children.
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Affiliation(s)
- Ila R Falcão
- School of Nutrition, Federal University of Bahia, Salvador, Brazil.
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil.
| | - Rita de Cássia Ribeiro-Silva
- School of Nutrition, Federal University of Bahia, Salvador, Brazil
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | | | - Rosemeire L Fiaccone
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
- Department of Statistics, Institute of Mathematics, Federal University of Bahia, Salvador, Brazil
| | - Aline Dos S Rocha
- School of Nutrition, Federal University of Bahia, Salvador, Brazil
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Naiá Ortelan
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Natanael J Silva
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
| | - Enny S Paixao
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
- Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Maria Yury Ichihara
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | - Laura C Rodrigues
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
- Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Mauricio L Barreto
- Center for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
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Hüseyin Çam H, Harunoğulları M, Polat Y. A study of low birth weight prevalence and risk factors among newborns in a public-hospital at Kilis, Turkey. Afr Health Sci 2020; 20:709-714. [PMID: 33163035 PMCID: PMC7609091 DOI: 10.4314/ahs.v20i2.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Low birth weight (LBW) is an important indicator of reproductive health and general health status of population. Objectives The present study was aimed to estimate the prevalence of low birth weight (LBW), and to investigate the associations between some risk factors and LBW in Syrian refugee and Turkish population in Kilis, Turkey. Methods The population of this study constituted of a total of 4379 infants born in Kilis State Hospital in 2016 using a retrospective cross-sectional study design. The data were collected from birth records. The data were analyzed using SPSS version 16.0. Binary logistic regression analysis was performed to identify predictors of low birth weight. Factors with a p-value < 0.05 were deemed to be statistically significant. Results The prevalence of LBW was 6.7% in all groups. Significant relationships were found between young maternal age, Syrian refugee mother, female infants, cesarean delivery and LBW. Conclusion The prevalence of low birth weight in the study area was comparatively lower than that of countrywide figure. Maternal related variables like, maternal age, mother's nationality, and mode of birth (vaginal, cesarean) take after up as well as new-born related variables like gender of the neonate were significantly related with low birth weight.
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Affiliation(s)
- Hasan Hüseyin Çam
- Kilis 7 Aralik University Yusuf Serefoglu Faculty of Health Sciences, Department of Nursing
- Corresponding author: Hasan HÜseyin Çam, Kilis 7 Aralik University Yusuf Serefoglu Faculty of Health Sciences, Department of Nursing
| | | | - Yadigar Polat
- Kilis 7 Aralik University Vocational School of Health Services, Department of Medical and Technical Service
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Abeywickrama G, S Padmadas S, Hinde A. Social inequalities in low birthweight outcomes in Sri Lanka: evidence from the Demographic and Health Survey 2016. BMJ Open 2020; 10:e037223. [PMID: 32457080 PMCID: PMC7252991 DOI: 10.1136/bmjopen-2020-037223] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To investigate social inequalities underlying low birthweight (LBW) outcomes in Sri Lanka. DESIGN Cross-sectional study. SETTING This study used the Sri Lanka Demographic and Health Survey 2016, the first such survey to cover the entire country since the Civil War ended in 2001. PARTICIPANTS Birthweight data extracted from the child health development records available for 7713 babies born between January 2011 and the date of interview in 2016. OUTCOME MEASURES The main outcome variable was birth weight, classified as LBW (≤2500 g) and normal. METHODS We applied random intercept three-level logistic regression to examine the association between LBW and maternal, socioeconomic and geographic variables. Concentration indices were estimated for different population subgroups. RESULTS The population-level prevalence of LBW was 16.9% but was significantly higher in the estate sector (28.4%) compared with rural (16.6%) and urban (13.6%) areas. Negative concentration indices suggest a relatively higher concentration of LBW in poor households in rural areas and the estate sector. Results from fixed effects logistic regression models confirmed our hypothesis of significantly higher risk of LBW outcomes across poorer households and Indian Tamil communities (AOR 1.70, 95% CI 1.02 to 2.83, p<0.05). Results from random intercept models confirmed there was substantial unobserved variation in LBW outcomes at the mother level. The effect of maternal biological variables was larger than that of socioeconomic factors. CONCLUSION LBW rates are significantly higher among babies born in poorer households and Indian Tamil communities. The findings highlight the need for nutrition interventions targeting pregnant women of Indian Tamil ethnicity and those living in economically deprived households.
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Affiliation(s)
- Gayathri Abeywickrama
- Department of Social Statistics and Demography, University of Southampton, Southampton, Hampshire, UK
| | - Sabu S Padmadas
- Department of Social Statistics and Demography, University of Southampton, Southampton, Hampshire, UK
- Global Health Research Institute, University of Southampton, Southampton, Hampshire, UK
| | - Andrew Hinde
- Department of Social Statistics and Demography, University of Southampton, Southampton, Hampshire, UK
- Southampton Statistical Sciences Research Institute, University of Southampton, Southampton, Hampshire, UK
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Hailemichael HT, Debelew GT, Alema HB, Weldu MG, Misgina KH. Determinants of adverse birth outcome in Tigrai region, North Ethiopia: Hospital-based case-control study. BMC Pediatr 2020; 20:10. [PMID: 31914947 PMCID: PMC6947822 DOI: 10.1186/s12887-019-1835-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 11/14/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adverse birth outcome which attributes to most perinatal deaths is an important indicator of child health and survival. Hence, this study aims to identify determinants of adverse birth outcome among mothers who gave birth in public hospitals of Tigrai region, North Ethiopia. METHODS Hospital based case-control study was conducted in Tigrai region, Ethiopia between December 2015 and January 2016 among 405 (135 cases and 270 controls) consecutively selected mothers who gave birth in four randomly selected public Hospitals. Mothers with adverse birth outcome (preterm birth; < 37 gestational weeks at birth, low birth weight; < 2.5 kg at birth, or still birth) were the cases while mothers without adverse birth outcome (live birth, birth weight ≥ 2.5 kg and of ≥37 gestational weeks at birth) were the controls. Data were collected by interview and reviewing medical records using structured questionnaire. The collected data were entered into database using EPI info version 3.5.1 then exported to SPSS version 21 for analysis. Finally, multivariate logistic regression was used to identify determinants of adverse birth outcomes at P value < 0.05. RESULT The mean age of cases and controls was 27.3 (SD = 6.6) and 26.14 (SD = 4.9) years, respectively. In a multivariate analysis; less than four antenatal care visits [AOR = 4.35, 95% CI: 1.15-13.50], not receiving dietary counseling [AOR = 11.24, 95% CI: 3.92-36.60], not using family planning methods [AOR = 4.06, 95% CI:1.35-17.34], less than 24 months inter pregnancy interval [AOR = 5.21, 95% CI: 1.89-13.86], and less than 11 g/dl hemoglobin level [AOR = 4.86, 95% CI: 1.83-14.01] were significantly associated with adverse birth outcomes. CONCLUSION AND RECOMMENDATION The number of antenatal care visits, ever use of family planning methods, not receiving dietary counseling during antenatal care follow up visits, short inter-pregnancy interval, and low hemoglobin level were identified as independent determinants of adverse birth outcome. A concerted effort should be taken improve family planning use, and antenatal care follow-up with special emphasis to maternal nutrition to prevent adverse birth outcomes.
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Affiliation(s)
| | | | | | - Meresa Gebremedhin Weldu
- Department of Public Health, College of Health Science, Aksum University, P.O.Box: 298, Axum, Ethiopia
| | - Kebede Haile Misgina
- Department of Public Health, College of Health Science, Aksum University, P.O.Box: 298, Axum, Ethiopia
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King C, McCollum ED. Trends in the global burden of paediatric lower respiratory infections. THE LANCET. INFECTIOUS DISEASES 2019; 20:4-5. [PMID: 31678028 PMCID: PMC7952014 DOI: 10.1016/s1473-3099(19)30557-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 08/06/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Carina King
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; Institute for Global Health, University College London, London WC1N 1EH, UK.
| | - Eric D McCollum
- Eudowood Division of Pediatric Respiratory Sciences, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Fang K, He Y, Mu M, Liu K. Maternal vitamin D deficiency during pregnancy and low birth weight: a systematic review and meta-analysis. J Matern Fetal Neonatal Med 2019; 34:1167-1173. [PMID: 31122092 DOI: 10.1080/14767058.2019.1623780] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The object of the present study was to estimate the relationship between maternal vitamin D deficiency during pregnancy and low birth weight by systematically review prevalence studies. METHODS We collected data from relevant studies published up to April 2019 using predefined inclusion/exclusion criteria. And all the studies were searched in PubMed, Embase, Cochrane Library, and Web of Science. RESULTS A total of 16 studies met the criteria and were included in the meta-analysis. When compared with normal serum levels of vitamin D, the maternal vitamin D deficiency had an increased risk of low birth weight (OR = 2.39; 95%CI 1.25-4.57; p = .008), and same results were found in the comparison of the mean (the total mean birth weight decreased by 0.08 kg; 95%CI -0.10 to -0.06; p < .001). CONCLUSION The evidence from this meta-analysis indicates a consistent association between vitamin D deficiency during pregnancy and an increased risk of low birth weight, and preventing maternal vitamin D deficiency may be an important public health strategy to help decrease the risk of low birth weight.
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Affiliation(s)
- Kehong Fang
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
| | - Yuna He
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
| | - Min Mu
- College of Medicine, Anhui University of Science and Technology Huainan, China
| | - Kai Liu
- Chinese Center for Disease Control and Prevention, National Institute of Occupation Health an Poison Control, Beijing, China
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Chen C, Cheng G, Pan J. Socioeconomic status and breastfeeding in China: an analysis of data from a longitudinal nationwide household survey. BMC Pediatr 2019; 19:167. [PMID: 31133000 PMCID: PMC6535851 DOI: 10.1186/s12887-019-1551-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 05/21/2019] [Indexed: 12/03/2022] Open
Abstract
Background Socioeconomic status is an important factor affecting the initiation and cessation of breastfeeding. However, limited evidence exists regarding the association between socioeconomic status and breastfeeding behavior in China on a national level. This study aims to investigate the relationship between socioeconomic status and the initiation and duration of breastfeeding in China. Methods Data were collected from the China Family Panel Studies, a longitudinal nationwide household survey. A total of 2938 infants born between 2010 and 2014 were included in the study. The logistic regression model was used to investigate the relationship between socioeconomic status and the initiation of breastfeeding. Meanwhile, the Cox proportional hazards model was used to investigate the relationship between socioeconomic status and the risk of breastfeeding cessation. Results Overall, 90.5% of infants were breastfed, while the average duration of breastfeeding was 8.66 months in China. The breastfeeding continuance rate at 12 months declined sharply, to 30.1%. The study’s findings also indicate that socioeconomic status did not significantly affect breastfeeding initiation. However, infants whose mothers had a high school or higher education and who scored 33–58 on the International Socio-Economic Index of Occupational Status (ISEI) were more likely to experience breastfeeding cessation, as were infants whose fathers had an ISEI score of 59–90. Conclusions Efforts to promote breastfeeding practices should be conducted comprehensively to target mothers with a high school or higher education, mothers with a medium occupational status, and fathers with a high occupational status.
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Affiliation(s)
- Chu Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Ren Min Nan Road, Chengdu, 610041, Sichuan, China
| | - Guo Cheng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Ren Min Nan Road, Chengdu, 610041, Sichuan, China
| | - Jay Pan
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Ren Min Nan Road, Chengdu, 610041, Sichuan, China. .,West China Research Centre for Rural Health Development, Sichuan University, No.17, Section 3, Ren Min Nan Road, Chengdu, 610041, Sichuan, China.
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Siyoum M, Melese T. Factors associated with low birth weight among babies born at Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia. Ital J Pediatr 2019; 45:48. [PMID: 30975170 PMCID: PMC6460807 DOI: 10.1186/s13052-019-0637-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 03/29/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Low birth weight is defined as infant born with weight of less than 2500 g. It is one of the major public health problems worldwide. In Ethiopia, there are limited evidences on factors contributing to low birthweight. OBJECTIVE To assess factors associated with low birth weight babies in Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia from March to April, 2018. METHODS AND MATERIALS An unmatched case control study was conducted at Hawassa University Comprehensive Specialized Hospital. All low birth weight newborns and two unmatched controls for each case were included in the study from March to April, 2018. Data were collected through face to face interview using a structured and pre-tested questionnaire. The collected data were managed with Epi-data version 3.1 software and exported to the Statistical Package for Social Science (SPSS) version 22. Bivariate and multivariate binary logistic regression were used to identify factors associated with low birth weight at p-value < 0.05 with their respective odds ratios and 95% confidence interval. Hosmer-Lemeshow test was used to assess goodness-of-fit. RESULTS In this study 330 mother-newborn pairs (110 cases and 220 controls) were participated making 100% response rate. Among the participants 325(98.48%) were married, 164 (49.7%) were Protestant, 296 (89.7%) had ANC follow up and 212 (64.24%) were multipara. Mothers' mid-upper arm circumference less than 220 mm [(AOR) =2.89, 95% CI: 1.58, 5.29)], lack of nutritional counseling [AOR = 2.37, 95%CI: 1.3, 4.34], presence of complications during pregnancy [AOR = 2.96, 95%CI: 1.55, 5.64)] and lack of iron supplementations during pregnancy [AOR = 2.89, 95%CI: 1.58, 5.29)] were significantly associated with Low birth weight. CONCLUSIONS Mothers' mid-upper arm circumference less than 220 mm, lack of nutritional counseling, presence of complications and lack of iron supplementations during current pregnancy were significantly associated with low birth weight. Counseling on nutrition during prenatal care needs attention of service providers.
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Affiliation(s)
- Melese Siyoum
- Department of Midwifery, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia.
| | - Teshome Melese
- Department of Midwifery, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
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Padonou SGR, Aguemon B, Bognon GMA, Houessou NE, Damien G, Ayelo P, Djossou E. Poor maternal anthropometric characteristics and newborns' birth weight and length: a cross-sectional study in Benin. Int Health 2019; 11:71-77. [PMID: 30107535 DOI: 10.1093/inthealth/ihy056] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 07/04/2018] [Indexed: 11/14/2022] Open
Abstract
Background Maternal undernutrition is known to negatively impact newborns' birth weight and length, but this finding is poorly documented in the Beninese population. This study aimed to assess the effect of maternal anthropometry on mean birth weight and length in a Beninese cohort of newborns. Methods A cross-sectional study was carried out in Tori Bossito, Republic of Benin. Pregnant women attending maternity wards between June 2007 and July 2008 were recruited. At delivery the women's characteristics, including weight and height, were gathered and newborns' birth weights and lengths were measured. Statistical analysis was performed using multiple linear regression. Results A total of 526 mother-infant pairs were enrolled; 29.8% of women had low weight status and 26.2% had short stature (<155 cm). The mean birth weight was 2985 g (standard deviation [SD] 384) the mean birth length was 48.7 cm (SD 2.2). Maternal low weight status (coefficient=-151.81, p<0.001) and short stature (coefficient=-135.49, p<0.001) reduced the mean birth weight. Similar results were found for mean birth length, which was decreased by maternal low weight status (coefficient=-0.42, p=0.04) and short stature (coefficient=-0.51, p=0.01). Conclusion Maternal undernutrition expressed by low anthropometry remains problematic in the Beninese population and induces transmission of malnutrition. Nutritional interventions are required to break this vicious cycle.
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Affiliation(s)
- Sètondji G R Padonou
- Département de Santé Publique, Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Cotonou, République du Benin
| | - Badirou Aguemon
- Département de Santé Publique, Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Cotonou, République du Benin
| | - Gilles M A Bognon
- Service de pédiatrie. Centre hospitalier universitaire départemental Ouémé-Plateau, Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Cotonou, République du Benin
| | - Nicole E Houessou
- Service de pédiatrie, Centre hospitalier universitaire Mére et Enfant Lagune, Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Cotonou, République du Benin
| | - Georgia Damien
- Département de Santé Publique, Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Cotonou, République du Benin
| | - Paul Ayelo
- Unité de recherche et d'enseignement en santé au travail et environnement, Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Cotonou, République du Benin
| | - Elisette Djossou
- Département de Santé Publique, Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Cotonou, République du Benin
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Aboye W, Berhe T, Birhane T, Gerensea H. Prevalence and associated factors of low birth weight in Axum town, Tigray, North Ethiopia. BMC Res Notes 2018; 11:684. [PMID: 30285895 PMCID: PMC6167810 DOI: 10.1186/s13104-018-3801-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 09/27/2018] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Weight at birth is a good indicator of the newborn's chances for survival, growth, long-term health and psychosocial development. Therefore, the aimed of this study is to assess the prevalence and associated factors of low birth weight in Axum town, Tigray, North Ethiopia. RESULT The magnitude of low birth weight was 8.8%. Height of mother adjusted odds ratio (AOR) 4.607 (CI 1.34-15.8), gestational age AOR 4.7 (CI 1.08-20.44), anti-natal care (ANC) visit AOR 0.076 (CI 0.009-0.645), anemia during pregnancy AOR 14.5 (CI 3.821-55.6) and drinking alcohol AOR 6.4 (CI 1.235-33.94) were found to be significantly associated with low birth weight. Pre-conceptual counseling on nutrition, about the effect of short suture on birth outcome and personal maternal habit (drinking alcohol), effective treatment and prevention of anemia and awareness on the importance ANC follow up should be the target.
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Affiliation(s)
- Wondim Aboye
- School of Public Health, College of Health Science, Aksum University, Aksum, Ethiopia
| | - Tesfay Berhe
- School of Public Health, College of Health Science, Aksum University, Aksum, Ethiopia
| | - Taddis Birhane
- School of Public Health, College of Health Science, Aksum University, Aksum, Ethiopia
| | - Hadgu Gerensea
- School of Nursing, College of Health Science, Aksum University, Aksum, Ethiopia
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Trends and determinants of stunting among under-5s: evidence from the 1995, 2001, 2006 and 2011 Uganda Demographic and Health Surveys. Public Health Nutr 2018; 21:2915-2928. [PMID: 30156173 PMCID: PMC6190071 DOI: 10.1017/s1368980018001982] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objective To describe trends of childhood stunting among under-5s in Uganda and to assess the impact of maternal education, wealth and residence on stunting. Design Serial and pooled cross-sectional analyses of data from Uganda Demographic and Health Surveys (UDHS) of 1995, 2001, 2006 and 2011. Prevalence of stunting and mean height-for-age Z-score were computed by maternal education, wealth index, region and other sociodemographic characteristics. Multivariable logistic and linear regression models were fitted to survey-specific and pooled data to estimate independent associations between covariates and stunting or Z-score. Sampling weights were applied in all analyses. Setting Uganda. Subjects Children aged <5 years. Results Weighted sample size was 14 747 children. Stunting prevalence decreased from 44·8% in 1995 to 33·2% in 2011. UDHS reported stunting as 38% in 1995, underestimating the decline because of transitioning from National Center for Health Statistics/Centers for Disease Control and Prevention standards to WHO standards. Nevertheless, one in three Ugandan children was still stunted by 2011. South Western, Mid Western, Kampala and East Central regions had highest odds of stunting. Being born in a poor or middle-income household, of a teen mother, without secondary education were associated with stunting. Other persistent stunting predictors included small birth size, male gender and age 2–3 years. Conclusions Sustained decrease in stunting suggests that child nutrition interventions have been successful; however, current prevalence does not meet Millennium Development Goals. Stunting remains a public health concern and must be addressed. Customizing established measures such as female education and wealth creation while targeting the most vulnerable groups may further reduce childhood stunting.
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He Z, Bishwajit G, Yaya S, Cheng Z, Zou D, Zhou Y. Prevalence of low birth weight and its association with maternal body weight status in selected countries in Africa: a cross-sectional study. BMJ Open 2018; 8:e020410. [PMID: 30158218 PMCID: PMC6119454 DOI: 10.1136/bmjopen-2017-020410] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The present study aimed to estimate the prevalence of low birth weight (LBW), and to investigate the association between maternal body weight measured in terms of body mass index (BMI) and birth weight in selected countries in Africa. SETTING Urban and rural household in Burkina Faso, Ghana, Malawi, Senegal and Uganda. PARTICIPANTS Mothers (n=11 418) aged between 15 and 49 years with a history of childbirth in the last 5 years. RESULTS The prevalence of LBW in Burkina Faso, Ghana, Malawi, Senegal and Uganda was, respectively, 13.4%, 10.2%, 12.1%, 15.7% and 10%. Compared with women who are of normal weight, underweight mothers had a higher likelihood of giving birth to LBW babies in all countries except Ghana. However, the association between maternal BMI and birth weight was found to be statistically significant for Senegal only (OR=1.961 (95% CI 1.259 to 3.055)). CONCLUSION Underweight mothers in Senegal share a greater risk of having LBW babies compared with their normal-weight counterparts. Programmes targeting to address infant mortality should focus on promoting nutritional status among women of childbearing age. Longitudinal studies are required to better elucidate the causal nature of the relationship between maternal underweight and LBW.
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Affiliation(s)
- Zhifei He
- School of Politics and Public Administration, Southwest University of Political Science and Law, Chongqing, China
| | - Ghose Bishwajit
- School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Dongsheng Zou
- School of Politics and Public Administration, Southwest University of Political Science and Law, Chongqing, China
| | - Yan Zhou
- School of Politics and Public Administration, Southwest University of Political Science and Law, Chongqing, China
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Levels and correlates of nutritional status of women of childbearing age in rural Bangladesh. Public Health Nutr 2018; 21:3037-3047. [PMID: 30107861 DOI: 10.1017/s1368980018001970] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The present study examined the prevalence of and risk factors for malnutrition in a population-based cohort of women of childbearing age in rural Bangladesh. DESIGN A cross-sectional study that collected pre-pregnancy weight, height, and data on selected risk factors for nutritional status of women. SETTING The study was conducted in Sylhet District of Bangladesh. SUBJECTS Study subjects included 13 230 non-pregnant women of childbearing age. Women were classified into underweight (<18·5 kg/m2), normal (18·5-24·9 kg/m2) and overweight/obese (≥25·0 kg/m2) using BMI; and into moderate to severe stunting (<150 cm), mild stunting (150-<155 cm) and normal (≥155 cm) using height. Two multinomial logistic regression models were fitted for BMI: model 1 examined individual and household factors associated with BMI, and model 2 additionally examined the association of community variables. The same analysis was conducted for height. RESULTS Prevalence of underweight, overweight/obesity and moderate to severe stunting was 37·0, 7·2 and 48·6 %, respectively. Women's education and household wealth were inversely related to both underweight status and stunting. Underweight rate was significantly lower in the post-harvest season. Women with any education and who belonged to households with higher wealth were more likely to be overweight/obese. CONCLUSIONS The study documented high underweight and stunting, and moderate overweight/obesity rates among rural Bangladeshi women; and recommends design and implementation of a multidimensional intervention programme based on individual-, household- and community-level risk factors that can address underweight, stunting and overweight/obesity to improve the nutritional status of women of childbearing age in Bangladesh.
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Is birth weight associated with blood pressure among African children and adolescents? A systematic review. J Dev Orig Health Dis 2018; 9:270-280. [PMID: 29353561 DOI: 10.1017/s2040174417001039] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
There is substantial evidence of an inverse association between birth weight and later blood pressure (BP) in populations from high-income countries, but whether this applies in low-income countries, where causes of low birth weight are different, is not certain. OBJECTIVE We conducted a review of the evidence on the relationship between birth weight and BP among African children and adolescents. Medline, EMBASE, Global Health and Web of Science databases were searched for publications to October 2016. Papers reporting the relationship between birth weight and BP among African children and adolescents were assessed. Bibliographies were searched for further relevant publications. Selected papers were summarized following the preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines. In total, 16 papers from 13 studies conducted in nine African countries (Nigeria, Republic of Seychelles, Gambia, Democratic Republic of Congo, Cameroon, South Africa, Algeria, Zimbabwe and Angola) were reviewed. Eight studies were cohorts, while five were cross-sectional. The relationship between birth weight and later BP varied with age of the participants. Studies in neonates showed a consistently positive association, while predominantly inverse associations were seen among children, and studies in adolescents were inconsistent. Based on the limited number of studies identified, the relationship between birth weight and later BP may vary with age in African children and adolescents. Not all studies adequately controlled for confounding, notably gender or age. Whether the inverse relationship between birth weight and BP in later life observed in Western settings is also seen in Africa remains unclear.
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Chen S, Yang Y, QV Y, Zou Y, ZHU H, Gong F, Zou Y, Yang H, WANG L, Lian BQ, Liu C, Jiang Y, Yan C, LI J, Wang Q, Pan H. Paternal exposure to medical-related radiation associated with low birthweight infants: A large population-based, retrospective cohort study in rural China. Medicine (Baltimore) 2018; 97:e9565. [PMID: 29480847 PMCID: PMC5943840 DOI: 10.1097/md.0000000000009565] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Low birthweight (LBW) is closely associated with fetal and perinatal mortality and morbidity. We identified the risk factors of LBW and geographical differences in LBW incidence in 30 Chinese provinces in the present study.This study was a population-based, retrospective cohort study performed in 30 Chinese provinces. We used data from the free National Pre-pregnancy Checkups Project, which is a countrywide population-based retrospective cohort study. To identify regional differences in LBW incidence, we used the Qinling-Huaihe climate line to divide China into northern and southern sections and the Heihe-Tengchong economic line to divide it into eastern and western sections. Multivariate unconditional logistic regression analysis with SAS 9.4 was used for data analysis. P < .05 was considered statistically significant.LBW incidence was 4.54% in rural China. Southern China had a significantly higher incidence (4.65%) than northern China (4.28%). Our main risk factor for LBW is paternal exposure to radiation (odds ratio = 1.537), which has never been studied before.This study identifies multiple risk factors of couples giving birth to LBW babies including paternal risk factors.
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Affiliation(s)
- Shi Chen
- Key Laboratory of Endocrinology of National Health and Family Planning Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College
| | - Yingying Yang
- Key Laboratory of Endocrinology of National Health and Family Planning Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College
| | - Yimin QV
- School of public health, PUMC, Beijing, China
| | - Yun Zou
- The Second Hospital of Jilin University. Changchun
| | - Huijuan ZHU
- Key Laboratory of Endocrinology of National Health and Family Planning Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College
| | - Fengying Gong
- Key Laboratory of Endocrinology of National Health and Family Planning Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College
| | - Yongwei Zou
- The Stomatology Hospital of Jilin University, Jilin, China
| | - Hongbo Yang
- Key Laboratory of Endocrinology of National Health and Family Planning Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College
| | - Linjie WANG
- Key Laboratory of Endocrinology of National Health and Family Planning Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College
| | - Bill Q. Lian
- University of Massachusetts Medical Center, Worcester, MA
| | - Cynthia Liu
- University of Kansas School of Medicine, 3901 Rainbow Blvd, Kansas City, KU
| | - Yu Jiang
- School of public health, PUMC, Beijing, China
| | - Chengsheng Yan
- Hebei Center for women and children's health, Shijiazhuang
| | - Jianqiang LI
- School of Software Engineering, Beijing University of Technology
| | - Qing Wang
- Tsinghua National Laboratory for Info. Science and Technology, Tsinghua University, Beijing
| | - Hui Pan
- Key Laboratory of Endocrinology of National Health and Family Planning Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College
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Ezeh OK. Trends and population-attributable risk estimates for predictors of early neonatal mortality in Nigeria, 2003-2013: a cross-sectional analysis. BMJ Open 2017; 7:e013350. [PMID: 28515184 PMCID: PMC5623451 DOI: 10.1136/bmjopen-2016-013350] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To assess trends in early neonatal mortality (ENM) and population-attributable risk (PAR) estimates for predictors of ENM in Nigeria. DESIGN, SETTING AND PARTICIPANTS A cross-sectional data on 63 844 singleton live births within the preceding 5 years from the 2003, 2008 and 2013 Nigeria Demographic and Health Surveys were used. Adjusted PARs were used to estimate the number of early neonatal deaths attributable to each predictor in the final multivariable Cox regression model. MAIN OUTCOME MEASURES ENM, defined as the death of a live-born singleton between birth and 6 days of life. RESULTS The ENM rate slightly declined from 30.5 (95% CI 26.1 to 34.9) to 26.1 (CI 24.3 to 27.9) during the study period. Approximately 36 746 (CI 14 656 to 56 920) and 37 752 (CI 23 433 to 51 126) early neonatal deaths were attributable to rural residence and male sex, respectively. Other significant predictors of ENM included small neonates (attributable number: 25 884, CI 19 172 to 31 953), maternal age <20 years (11 708, CI 8521 to 17 042), caesarean section (6312, CI 4260 to 8521) and birth order ≥4 with a short birth interval (≤2 years) (18 929, CI 12 781 to 25 563)). CONCLUSIONS To improve early neonatal survival in Nigeria, community-based interventions are needed for small neonates, and to promote delayed first pregnancy, child spacing and timely referral for sick male neonates and caesarean delivery.
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Affiliation(s)
- Osita Kingsley Ezeh
- School of Science and Health, Western Sydney University, Penrith, New South Wales, Australia
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