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      Determinants of low birth weight among live birth newborns delivered at public hospitals in Gamo Gofa Zone, South Ethiopia: Unmatched case control study

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          Abstract

          Background:

          Birth weight is one of the major determinants of perinatal survival, infant morbidity, and mortality. There are only few published reports on assessment of low birth weight in Ethiopia and the determinants of low birth weight have not been well characterized.

          Objective:

          The aim of this study was to assess determinants of low birth weight among live birth newborns delivered at public hospitals in Gamo Gofa Zone, South Ethiopia.

          Methods:

          Institution-based case control study was conducted from February 25 to April 25, 2018 and consecutively selected 60 cases and 240 controls were enrolled in this study. The data were collected using face-to-face interview and review of medical records. Moreover, we have measured the newborns’ birth weight using a standard weight scale and mother’s mid-upper arm circumference using a standard World Health Organization mid-upper arm circumference measuring tape. Statistical analysis of the data was done using SPSS version 21.

          Results:

          A total of 300 newborns were included in the study. Late antenatal care booking (adjusted odds ratio = 1.87, confidence interval = [1.32–2.6]), birth interval <2 years (adjusted odds ratio = 0.385, confidence interval = [0.176–0.83]), anemia (adjusted odds ratio = 4.4, confidence interval = [1.84–10.5]), mid-upper arm circumference <23 cm (adjusted odds ratio = 7.99, confidence interval = [3.5–20.3]), nutritional counseling (adjusted odds ratio = 5.85, confidence interval = [2.14–14.8]), and husband smoking (adjusted odds ratio = 4.73; confidence interval = [1.42–15.7]) were found to be determinant factors of low birth weight.

          Conclusion:

          Most of the determining factors of low birth weight were preventable. Therefore, clinical and public health interventions should target on those determinant factors to prevent its adverse effects.

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          Most cited references34

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          Maternal nutrition and birth outcomes.

          In this review, the authors summarize current knowledge on maternal nutritional requirements during pregnancy, with a focus on the nutrients that have been most commonly investigated in association with birth outcomes. Data sourcing and extraction included searches of the primary resources establishing maternal nutrient requirements during pregnancy (e.g., Dietary Reference Intakes), and searches of Medline for "maternal nutrition"/[specific nutrient of interest] and "birth/pregnancy outcomes," focusing mainly on the less extensively reviewed evidence from observational studies of maternal dietary intake and birth outcomes. The authors used a conceptual framework which took both primary and secondary factors (e.g., baseline maternal nutritional status, socioeconomic status of the study populations, timing and methods of assessing maternal nutritional variables) into account when interpreting study findings. The authors conclude that maternal nutrition is a modifiable risk factor of public health importance that can be integrated into efforts to prevent adverse birth outcomes, particularly among economically developing/low-income populations.
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            The maternal and fetal physiologic effects of nicotine.

            The effects of nicotine are seen in every trimester of pregnancy, from increased spontaneous abortions in the first trimester, to increased premature delivery rates and decreased birth weights in the final trimester. The birth weight of a baby is dependent on two factors: the gestational age of the fetus at the time of delivery and the rate of fetal growth. Nicotine has been shown to affect both of these factors. Carbon monoxide, also found in tobacco, forms carboxyhemoglobin, which inhibits the release of oxygen into fetal tissues. Nicotine readily gains access to the fetal compartment via the placenta, with fetal concentrations generally 15% higher than maternal levels. The primary metabolite of nicotine, cotinine, has a half-life of 15 to 20 hours and serum concentrations that are 10-fold higher than nicotine; thus, cotinine provides a better index of nicotine exposure because of its longer half-life. Nicotine concentrates in fetal blood, amniotic fluid, and breastmilk. The fetus and neonate may also have environmental tobacco exposure that may be significant. In animal models and humans, nicotine increases maternal blood pressure and heart rate, with a concomitant reduction in uterine blood flow. An increase in fetal heart rate is also seen, which is thought to be caused by catecholamine release. The impact of nicotine on the respiratory and central nervous system is also reviewed. In conclusion, the physiological effect of tobacco on fetal growth seems to be a culmination of both the vasoconstrictive effects of nicotine on the uterine and potentially the umbilical artery and the effects on oxygenation by carboxyhemoglobin.
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              Adverse birth outcomes among deliveries at Gondar University Hospital, Northwest Ethiopia

              Background Adverse birth outcomes are major public health problems in developing countries. Data, though scarce in developing countries including Ethiopia, on adverse birth outcomes and the risk factors are important for planning maternal and child health care services. Hence, this study aimed to determine the prevalence and associated factors of adverse birth outcomes among deliveries at Gondar University Hospital, Northwest Ethiopia. Methods Institution based cross-sectional study was conducted in February 2013 at Gondar University Hospital. Data were collected by face-to-face interview of 490 women after verbal informed consent using a pretested and structured questionnaire. Gestational age was determined based on the last normal menstrual period. Birth weight was measured following standards. Multiple logistic regressions were fitted and odds ratios with their 95% confidence interval were computed to identify associated factors. Results The mean age of women was 26.2 (±5.2 SD) years. HIV infection among laboring women was 4.8%. About 23% of women had adverse birth outcomes (14.3% preterm, 11.2% low birth weight and 7.1% still births). Women having history of either preterm delivery or small baby (AOR: 3.1, 95% CI 1.1- 8.4) were more likely to have preterm births. Similarly, history of delivering preterm or small baby (AOR: 8.4, 95% CI 2.4- 29.4), preterm birth (AOR: 5.5, 95% CI 2.6- 11.6) and hypertension (AOR: 5.8, 95% CI 1.8- 19.6) were associated factors with low birth weight. Ante partum haemorrhage (AOR: 8.43, 95% CI 1.28- 55.34), hypertension (AOR: 9.5, 95% CI 2.1-44.3), history of perinatal death (AOR: 13.9, 95% CI 3.3- 58.5) and lack of antenatal care follow up (AOR: 9.7, 95% CI 2.7 - 35.8) were significantly associated with still birth. Conclusions Prevalence of adverse birth outcomes (still birth, preterm birth and low birth weight) were high and still a major public health problem in the area. Histories of perinatal death, delivering preterm or small baby, ante partum hemorrhage, lack of ante natal care follow up and hypertension were associated factors with adverse birth outcomes. Thus, further enhancements of ante natal and maternal care and early screening for hypertension are recommended.
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                Author and article information

                Journal
                SAGE Open Med
                SAGE Open Med
                SMO
                spsmo
                SAGE Open Medicine
                SAGE Publications (Sage UK: London, England )
                2050-3121
                27 July 2020
                2020
                : 8
                : 2050312120940544
                Affiliations
                [1 ]Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
                [2 ]Department of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
                [3 ]Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
                [4 ]Department of Biomedical Sciences, School of Medicine, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
                Author notes
                [*]Alemu Basazin Mingude, Department of Nursing, College of Medicine and Health Sciences, Wolkite University, P.O. Box 07, Wolkite, Ethiopia. Email: alexppx0809b@ 123456gmail.com
                Author information
                https://orcid.org/0000-0003-0369-8734
                https://orcid.org/0000-0001-5430-0971
                Article
                10.1177_2050312120940544
                10.1177/2050312120940544
                7385820
                32782793
                0c0d0f9b-27f5-4677-aea8-ea761b1a8299
                © The Author(s) 2020

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 10 April 2019
                : 17 June 2020
                Funding
                Funded by: Arba Minch University, ;
                Categories
                Original Article
                Custom metadata
                January-December 2020
                ts1

                determinants,low birth weight,ethiopia
                determinants, low birth weight, ethiopia

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