Risk factors for low birth weight in hospitals of North Wello zone, Ethiopia: A case-control study

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Abstract

Background

Low birth weight at birth is an important underlying contributor for neonatal and infant mortality. It accounts for nearly half of all perinatal deaths. Identifying predictors of low birth weight is the first essential step in designing appropriate management strategies. Hence, this study aimed to identify risk factors for low birth weight in hospitals of northeastern Ethiopia.

Methods

An institution based case-control study design was conducted from 10 ^th April to 15 ^th December 2016. Three hundred sixty mother-infant pairs (120 low birth weight babies as cases and 240 normal birth weights as controls) were included in the study. Data were collected by face-to-face interview. Univariable and multivariable logistic regression models were computed to examine the effect of independent variables on outcome variable using SPSS 20.0. Variables with p-value <0.05 were considered statistically significant.

Results

The mean (±SD) gestational age and birth weight (±SD) were 39.2 (±1.38) weeks and 2800 (±612), grams respectively. Partner’s education/being illiterate (AOR: 4.09; 95% CI 1.45, 11.50), antenatal care visit at private health institutions (AOR: 0.13; 95% CI 0.02, 0.66), having history of obstetric complications (AOR: 5.70; 95% CI 2.38, 13.63), maternal weight during pregnancy (AOR: 4.04; 95% CI 1.50, 10.84) and gravidity (AOR: 0.36; 95% CI 0.18, 0.73) were significantly associated with low birth weight. Additionally, a site for water storage and water treatment were significant environmental factors.

Conclusion

Maternal weight during pregnancy, paternal education, previous obstetric complication and place of antenatal follow-up were associated with low birth weight. The risk factors identified in this study are preventable. Thus, nutritional counseling, health education on improvement of lifestyle and early recognition and treatment of complications are the recommended interventions.

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Most cited references 33

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Maternal anemia and risk of adverse birth and health outcomes in low- and middle-income countries: systematic review and meta-analysis.

Md Mizanur Rahman, Sarah Krull Abe, Md. Rahman … (2016)

Anemia is a leading cause of maternal deaths and adverse pregnancy outcomes in developing countries.

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Outcomes for extremely premature infants.

Hannah Glass, Andrew Costarino, Stephen A Stayer … (2015)

Premature birth is a significant cause of infant and child morbidity and mortality. In the United States, the premature birth rate, which had steadily increased during the 1990s and early 2000s, has decreased annually for 7 years and is now approximately 11.39%. Human viability, defined as gestational age at which the chance of survival is 50%, is currently approximately 23 to 24 weeks in developed countries. Infant girls, on average, have better outcomes than infant boys. A relatively uncomplicated course in the intensive care nursery for an extremely premature infant results in a discharge date close to the prenatal estimated date of confinement. Despite technological advances and efforts of child health experts during the last generation, the extremely premature infant (less than 28 weeks gestation) and extremely low birth weight infant (<1000 g) remain at high risk for death and disability with 30% to 50% mortality and, in survivors, at least 20% to 50% risk of morbidity. The introduction of continuous positive airway pressure, mechanical ventilation, and exogenous surfactant increased survival and spurred the development of neonatal intensive care in the 1970s through the early 1990s. Routine administration of antenatal steroids during premature labor improved neonatal mortality and morbidity in the late 1990s. The recognition that chronic postnatal administration of steroids to infants should be avoided may have improved outcomes in the early 2000s. Evidence from recent trials attempting to define the appropriate target for oxygen saturation in preterm infants suggests arterial oxygen saturation between 91% and 95% (compared with 85%-89%) avoids excess mortality; however, final analyses of data from these trials have not been published, so definitive recommendations are still pending. The development of neonatal neurocritical intensive care units may improve neurocognitive outcomes in this high-risk group. Long-term follow-up to detect and address developmental, learning, behavioral, and social problems is critical for children born at these early gestational ages.The striking similarities in response to extreme prematurity in the lung and brain imply that agents and techniques that benefit one organ are likely to also benefit the other. Finally, because therapy and supportive care continue to change, the outcomes of extremely low birth weight infants are ever evolving. Efforts to minimize injury, preserve growth, and identify interventions focused on antioxidant and anti-inflammatory pathways are now being evaluated. Thus, treating and preventing long-term deficits must be developed in the context of a "moving target."

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Parity and low birth weight and preterm birth: a systematic review and meta-analyses.

, Prakesh S. Shah (2010)

To systematically review the risks of pregnancy outcomes among women of different parity. Electronic databases were searched for studies, in English language, in which primary objective was to assess association between parity and pregnancy outcomes. Meta-analyses were performed and unadjusted odds ratios (ORs) and mean differences along with 95% confidence interval (CI) were calculated. Low birth weight (LBW), preterm birth (PTB), small for gestational age (SGA), birth weight, and gestational age. Forty-one studies, most with moderate risk of bias were included. Nulliparity was associated with increased unadjusted odds of LBW (OR 1.41, 95% CI 1.26, 1.58) and SGA (OR 1.89, 95% CI 1.82, 1.96) and reduction in birth weight (weighted mean difference -282 g, 95% CI -486, -79 g) but not PTB (OR 1.13, 95% CI 0.96, 1.34). Grand multiparity and great grand multiparity were not associated with LBW (OR 1.10, 95% CI 0.95, 1.32 and OR 0.92, 95% CI 0.78, 1.09) or PTB (OR 0.96, 95% CI 0.77, 1.19 and OR 1.32, 95% CI 0.61, 2.83). Nulliparity was associated with a significantly increased unadjusted risk of LBW/SGA birth, whereas grand multiparity and great grand multiparity were not associated with increased risk of pregnancy outcomes.

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Author and article information

Contributors

Tesfahun Mulatu Wachamo: Role: ConceptualizationRole: Project administrationRole: Writing – original draft

Nigus Bililign Yimer:

ORCID: http://orcid.org/0000-0001-5610-8369

Role: Formal analysisRole: MethodologyRole: Writing – review & editing

Asmamaw Demis Bizuneh: Role: Data curationRole: SupervisionRole: Writing – review & editing

Eduardo Ortiz-Panozo: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS ONE

Journal ID (publisher-id): plos

Journal ID (pmc): plosone

Title: PLoS ONE

Publisher: Public Library of Science (San Francisco, CA USA )

ISSN (Electronic): 1932-6203

Publication date (Electronic): 20 March 2019

Publication date Collection: 2019

Volume: 14

Issue: 3

Electronic Location Identifier: e0213054

Affiliations

[1 ] Department of Public Health, Faculty of Health Sciences, Woldia University, Woldia, Ethiopia

[2 ] Department of Midwifery, Faculty of Health Sciences, Woldia University, Woldia, Ethiopia

[3 ] Department of Nursing, Faculty of Health Sciences, Woldia University, Woldia, Ethiopia

National Institute of Public Health, MEXICO

Author notes

Competing Interests: The authors have declared that no competing interests exist.

* E-mail: bililignnigus@ 123456gmail.com

Author information

Nigus Bililign Yimer http://orcid.org/0000-0001-5610-8369

Article

Publisher ID: PONE-D-17-13398

DOI: 10.1371/journal.pone.0213054

PMC ID: 6426181

PubMed ID: 30893344

SO-VID: 60a86868-e98d-41b4-93bc-8899d19ac5c5

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 8 May 2017

Date accepted : 14 February 2019

Page count

Figures: 0, Tables: 4, Pages: 15

Funding

Woldia University sponsored this study. www.wldu.edu.et The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Data Availability All relevant data are within the paper and its Supporting Information files.

Risk factors for low birth weight in hospitals of North Wello zone, Ethiopia: A case-control study

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Most cited references 33

Maternal anemia and risk of adverse birth and health outcomes in low- and middle-income countries: systematic review and meta-analysis.

Outcomes for extremely premature infants.

Parity and low birth weight and preterm birth: a systematic review and meta-analyses.

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