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      Factors associated with low birthweight among newborns delivered at public health facilities of Nekemte town, West Ethiopia: a case control study

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          Abstract

          Background

          Low birthweight (LBW) remains the most important risk factor which attributed to mortality of 15–20% of newborns across the globe. An infant with low birthweight is more likely to have stunting in childhood and develop markers of metabolic risk factors at his later age. Furthermore, LBW is a risk for inter-generational assaults of malnutrition as it is the risk for sub optimal growth until adulthood, affecting women’s and male’s reproductive capabilities. Thus, there is enough concern to study the determinants of LBW across different settings. Accordingly, this study was conducted to assess the determinants of low birthweight s in public health facilities of Nekemte town, West Ethiopia.

          Methods

          Facility based unmatched case control study was employed from February to April 2017. The data were collected using structured, pretested interviewer administered questionnaire in all public health facilities of Nekemte town. Consecutive live births of less than 2500 g in each of the hospitals and health centres were selected as cases and succeeding babies with weights of at least 2500 g as controls. Data were entered in to Epi-data software version 3.1 and exported to SPSS Version 21 and analyzed using frequency, cross-tabs and percentage. Factors with p-value < 0.25 in Bivariate analysis were entered in to multivariable logistic regression and statistical significance was considered at p-value < 0.05.

          Result

          A total 279 (93 cases &186 controls) were included in the study with a mean birthweight of 2138.3 g ± SD 206.87 for cases and 3145.95 g ± SD 415.98 for controls. No iron-folate supplementation (AOR = 2.84, 95% CI, 1.15–7.03), no nutritional counselling (AOR = 4.05, 95%CI, 1.95–8.38), not taking snacks (AOR =3.25, 95%CI, 1.64–6.44), maternal under nutrition (AOR =5.62, 95%CI, 2.64–11.97), anemia (AOR = 3.54, 95%CI, 1.46–8.61) and inadequate minimum dietary diversity score of women MDDS-W (AOR = 6.65, 95%CI, 2.31–19.16) were factors associated with low birthweight .

          Conclusion

          Lacking nutrition counselling during pregnancy, lacking iron/folic acid supplementation during pregnancy, not taking snacks during pregnancy, maternal under-nutrition, maternal anemia and inadequate minimum dietary diversity score of women (MDDS-W) were independently associated with LBW. Thus, public health intervention in the field of maternal and child health should address these determinants.

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          Most cited references 25

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          The Social Determinants of Infant Mortality and Birth Outcomes in Western Developed Nations: A Cross-Country Systematic Review

          Infant mortality (IM) and birth outcomes, key population health indicators, have lifelong implications for individuals, and are unequally distributed globally. Even among western industrialized nations, striking cross-country and within-country patterns are evident. We sought to better understand these variations across and within the United States of America (USA) and Western Europe (WE), by conceptualizing a social determinants of IM/birth outcomes framework, and systematically reviewing the empirical literature on hypothesized social determinants (e.g., social policies, neighbourhood deprivation, individual socioeconomic status (SES)) and intermediary determinants (e.g., health behaviours). To date, the evidence suggests that income inequality and social policies (e.g., maternal leave policies) may help to explain cross-country variations in IM/birth outcomes. Within countries, the evidence also supports neighbourhood SES (USA, WE) and income inequality (USA) as social determinants. By contrast, within-country social cohesion/social capital has been underexplored. At the individual level, mixed associations have been found between individual SES, race/ethnicity, and selected intermediary factors (e.g., psychosocial factors) with IM/birth outcomes. Meanwhile, this review identifies several methodological gaps, including the underuse of prospective designs and the presence of residual confounding in a number of studies. Ultimately, addressing such gaps including through novel approaches to strengthen causal inference and implementing both health and non-health policies may reduce inequities in IM/birth outcomes across the western developed world.
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            Improving women's diet quality preconceptionally and during gestation: effects on birth weight and prevalence of low birth weight—a randomized controlled efficacy trial in India (Mumbai Maternal Nutrition Project)12345

            Background: Low birth weight (LBW) is an important public health problem in undernourished populations. Objective: We tested whether improving women's dietary micronutrient quality before conception and throughout pregnancy increases birth weight in a high-risk Indian population. Design: The study was a nonblinded, individually randomized controlled trial. The intervention was a daily snack made from green leafy vegetables, fruit, and milk (treatment group) or low-micronutrient vegetables (potato and onion) (control group) from ≥90 d before pregnancy until delivery in addition to the usual diet. Treatment snacks contained 0.69 MJ of energy (controls: 0.37 MJ) and 10–23% of WHO Reference Nutrient Intakes of β-carotene, riboflavin, folate, vitamin B-12, calcium, and iron (controls: 0–7%). The primary outcome was birth weight. Results: Of 6513 women randomly assigned, 2291 women became pregnant, 1962 women delivered live singleton newborns, and 1360 newborns were measured. In an intention-to-treat analysis, there was no overall increase in birth weight in the treatment group (+26 g; 95% CI: −15, 68 g; P = 0.22). There was an interaction (P 21.8) thirds of BMI, respectively]. In 1094 newborns whose mothers started supplementation ≥90 d before pregnancy (per-protocol analysis), birth weight was higher in the treatment group (+48 g; 95% CI: 1, 96 g; P = 0.046). Again, the effect increased with maternal BMI (−8, +79, and +113 g; P-interaction = 0.001). There were similar results for LBW (intention-to-treat OR: 0.83; 95% CI: 0.66, 1.05; P = 0.10; per-protocol OR = 0.76; 95% CI: 0.59, 0.98; P = 0.03) but no effect on gestational age in either analysis. Conclusions: A daily snack providing additional green leafy vegetables, fruit, and milk before conception and throughout pregnancy had no overall effect on birth weight. Per-protocol and subgroup analyses indicated a possible increase in birth weight if the mother was supplemented ≥3 mo before conception and was not underweight. This trial was registered at www.controlled-trials.com/isrctn/ as ISRCTN62811278.
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              Etiology and prognosis of pregnancy-related pelvic girdle pain; design of a longitudinal study

              Background Absence of knowledge of pregnancy-related pelvic girdle pain (PPGP) has prompted the start of a large cohort study in the Netherlands. The objective of this study was to investigate the prevalence and incidence of PPGP, to identify risk factors involved in the onset and to determine the prognosis of pregnancy-related pelvic girdle pain. Methods/design 7,526 pregnant women of the southeast of the Netherlands participated in a prospective cohort study. During a 2-year period, they were recruited by midwives and gynecologists at 14 weeks of pregnancy. Participants completed a questionnaire at baseline, at 30 weeks of pregnancy, at 2 weeks after delivery, at 6 months after delivery and at 1 year after delivery. The study uses extensive questionnaires with questions ranging from physical complaints, limitations in activities, restriction in participation, work situation, demographics, lifestyle, pregnancy-related factors and psychosocial factors. Discussion This large-scale prospective cohort study will provide reliable insights in incidence, prevalence and factors related to etiology and prognosis of pregnancy-related pelvic girdle pain.
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                Author and article information

                Contributors
                shimelisgirma@gmail.com
                fikaduteshale1@gmail.com
                esk1agid@gmail.com
                destish.haf@gmail.com
                geni_31280@yahoo.com
                dewanazeritu@gmail.com
                bereket_g@yahoo.com
                Journal
                BMC Pregnancy Childbirth
                BMC Pregnancy Childbirth
                BMC Pregnancy and Childbirth
                BioMed Central (London )
                1471-2393
                2 July 2019
                2 July 2019
                2019
                : 19
                Affiliations
                [1 ]ISNI 0000 0001 2034 9160, GRID grid.411903.e, Department of Psychiatry, , Institute of Health, Jimma University, ; Jimma, Ethiopia
                [2 ]GRID grid.442844.a, Department of Public Health, College of Medicine and Health Science, , Arba Minch University, ; Arba Minch, Ethiopia
                [3 ]Department of Midwifery, Arba Minch College of Health Sciences, Arba Minch, Ethiopia
                [4 ]GRID grid.442844.a, Department of Statistics, College of Natural Science, , Arba Minch University, ; Arba Minch, Ethiopia
                Article
                2372
                10.1186/s12884-019-2372-x
                6604438
                31266469
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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                Research Article
                Custom metadata
                © The Author(s) 2019

                Obstetrics & Gynecology

                low birthweight, maternal nutritional status, nekemte town

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