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      Maternal factors contributing to low birth weight deliveries in Tshwane District, South Africa

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          Abstract

          Background

          Low birth weight continues to be a main cause of child morbidity and mortality. Low birth weight can cause complications in adult life, and is therefore a public health concern. In this study, we determined the maternal factors that contribute to low birth weight (LBW) deliveries in Tshwane District, South Africa.

          Methods

          We conducted a case control study of 1073 randomly selected mothers who delivered babies in four hospitals in the district. We reviewed antenatal and maternity registers to obtain information about the mothers and their offspring. We fitted a multiple logistic regression to examine relationships between possible factors associated with LBW.

          Results

          From the total sample of mothers (n = 1073), 77% (n = 824) were adult women, aged 20 to 35 years. Of the adult mothers, 38.54% (n = 412) delivered low birth weight (LBW) infants. The mean gestational age and weight of all infants at birth was 37.16 weeks (SD 2.92) and 2675.48 grams (SD 616.16) respectively. LBW was associated with prematurity, odds ratio (OR) 7.15, 95% confidence interval (CI) 5.18 to 9.89; premature rupture of membranes OR 7.33, 95% CI 2.43 to 22.12 and attending fewer than five antenatal care (ANC) visits OR 1.30, 95% CI 1.06 to 1.61. Male infants were less likely to be LBW, in this population.

          Conclusion

          Women who attended fewer than five ANC visits were predisposed to give birth to low birth weight babies. Mothers should be encouraged to attend ANC visits to detect adverse events like premature rupture of membranes and premature labour timeously.

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          Most cited references22

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          Socioeconomic disparities in adverse birth outcomes: a systematic review.

          Adverse birth outcomes, such as preterm birth and low birth weight, have serious health consequences across the life course. Socioeconomic disparities in birth outcomes have not been the subject of a recent systematic review. The aim of this study was to systematically review the literature on the association of socioeconomic disadvantage with adverse birth outcomes, with specific attention to the strength and consistency of effects across socioeconomic measures, birth outcomes, and populations. Relevant articles published from 1999 to 2007 were obtained through electronic database searches and manual searches of reference lists. English-language studies from industrialized countries were included if (1) study objectives included examination of a socioeconomic disparity in a birth outcome and (2) results were presented on the association between a socioeconomic predictor and a birth outcome related to birth weight, gestational age, or intrauterine growth. Two reviewers extracted data and independently rated study quality; data were analyzed in 2008-2009. Ninety-three of 106 studies reported a significant association, overall or within a population subgroup, between a socioeconomic measure and a birth outcome. Socioeconomic disadvantage was consistently associated with increased risk across socioeconomic measures, birth outcomes, and countries; many studies observed racial/ethnic differences in the effect of socioeconomic measures. Socioeconomic differences in birth outcomes remain pervasive, with substantial variation by racial or ethnic subgroup, and are associated with disadvantage measured at multiple levels (individual/family, neighborhood) and time points (childhood, adulthood), and with adverse health behaviors that are themselves socially patterned. Future reviews should focus on identifying interventions to successfully reduce socioeconomic disparities in birth outcomes. 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
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            Adverse maternal and perinatal outcomes in adolescent pregnancies: The Global Network’s Maternal Newborn Health Registry study

            Background Adolescent girls between 15 and 19 years give birth to around 16 million babies each year, around 11% of births worldwide. We sought to determine whether adolescent mothers are at higher risk of maternal and perinatal adverse outcomes compared with mothers aged 20–24 years in a prospective, population-based observational study of newborn outcomes in low resource settings. Methods We undertook a prospective, population-based multi-country research study of all pregnant women in defined geographic areas across 7 sites in six low-middle income countries (Kenya, Zambia, India, Pakistan, Guatemala and Argentina). The study population for this analysis was restricted to women aged 24 years or less, who gave birth to infants of at least 20 weeks’ gestation and 500g or more. We compared adverse pregnancy maternal and perinatal outcomes among pregnant adolescents 15-19 years, <15 years, and adults 20-24 years. Results A total of 269,273 women were enrolled from January 2010 to December 2013. Of all pregnancies 11.9% (32,097/269,273) were in adolescents 15-19 years, while 0.14% (370/269,273) occurred among girls <15 years. Pregnancy among adolescents 15-19 years ranged from 2% in Pakistan to 26% in Argentina, and adolescent pregnancies <15 year were only observed in sub-Saharan Africa and Latin America. Compared to adults, adolescents did not show increased risk of maternal adverse outcomes. Risks of preterm birth and LBW were significantly higher among both early and older adolescents, with the highest risks observed in the <15 years group. Neonatal and perinatal mortality followed a similar trend in sub-Saharan Africa and Latin America, with the highest risk in early adolescents, although the differences in this age group were not significant. However, in South Asia the risks of neonatal and perinatal death were not different among adolescents 15-19 years compared to adults. Conclusions This study suggests that pregnancy among adolescents is not associated with worse maternal outcomes, but is associated with worse perinatal outcomes, particularly in younger adolescents. However, this may not be the case in regions like South Asia where there are decreasing rates of adolescent pregnancies, concentrated among older adolescents. The increased risks observed among adolescents seems more likely to be associated with biological immaturity, than with socio-economic factors, inadequate antenatal or delivery care. Trial registration number NCT01073475
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              Maternal associated factors of low birth weight: a hospital based cross-sectional mixed study in Tigray, Northern Ethiopia

              Background Birth weight is an important determinant of child survival and development. So far, the prevalence and traditional maternal feeding practice correlates of low birth weight have not been explored well in Ethiopia. Therefore, the purpose of this study was to determine the prevalence and associated factors of low birth weight among mothers who delivered at governmental hospitals, Northern, Ethiopia. Methods A cross-sectional mixed study design was carried out in 3 zonal hospitals among 308 mothers and their respective live born baby consecutively using interviewer administered piloted questionnaire and 3 focus group discussions were conducted for the qualitative part. The mothers were interviewed and assessed within 6 hours of delivery; all babies were weighed on standard beam balance from Aug 2 to Sep 12. Data were entered, cleaned and analyzed using SPSS version 16.0. Bivariate and multivariate logistic regression was employed to identify the predictors at p < 0.05. For the qualitative study design, following iterative hearing of the discussions verbatim interpretation was done & categorized in to themes and finally triangulated with the quantitative results. Results The prevalence of low birth weight was found to be 14.6 % (95 % CI = 12.56-16.61) and the mean and standard deviations of the birth weights were 3094.9 ± 587.6 grams. Low birth weight was associated with rural place of residence (AOR = 4.34 (95 % CI = 1.99-9.48)), preterm birth/gestational age less than 37 weeks (AOR = 18.5 (95 % CI = 4.94-69.4)), presence of any chronic medical illness (AOR = 5.3 (95 % CI = 1.12-25.45) and maternal weight <50 kg (AOR = 2.26 (95 % CI = 1.06-4.80)). It was found that tradition of selection and preference of nutritionally poor food items during pregnancy was deep-rooted in the community. Conclusion The prevalence of low birth weight was found to be high and it was associated with rural place of residence, gestational age <37 wks, presence of any chronic medical illness & maternal weight <50 kg. Emphasis should be given to nutritional counseling and disease specific ANC provision by skilled health professionals; Discussions with the community and religious leaders are mandatory aspect on the tradition of feeding of pregnant mothers to tackle the problem. This study also calls for community based further studies.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: MethodologyRole: ResourcesRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: SupervisionRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: MethodologyRole: ValidationRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: Funding acquisitionRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                1 March 2019
                2019
                : 14
                : 3
                : e0213058
                Affiliations
                [1 ] University of Pretoria, Faculty of Health Sciences, School of Health Systems and Public Health, Pretoria, South Africa
                [2 ] University of Pretoria, Faculty of Health Sciences, Department of Family Medicine, Pretoria, South Africa
                [3 ] PreLuHa consult, Zomba, Malawi
                [4 ] University of Fort Hare, Faculty of Health Sciences, East London, South Africa
                University of the Witwatersrand, SOUTH AFRICA
                Author notes

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

                Author information
                http://orcid.org/0000-0001-5896-7909
                http://orcid.org/0000-0002-5789-2375
                Article
                PONE-D-18-06002
                10.1371/journal.pone.0213058
                6396915
                30822317
                96177a06-4aca-4054-ad5f-8824cc1bf67d
                © 2019 Tshotetsi et al

                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
                : 24 February 2018
                : 15 February 2019
                Page count
                Figures: 0, Tables: 6, Pages: 13
                Funding
                Funded by: University of Pretoria (ZA) School of Health Systems and Public Health research committee
                Award Recipient :
                The authors received funding from the University of Pretoria (No 4837 - www.up.ac.za). The funders had no role in study design, data collection, analysis, decision to publish, or preparation of the manuscript.
                Categories
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                Custom metadata
                Data used for this article was from a research study for partial fulfillment of graduating in MSc Epidemiology. Data collected from this research is an intellectual property of the University of Pretoria and can be made available by contacting the Ethics Research committee chairperson at the following: fhsethics@ 123456up.ac.za .

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