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

• Teshale Fikadu ORCID: orcid.org/0000-0002-4177-9159 ²,
• Eskeziyaw Agdew²,
• Desta Haftu^two,
• Genet Gedamu²,
• Zeritu Dewana³ &
• Bereket Getachew⁴

BMC Pregnancy and Childbirth volume 19, Commodity number:220 (2019) Cite this commodity

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Abstruse

Groundwork

Low birthweight (LBW) remains the most important risk gene which attributed to mortality of 15–20% of newborns across the globe. An infant with low birthweight is more probable to have stunting in childhood and develop markers of metabolic risk factors at his subsequently historic period. Furthermore, LBW is a take a chance for inter-generational assaults of malnutrition equally information technology is the take a chance for sub optimal growth until machismo, affecting women'due south and male'southward reproductive capabilities. Thus, there is enough concern to study the determinants of LBW across different settings. Accordingly, this study was conducted to appraise 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 nerveless using structured, pretested interviewer administered questionnaire in all public health facilities of Nekemte boondocks. Consecutive live births of less than 2500 g in each of the hospitals and wellness centres were selected as cases and succeeding babies with weights of at to the lowest degree 2500 thou equally controls. Data were entered in to Epi-information software version 3.1 and exported to SPSS Version 21 and analyzed using frequency, cross-tabs and pct. Factors with p-value < 0.25 in Bivariate assay were entered in to multivariable logistic regression and statistical significance was considered at p-value < 0.05.

Effect

A full 279 (93 cases &186 controls) were included in the study with a hateful birthweight of 2138.3 thou ± SD 206.87 for cases and 3145.95 g ± SD 415.98 for controls. No atomic number 26-folate supplementation (AOR = ii.84, 95% CI, ane.15–7.03), no nutritional counselling (AOR = iv.05, 95%CI, i.95–eight.38), not taking snacks (AOR =3.25, 95%CI, ane.64–6.44), maternal under nutrition (AOR =5.62, 95%CI, 2.64–11.97), anemia (AOR = 3.54, 95%CI, i.46–8.61) and inadequate minimum dietary diversity score of women MDDS-W (AOR = 6.65, 95%CI, 2.31–xix.xvi) were factors associated with low birthweight .

Conclusion

Defective nutrition counselling during pregnancy, lacking fe/folic acrid supplementation during pregnancy, not taking snacks during pregnancy, maternal under-diet, 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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Background

The Globe Wellness Organization (WHO) defined low birthweight (LBW) as weight less than 2500 1000 at nativity. Low birthweight contributes to a diversity of pitiable health outcomes [ane].

The majority of LBW in depression income countries is due to IUGR, while it is generally due to preterm birth in high income countries. Although in many cases, the causes of prematurity are vague, they may include maternal high claret pressure, acute infections, hard physical work, multiple births, stress, anxiety, and other psychological factors such as gender-based violence. The causes of IUGR include, poor nutritional status of the mother at conception, low weight gain during pregnancy due to insufficient dietary intake or actress expenditure of calories (hard work), brusque maternal height due to youthful nether-nutrition and infections, anemia, acute and chronic infections that could result in under-nutrition and consecutive poor pregnancy outcomes including LBW [two].

LBW is a global public health challenging problem. Its loftier priority stems from the fact that it is the major determinant of infant morbidity and that it contributes markedly to the overall burden of babyhood expiry. LBW has also been linked to the high prevalence of stunting seen in depression income countries and may be important in the ethology of chronic dietary diseases such every bit obesity, diabetes and cardiovascular diseases in adulthood [2].

Worldwide more 20 million low birthweight occur annually with the incidence of 15 to twenty%, majority of this occur in low- and center-income countries and 95.6% occur in developing nations. Its regional judge was 28% in South asia, 13% in sub-Saharan Africa and 13% in least developed country [1, 3] As EDHS 2011 written report in Addis Ababa, Ethiopia eleven.4% are LBW [four].

Being born with LBW is mostly recognized every bit a disadvantage for the infant. Amongst all neonatal decease 60 to 80% occur due to LBW. It is an important cause of perinatal mortality and both short- and long-term infant and babyhood morbidity. Mortality rate of LBW infant were up to 40 times higher than infants with birthweights of at least 2500 g, and they are many times more likely to end upward with long-term handicapping conditions [five,7,8,9,ten,11].

A contempo report washed in India has reported that maternal age (< 19 years), rural residence, maternal weight (< 45 kg), gestational age (< 37 weeks), bad obstetric history and Pregnancy-induced hypertension have a strong clan with low birthweight. A number of studies take shown correlates of babe'south maternal nutritional condition, young maternal age, bad obstetric history, maternal anemia and rural settlements, antenatal care received, prematurity, the birth interval with low birthweight [12,14,15,xvi,17,18,19,twenty,21,22,23,24,25,26,27,28,29]. However, the majority of these studies did not address maternal nutritional status and maternal dietary practices. Therefore, the aim of this report was to make up one's mind nutritional and others factors associated with LBW among newborns delivered at public health facilities of Nekemte town, West Ethiopia.

Methods and materials

Report setting and sampling

An institution-based unmatched instance control study was employed in public wellness facilities of Nekemte boondocks from March to April, 2017. The town is located 340 km westward of Addis Ababa (the capital urban center of Ethiopia). Information technology had an estimated total population of 110, 688 people in the year 2016/17 which is projected from the 2007 Ethiopia Key Statistical Agency. There are two public health centres and 2 hospitals providing commitment service for pregnant women and these public health facilities were included in the study.

Cases were all live births of less than 2500 g while controls were all alive birthweight of at least 2500 one thousand.

Sample size was calculated using Epi info version 7 by bold the proportion of women with anemia among controls and cases were 11.6 and 25.8% respectively, 95% CI, 80% power, case to control ratio of ane:two and deemed for 10% possible non-response. The full sample size was 279 (93 cases and 186 controls). To calculate sample size, maternal anemia was chosen as an independent variable since information technology gave maximum sample size. The two hospitals and ii health centres institute in Nekemte town were included. The sample is allocated proportionally based on the number of births in a 5 months period. Consecutive sampling was used to select cases and systematic random sampling was used to select controls. Controls were selected from the same health facility from which cases were selected.

Data collection and measurements

Semi structured interviewer administered questionnaires that contain; nutritional and dietary related factors, socio demographic and socio-economical related factors, medical and obstetrics related factors, behaviour related factors, environmental related factors and babe related factors. The interviews were conducted at the health facility after the mother had given birth. Questionnaires were prepared in English language and translated to local language (Afaan Oromo) by linguistic communication experts and retranslated dorsum to English by another person to check consistency. Food security condition of households was determined based on nine standard household food insecurity (HFIAS) questions that were validated for a low income state. Maternal dietary variety (MDD-West) was adamant by using 24-h dietary call up method past MDD-Due west. Maternal haemoglobin level was reviewed from client card from each public health facilities to determine anaemia.

The neonate's weight was measured using a balanced Seca calibration (Federal republic of germany) to the nearest 0.01 m inside one hours of birth. The mid-upper arm circumference (MUAC) of the mother was measured right subsequently delivery using flexible non-stretchable standard tape mensurate.

Data assay

Data was checked for completeness, coded and entered into Epi information version iii.i and exported to SPSS version 21.0 statistical software for assay. Descriptive statistics were presented using standard statistical parameters such as percentages, means and standard deviations. Bivariate analysis was washed and all explanatory variables with a p-value less than 0.25 were included in multivariable analysis. Multi variable conditional logistic regression analysis was employed to decide independent determinant factors.

Wealth index was calculated as a composite indicator of living standard by considering variables related to ownership of household avails. The computation was prepared using principal component assay and a continuous variable was generated by summing up the main components into one. Household nutrient insecurity access scale scores (0–27), were summed to produce an index of household food insecurity. As to maternal dietary diversity scores, a pregnant woman was assigned to exist acceptable if her MDD-Due west score was > 5 or inadequate with a MDD-W score < v. Hosmer and lemeshow test was used to asses model fitness (p = 0.75) and variance aggrandizement factor (VIF) and tolerance exam were used to bank check multicollinearity.

Results

Full of 279 (93 cases and 186 controls) were participants in the report. Hateful birthweight of cases and controls were 2138.28 g ± 206.87 and 3145.16 g ± 414.99. Bulk of the newborns were males 49 (52.7%) for cases and 117(62.9%) for controls. 50-two (55.ix%) of cases and 111(59.7) of controls came from an urban setting. Mothers of 61cases (65.6%) and 154 controls (82.5%) did not attend formal education. (Table ane).

Tabular array i Socio-economic and demographic characteristics of mothers of the study participants in Nekemte town, Westward Ethiopia, 2017

Full size table

Mean maternal top for cases and controls was 155 cm ± 0.07 and 159 cm ± 0.07. Under-nutrition in mothers as defined by MUAC < 23 cm was 52.7% for cases and 13.4% for controls (Tabular array ii).

Table 2 Nutritional related characteristics of mothers of written report participants in Nekemte town, West Ethiopia, 2017

Full size table

Findings of multivariable logistic regression indicated that lack of maternal atomic number 26 and folic acid supplementation during pregnancy (AOR = 2.84, 95%CI, 1.15–seven.03), lack of nutritional counselling during the electric current pregnancy (AOR = 4.05, 95% CI, 1.95–eight.38), not taking snacks (AOR = 3.25, 95%CI, one.64–six.44), maternal under nutrition (AOR = 5.62, 95%CI, 2.64–11.97), and maternal anaemia (AOR = 3.54, 95%CI, 1.46–8.61) were positively associated with low birthweight (Table 3).

Tabular array 3 Factors independently associated with LBW among newborns delivered in public wellness facilities of Nekemte town, Due west Ethiopia, 2017

Total size tabular array

Discussion

LBW is a global challenging public health trouble. Its high priority stems from the fact that it is the major predictor of infant morbidity and mortality [30].

In this written report mothers not counselled nigh diet during pregnancy had significantly higher odds of LBW than their counterparts. Nutritional counselling may improve their feeding behaviour and hence, their nutritional status which may assist mothers to decrease the risk of delivering LBW babies. The finding was consistent with studies done in Ethiopia [20, 31]. The run a risk of low birthweight was college amidst mothers who did not have snacks during the electric current pregnancy, consistent with studies done in Federal democratic republic of ethiopia and Ghana [13, 21]. Mothers who were counselled nigh feeding practices during pregnancy were 88% less likely to requite nativity to LBW infants than their counterparts. At that place is mounting prove from controlled trials that improving food intake during pregnancy effectively reduces the risk of giving nativity to LBW babies [26, 27]. Similarly, iron and folic acid supplements during pregnancy had a significantly lowering incidence of LBW, in agreement with a report from Bangladesh [22]. This is farther supported by a randomized, double-blind controlled trial comparison standard iron supplementation with multiple micronutrients during pregnancy [26]. Fe-solitary supplementation could protect against low birthweight equally compared to multiple micronutrients supplementation [26]. In add-on, an overview of controlled trials suggested a 41% decline in the prevalence of intrauterine growth retardation with folic acid supplementation [27].

Furthermore, our study reviled that anaemic mothers had higher odds to deliver LBW neonates, consequent with a study in Republic of yemen [12]. Micronutrient deficiency during pregnancy has been shown to have serious implications on the developing foetus and hence, birthweight. Severe anaemia could impair oxygen delivery to the foetus and thus interfere with normal intrauterine growth.

Consequences of inadequate nutritional intake and poor nutritional status not just directly touch on women's wellness condition, but may besides accept a negative touch on birth- weight and early development. Our findings were consistent with a study from rural Oromia in Federal democratic republic of ethiopia, in which women in the inadequate MDD-West group had an increased risk of LBW and PTB [21]. Similarly, a report from Ghana showed that women dietary diversity scores and dietary patterns were found to exist protective against low birthweight [13]. However, a recent randomized trial in Bharat of increased consumption of dairy, fruits, and light-green leafy vegetables before and during pregnancy through a especially formulated snack had no effect on birthweight [32]. This discrepancy might be due to differences in study population, geographical location, and study design.

Main strength of this report was taking birthweight within 1 hour after nascence. Measurement of some explanatory variables were, however, prone to recall bias. Finally, findings of this report tin take a significant implication for prevention of depression birthweight and emphasis should be given to diet education, nutrition assessment, supplementation of fe-folic acid and prevention of anaemia during pregnancy.

Conclusion and recommendation

Several factors were plant to be associated with low birthweight. Lack of iron and folic acrid supplementation, absence of nutritional counselling during pregnancy, not taking snacks during pregnancy, MUAC less than 23, maternal anaemia and inadequate MDD-W were identified to be significant predictors of LBW. Governmental and not-governmental organizations working on maternal and child health should focus on identified factors in order to tackle the problem of LBW.

Availability of data and materials

All relevant data are within the newspaper and its Supporting Data.

Abbreviations

AOR:

adjusted odds ratio

CI:

confidence interval

HFIAS:

Household Nutrient Insecurity Access Scale

LBW:

Low Birthweight

MDD-W:

Minimum dietary diversity score of women

MUAC:

Mid upper arm circumference

VIF:

Variable inflation factor

WHO:

Globe health organisation

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Acknowledgments

The authors would similar to express their gratitude to respective health facility, data collectors, supervisors and study participants for their diligence and dedication in the collecting and inputting loftier quality data used in the study.

Disharmonize interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Author information

Affiliations

1. Section of Psychiatry, Establish of Health, Jimma University, Jimma, Ethiopia

   Shimelis Girma

2. Department of Public Health, College of Medicine and Health Scientific discipline, Arba Minch University, Arba Minch, Ethiopia

   Teshale Fikadu, Eskeziyaw Agdew, Desta Haftu & Genet Gedamu

3. Department of Midwifery, Arba Minch College of Health Sciences, Arba Minch, Ethiopia

   Zeritu Dewana

4. Department of Statistics, College of Natural Scientific discipline, Arba Minch University, Arba Minch, Ethiopia

   Bereket Getachew

Contributions

SG involved from the inception to blueprint, acquisition of data, analysis and interpretation, drafting the manuscript, TF involved in the conquering, assay, interpretation and revision of the manuscript, EA involved in the conquering, analysis, interpretation and revision of the manuscript, DH involved in the acquisition, analysis, interpretation and revision of the manuscript, GG involved in the conquering, analysis, estimation and revision of the manuscript, BG involved in the conquering, analysis, interpretation and revision of the manuscript and ZD involved in the acquisition, assay, interpretation and revision of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Teshale Fikadu.

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Ethics approval and consent to participate

Upstanding approval and clearance was obtained from Wollega university ethical review lath. Informed written consent was obtained from mothers, each report participants was informed virtually the aim of the study and participant involvement was on voluntary footing. All neonates with low birthweight were linked to neonatal care eye in the hospitals.

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Girma, Southward., Fikadu, T., Agdew, E. et al. Factors associated with low birthweight among newborns delivered at public wellness facilities of Nekemte town, West Ethiopia: a instance command study. BMC Pregnancy Childbirth 19, 220 (2019). https://doi.org/10.1186/s12884-019-2372-10

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• Received: 22 March 2018

• Accustomed: 24 June 2019

• Published: 02 July 2019

• DOI : https://doi.org/x.1186/s12884-019-2372-x

Keywords

• Depression birthweight
• Maternal nutritional status
• Nekemte town

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