Predictors of low birth weight and preterm birth in rural Uganda: Findings from a birth cohort study
Loading...
Date
2014
Journal Title
Journal ISSN
Volume Title
Publisher
PloS one
Abstract
Approximately 20.5 million infants were born weighing <2500 g (defined as low birthweight
or LBW) in 2015, primarily in low- and middle-income countries (LMICs). Infants born LBW,
including those born preterm (<37 weeks gestation), are at increased risk for numerous consequences,
including neonatal mortality and morbidity as well as suboptimal health and
nutritional status later in life. The objective of this study was to identify predictors of LBW
and preterm birth among infants in rural Uganda.
Methods
Data were derived from a prospective birth cohort study conducted from 2014–2016 in 12
districts across northern and southwestern Uganda. Birth weights were measured in triplicate
to the nearest 0.1 kg by trained enumerators within 72 hours of delivery. Gestational
age was calculated from the first day of last menstrual period (LMP). Associations between
household, maternal, and infant characteristics and birth outcomes (LBW and preterm birth)
were assessed using bivariate and multivariable logistic regression with stepwise, backward
selection analyses.
Results
Among infants in the study, 4.3% were born LBW (143/3,337), and 19.4% were born preterm
(744/3,841). In multivariable analysis, mothers who were taller (>150 cm) (adjusted
Odds Ratio (aOR) = 0.42 (95% CI = 0.24, 0.72)), multigravida (aOR = 0.62 (95% CI = 0.39, 0.97)), or with adequate birth spacing (>24 months) (aOR = 0.60 (95% CI = 0.39, 0.92))
had lower odds of delivering a LBW infant Mothers with severe household food insecurity
(aOR = 1.84 (95% CI = 1.22, 2.79)) or who tested positive for malaria during pregnancy
(aOR = 2.06 (95% CI = 1.10, 3.85)) had higher odds of delivering a LBW infant. In addition,
in multivariable analysis, mothers who resided in the Southwest (aOR = 0.64 (95% CI =
0.54, 0.76)), were �20 years old (aOR = 0.76 (95% CI = 0.61, 0.94)), with adequate birth
spacing (aOR = 0.76 (95% CI = 0.63, 0.93)), or attended �4 antenatal care (ANC) visits
(aOR = 0.56 (95% CI = 0.47, 0.67)) had lower odds of delivering a preterm infant; mothers
who were neither married nor cohabitating (aOR = 1.42 (95% CI = 1.00, 2.00)) or delivered
at home (aOR = 1.25 (95% CI = 1.04, 1.51)) had higher odds.
Conclusions
In rural Uganda, severe household food insecurity, adolescent pregnancy, inadequate birth
spacing, malaria infection, suboptimal ANC attendance, and home delivery represent modifiable
risk factors associated with higher rates of LBW and/or preterm birth. Future studies
on interventions to address these risk factors may be warranted.
Description
Keywords
Birth weight, Preterm birth, Rural Uganda
Citation
Karthik, L., Kumar, G., Keswani, T., Bhattacharyya, A., Chandar, S. S., & Bhaskara Rao, K. V. (2014). Protease inhibitors from marine actinobacteria as a potential source for antimalarial compound. PloS one, 9(3), e90972. https://doi.org/10.1371/journal.pone.0235626