Research Article: Incidence and recurrence risk of low birth weight in Northern Tanzania: A registry based study

Date Published: April 22, 2019

Publisher: Public Library of Science

Author(s): Miriam H. Mvunta, Innocent B. Mboya, Sia E. Msuya, Beatrice John, Joseph Obure, Michael J. Mahande, Massimo Ciccozzi.

http://doi.org/10.1371/journal.pone.0215768

Abstract

Low birth weight (LBW) is an important indicator of newborn survival. It is associated with higher risk of morbidity, mortality and long-term health consequences. Little has been done on incidence and recurrence risk of LBW in developing countries including Tanzania. This study aimed to determine the incidence and recurrence risk of LBW among women who delivered at Kilimanjaro Christian Medical Center (KCMC), Tanzania.

A hospital-based prospective cohort study was conducted using maternally-linked data from KCMC birth registry between 2000 and 2010. A total of 26,191 women delivered singleton live babies during the study period. Of these, 4,603 (17.6%) had subsequent pregnancies. The recurrence risk of LBW was estimated using a multivariable log-binomial regression model. A robust variance estimator was used to account for correlation between births of the same mother.

The incidence of LBW was 7.1%. The absolute recurrence risk of LBW was 28.1%. This corresponds to a relative risk (RR) of 5.08-fold, 95% CI 4.01–6.45). Antenatal care visits (<4) (RR: 5.00; 95% CI 3.58–6.98), preterm birth (RR: 4.55; 95% CI 3.21–6.43), positive HIV status (RR: 7.49: 95% CI 3.91–14.36) and preeclampsia (RR: 4.37; 2.60–7.35) in the first pregnancy were important predictors of LBW recurrence. The incidence of LBW and its recurrence was high in the study population. Women with previous history of LBW had higher risk of recurrent LBW in subsequent pregnancies. Identification of factors associated with LBW recurrence, proper post-partum care management to ensure Healthy Timing and Spacing of Pregnancy, Pre-conception care and close clinical follow-up during subsequent pregnancy may help reduce LBW recurrence.

Partial Text

Low birth weight (LBW) is defined as the newborn weight at birth of less than 2500 grams regardless of gestational age [1–3]. It is an important indicator for newborn survival. LBW may result from prematurity or intra uterine growth retardation or both [1]. It is associated with higher risk of morbidity, mortality and long-term life health consequences [4]. It has been estimated that 15% to 20% of all births worldwide are low birth weight, which corresponds to more than 20 million births a year [3].

There were 26,191 women who delivered at KCMC between 2000–2010, this corresponds to 30,800 deliveries. Out of these, 2,497 (9.5%) women had LBW infants in their first pregnancy. A total of 4,603 women confirmed to have more than one delivery within the follow up time, out of which 325 (7.1%) had recurrent LBW.

This study explored the incidence of LBW, LBW recurrence and associated factors among women who delivered singletons in subsequent pregnancies. A total of 9.5% women had LBW baby in their first pregnancy. The incidence of LBW in subsequent pregnancy was 7.1% while the absolute risk of recurrence was 28.1%. Predictors of LBW in subsequent pregnancy included delivery of LBW baby in first pregnancy, less than 4 visits attendance to antenatal care, prematurity, HIV positive status of mother and preeclampsia.

Incidence of LBW in subsequent pregnancy was 7.1% and the absolute risk of LBW recurrence in this population was 28.1% which is higher compared to 5.2% among those who delivered a normal birth weight baby. Recurrent LBW was associated with the history of LBW in first pregnancy, history of pre-eclampsia/ eclampsia, prematurity, inadequate antenatal care visits and HIV positive status of the mother. Identification of factors associated with LBW recurrence, proper post-partum care management to ensure Healthy Timing and Spacing of Pregnancy, Pre-conception care and close clinical follow-up during subsequent pregnancy may help reduce LBW recurrence.

 

Source:

http://doi.org/10.1371/journal.pone.0215768

 

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