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

Date Published: March 1, 2019

Publisher: Public Library of Science

Author(s): Lumbani Tshotetsi, Loveness Dzikiti, Precious Hajison, Shingairai Feresu, Daynia Elizabeth Ballot.


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.

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.

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.

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.

Partial Text

Low birth weight (LBW–a baby born with less than 2500 grams) is a major cause of child morbidity and mortality, especially in sub-Saharan Africa, where most LBW babies are born [1]. Although data from Africa is not readily available, we know that treating LBW neonates is associated with high hospital expenditure in many countries [2]. The incidence of LBW deliveries has been associated with diverse factors [1], of which many are linked to a disadvantaged socio-economic status [3]. Low birth weight is an important public health concern than cannot be overlooked.

We included 1073 women who delivered at various study sites in Tshwane District. The mean age of the women was 24.18 (SD 5.13) years, 77% of whom were 20 years and older. The mean gestational age at first antenatal visit was 22.78 weeks (see Table 1), while the mean gestational age at birth was 37.16 weeks. The mean birthweight was 2675.48 grams, mean length of the infant was 48.86 centimetres, and mean head circumference was 33.21 cm. See Table 1 below

We conducted a case control study to identify the factors associated with giving birth to a LBW baby in Tshwane, South Africa. In our sample of 1073 mothers, 77% were between the 20 and 35 years old. Young mothers (<20 years) did not have an increased risk of delivering a LBW baby. In this study, LBW was associated with older maternal age; preterm birth; inadequate prenatal care; maternal HIV and syphilis infections; premature rupture of membranes and preeclampsia; and infant sex. Low birth weight continues to affect the health and wellbeing of infants. By recognising the risk factors that contribute to LBW, interventions can be tailored to address those factors. Low birth weight is a public health concern of unknown magnitude in Africa, and particularly in Tshwane District, South Africa [36]. Therefore, it is important to create an awareness of LBW amongst mothers so that they can take control of their lives and that of their unborn child during pregnancy. Additionally, ANC attendance should be advocated through different platforms such as community oriented primary care and social media (mom—connect) for prompt interventions to prevent LBW. Lowering the incidence of LBW will help in reducing infant morbidity and mortality in South Africa, and similar settings.   Source:


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