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Indian Pediatr. 1994 Oct;31(10):1221-5.

Determinants of low birth weight: a community based prospective cohort study.

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  • 1K.E.M. Hospital Research Centre, Rasta Peth, Pune.

Abstract

The study aimed at identifying and quantifying determinants of low birth weight (LBW) by following a community based prospective cohort of pregnant women in 45 villages in Pune district. In the 1922 live births born to mothers without a chronic illness, in whom birth weight was available within 24 hours, the cumulative incidence of LBW (< 2500 g) was 29%. The unadjusted relative risks for LBW were significantly higher for lower socio-economic status (RR = 1.71), maternal age less than 20 years (RR = 1.27), primiparity (RR = 1.32), last pregnancy interval less than 6 months (RR = 1.48), non-pregnant weight less than 40 kg (RR = 1.3), height below 145 cm (RR = 1.51), hemoglobin less than 9 g/dl (RR = 1.53) and third trimester bleeding (RR = 1.87). Multivariate logistic regression analysis showed that the adjusted odds ratio for LBW decreased with increasing gestational duration, non-pregnant weight, parity and rising education level of the mother. Socio-economic status, non-pregnant weight, maternal height, and severe anemia in pregnancy had substantial attributable risk per cent for LBW (41.4%, 22.9%, 29.5% and 34.5%, respectively). The findings suggest that selectively targetted interventions such as improving maternal education and nutrition, specifically anemia, wider availability of contraception to delay the first pregnancy and to increase pregnancy intervals may help in identifying and ensuring adequate care for those women at greatest risk of LBW.

PIP:

In India, medical social workers followed a cohort of 1922 pregnant women in 45 contiguous villages in Pune District at monthly intervals so researchers could identify and quantify risk factors of low birth weight (LBW: 2500 g). 29% of the infants were LBW infants. LBW infants were significantly more likely to be born to mothers of very low socioeconomic status (unadjusted relative risk [RR] = 1.71), aged less than 20 (RR = 1.27), pregnant for the first time (RR = 1.32), whose last pregnancy interval was shorter than 6 months (RR = 1.48), whose nonpregnant weight was less than 40 kg (RR = 1.3), whose height was less than 145 cm (RR = 1.51), whose hemoglobin was less than 9 g/dl (RR = 1.53), who bled during the third trimester (RR = 1.87), and who delivered the infant prematurely (i.e., 32 weeks) (RR = 3.84). Mothers with 8-10 years of formal schooling were less likely to have an LBW infant than illiterate mothers (RR = 0.78). Boys were less likely to be LBW infants than girls (RR = 0.78). The multivariate logistic regression analysis revealed that the adjusted odds ratio for LBW fell as gestational age (0.207), nonpregnant weight (0.711), parity (0.835), and maternal educational status (0.869) increased. The attributable risk percentages for risk factors were 73.9% for premature birth, 46.6% for third trimester bleeding, 41.4% for very low socioeconomic status, 34.5% for hemoglobin less than 9 g/dl, 32.5% for last pregnancy interval shorter than 6 months, 29.5% for height less than 145 cm, 24.4% for primiparity, 22.9% for nonpregnant weight less than 40 kg, 21.3% for adolescent mother, and 21.5% (preventive fraction) for high maternal educational status. These findings suggest that health professionals should target limited resources to improving maternal education and nutrition status (i.e., reducing anemia), to providing wider availability of contraception to delay age at first pregnancy and to increase intervals between births, and to making sure that mothers at greatest risk of delivering a LBW infant receive appropriate care.

PMID:
7875782
[PubMed - indexed for MEDLINE]
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