Comparisons of newborn birthweights with maternal factors at Phalombe District Hospital, Malawi: a retrospective record review

Abstract

Background: Birthweight is an important indicator of the newborn's future health. Maternal factors, including age, HIV status, parity and obstetric complications ([pre]-eclampsia, antepartum hemorrhage [APH] and sepsis), however, have been shown as risk factors of low birthweight (LBW). For data-guided interventions, we compared newborn birthweights with these factors at Phalombe District Hospital, Malawi. Methods: Using a retrospective record review study design, we extracted data of 1,308 women and their newborns from maternity registers (October, 2022-March, 2023). Data were skewed. Its distribution in each group had different variabilities/shapes. We used Mann-Whitney U/Kruskal-Wallis H tests to compare mean ranks of birthweights. Results: Prevalence of LBW was 17.4% and median birthweight was 2,900.00g (interquartile range [IQR] 2,600.00g-3,200.00g). We observed significant difference in newborn birthweights among adolescent girls (≤19 years), young women (20-24 years), older women (25-34 years) and women of advanced maternal age (≥35 years), (mean ranks: 600.32, 650.85, 690.62 and 735.34, respectively, H[3] = 20.30, p<.001, η2 = 0.01). Pairwise comparisons showed significant differences in newborn birthweights of adolescent girls and older women (p = .006), adolescent girls and women of advanced maternal age (p<.001). We observed no significant differences in newborn birthweights between HIV+ and HIV- women (mean ranks: 608.86 and 659.28, respectively, U = 67,748.50, Z = -1.417, p = .157, r = 0.04). We found significant differences in newborn birthweights between primiparous and multiparous women (mean ranks: 600.95 and 697.16, respectively, U = 180,062.00, Z = -4.584, p<.001, r = 0.13), women with and women with no (pre)-eclampsia, APH and sepsis (mean ranks: 340.09 and 662.64, respectively, U = 10,662.00, Z = -4.852, p<.001, r=0.13). Conclusion: Significant differences reported notwithstanding, small effect sizes and a high prevalence of LBW were observed. Thus, all pregnant women should be prioritized to improve birthweight outcomes. Those with complications, however, require special care.