Determinants and adverse perinatal outcomes of low birth weight newborns delivered in Hawassa University Comprehensive Specialized Hospital, Ethiopia: a cohort study

Abstract

Objective: Globally an estimated 15% to 20% of all births are low birth weight, representing more than 20 million births a year. Low birth weights are at a greater risk of both short and long-term sequels. Therefore, this study was conducted to assess determinants and perinatal outcomes of low birth weight newborns delivered in Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia. Results: A total of 420 mothers were included in the study with a response rate of 97%. The mean birth weights of the neonate were 3360 (± 870 SD) grams and the incidence of low birth weight was found to be 16.6% (95% CI 13.46-18.38). Previous abortion [RR = 1.87 (2.53, 12.5)], hypertensive disorder [RR = 4.59 (4.93, 42.7)], having < 4 antenatal visits [RR = 3.45 (2.35, 13.8)] and prematurity [RR = 18.2 (6.24, 34.5)] was increased the risk of low birth weight. Low birth weight neonates were associated with a low Apgar score [RR = 18.2 (6.24, 34.5)] and early neonatal death [RR = 18.2 (6.24, 34.5)]. For this, identifying populations at the greatest risk of previous abortion, hypertensive disorders of pregnancy and prematurity were the major priorities aimed at reducing low birth weight. Incorporate mental health in the prenatal visit, improving the care for a high-risk pregnant woman was also recommended.

Low Birth Weight and Adverse Perinatal Outcomes

“…This can be due the reason that hypertension results in uteroplacental insufficiency. Similarly, the studies also reported that mothers who had fewer ANV visit than the WHO recommendations (<4 ANC visit) were more likely to give a low-weight newborn than those who adhered to the recommended ANC visits, who have more than four times [28]. This is also supported by other evidences [36,40,47].…”

“…In addition, findings also showed that those women who have at least one previous abortion were at greatest risk of giving LBW neonates as evidenced by a study done in Ethiopia [28], Denmark, and the USA [49,50] and a meta-analysis in Canada [17]. The report also in-line with the study by Bossley [51] showed that women who had an abortion in the first or second trimester had a 35% increased risk of a LBW baby and a 36% raised risk of a preterm baby in later pregnancies and Ethiopia [52] found that previous adverse pregnancy outcomes were associated with recent outcome.…”

“…Moreover, hypertensive disorder of pregnancy, a leading cause of maternal near miss and perinatal mortality, has a significant effect on the increasing trend of LBW in Africa. There was a higher risk of delivering a low-weight infant among mothers with hypertension during pregnancy as compared with their counterparts [28]. The association is increased if the delivery occurs before reaching 37 weeks of gestation [46].…”

“…The most common diagnoses associated with indicated low birth weight and preterm birth are hypertensive disorders, hemorrhage, and acute or chronic fetal compromise (fetal distress or intrauterine growth restriction). A recent study in Hawassa University Comprehensive Specialized Hospital, Southern Ethiopia, showed that previous abortion, hypertensive disorder of pregnancy, frequency of ANC visit, and gestational age at birth were the commonest predictors of LBW [28]. Sociodemographic (Figure 1),…”

“…A recent study revealed that 68% of the LBW neonates and 48% of the NBW neonates had adverse perinatal outcomes [28]. LBW newborns significantly increased the greater risk of low Apgar score (42%), early neonatal death (19.3%) and NICU admission (22.6%) [28], and increased chronic kidney disease (CKD) [62].…”