Determinants of low birthweight, small‐for‐gestational‐age and preterm birth in Lombok, Indonesia: analyses of the birthweight cohort of the SUMMIT trial

Abstract

Abstractobjective To examine the determinants of low birthweight (LBW), small-for-gestation (SGA) and preterm births in Lombok, Indonesia, an area of high infant mortality.methods Data from The Supplementation with Multiple Micronutrient Intervention Trial (SUMMIT), a double-blind cluster-randomised controlled trial, were analysed. The odds ratio of factors known to be associated with LBW, SGA and preterm birth was assessed and adjusted for the cluster design of the trial using hierarchical logistic regression. Determinants included constitutional, demographic and psychosocial factors, toxic exposure, maternal nutrition and obstetric history and maternal morbidity during and prior to pregnancy. Population attributable risks of modifiable determinants were calculated.results A cohort of 14 040 singleton births was available for analysis of LBW, with 13 498 observations for preterm births and 13 461 for SGA births. Determinants of LBW and SGA were similar and included infant's sex, woman's education, season at birth, mothers' residence, household wealth, maternal mid-upper arm circumference (MUAC), height and a composite variable of birth order and pregnancy interval. Socioeconomic indicators were also related to preterm births and included mother's education, residence and household wealth, while nutritional-related factors including low MUAC and birth order and interval were associated with preterm birth but not maternal height. Nausea was protective of preterm birth, while diarrhoea was associated with higher odds of preterm birth. Oedema during pregnancy was protective of SGA but associated with higher odds of preterm delivery. Around 33%, 13% and 13% of the determinants of LBW, SGA and preterm births were preventable.conclusion Women's education, maternal nutrition and household wealth and family planning are key factors to improving birth outcomes.

Nutritional status of lactating women in Bogor district, Indonesia: cross-sectional dietary intake in three economic quintiles and comparison with pre-pregnant women

“…This compares with a similar figure of nearly 12·5 % in the PPW. MUAC may be considered as an indicator of nutritional status, independent of body weight, and thus more robust for comparison between PPW, pregnant and LW (10,11) . BMI calculation among the LW revealed that 9 % of them were underweight (BMI <18·5 kg/m 2 ), whereas nearly 19 % of them were overweight/obese (BMI >25·0 kg/m 2 ).…”

“…Validation was carried out during a pre-test with ten LW and PPW, after which the questionnaires and screening forms were finalised. Women with MUAC measurement <23·5 cm were considered as chronically deficient in energy (10,11) . A semi-quantitative FFQ was administered to assess frequency and amount of intake of different food groups during the past 1 week.…”

Biopsychosocial and Economic Determinants of Low Birth Weight in Jambi, South Sumatera: Path Analysis

“…Jenis kelamin bayi yang dilahirkan perempuan merupakan faktor risiko yang dapat meningkatkan kelahiran dengan berat lahir rendah (Sebayang et al, 2012;Kader dan Perera, 2014;Pramono dan Paramita, 2015;Andayasari dan Opitasari, 20-16;Momeni et al, 2017 ;Taywade dan Pisudde, 2017). Stres selama masa kehamilan terbukti dapat berisiko melahirkan bayi dengan berat lahir rendah (Schetter, 2011 ;Schetter dan Tanner, 2012;Tandu-Umba et al, 2014;Kim et al, 2017).…”

“…Pendidikan ibu rendah juga berisiko melahirkan bayi berat lahir rendah (Sebayang et al, 2012;Mahmoodi et al, 2013;Kader dan Perera, 2014;Demelash et al, 2015;Islam dan ElSayed, 2015). Pendidikan ibu rendah dapat memengaruhi pendapatan didalam keluarga.…”

“…Pendidikan ibu rendah dapat memengaruhi pendapatan didalam keluarga. Pendapatan keluargarendah dapat memengaruhi kualitas asupan nutrisi ibu sehingga pendapatan keluarga rendah berisiko menyebabkan kelahiran bayi berat lahir rendah (Sebayang et al, 2012;Kayode et al, 2014;Demelash et al, 2015;Mahumud et al, 2017;Taywade dan Pisudde, 2017). Berdasarkan latar belakang tersebut peneliti tertarik untuk mengambil judul determinan biopsikososial ekonomi pada kejadian bayi berat lahir rendah di Kota Jambi.…”