Maternal demographic and antenatal factors, low birth weight and preterm birth: findings from the mother and child in the environment (MACE) birth cohort, Durban, South Africa

Abstract

Background Low birthweight (LBW) and preterm birth (PB) remain the leading cause of morbidity and mortality in neonates worldwide. The aim of this study was to identify maternal demographic and antenatal factors associated with PB and LBW among low socio-economic communities. Methods Pregnant women (n = 1099) were recruited in the first trimester into the Mother and Child in the Environment (MACE) birth cohort in Durban, South Africa. Maternal factors such as demographic information, health status, residential area, occupational, personal and environmental smoking and biomass fuel use were obtained through standardised interviews, while clinical status was obtained in each trimester and antenatal information on HIV status and treatment, syphilis and conditions such as pregnancy induced hypertension, diabetes etc. was extracted from the antenatal assessments. Key outcomes of interest were preterm birth and low birthweight. The latter data was obtained from the clinical assessments performed by midwives at delivery. Logistic regression models identified factors associated with PB and LBW. Results Of the 760 live births, 16.4 and 13.5% were preterm and LBW, respectively. Mothers who delivered by caesarean section had an increased odds of having LBW babies (Adjusted odds ratio (AOR): 1.7; 95% CI: 1.1–2.7) and PB (AOR: 1.7, 95% CI: 1.1–2.7) versus normal vaginal deliveries. Mothers > 30 years (AOR: 1.8, 95% CI: 1.1–2.9) and current smokers (AOR: 2.7, 95% CI: 1.3–5.8) had an increased odds of having PB babies. Compared to younger mothers and non-smokers respectively. An effect of PB and LBW was seen among mothers with high BMI (25.0–29.9 kg/m2) (PB: AOR: 0.5, 95% CI: 0.3–0.9 and LBW: AOR: 0.5, 0.5, CI: 0.3–0.8), and obese BMI (> 30 kg/m2) (PB: AOR: 0.5, 95% CI: 0.3–0.9 and LBW: AOR: 0.4, CI: 0.2–0.7). Maternal HIV (PB AOR: 1.4 and LBW AOR: 1.2) and history of sexually transmitted infections (PB AOR: 2.7 and LBW AOR: 4.2) were not statistically significant. Conclusion Maternal age, cigarette smoking and caesarean delivery were associated with LBW and PB. Findings highlight the need of maternal health interventions to improve new-born health outcomes.

Household Food Insecurity and Demographic Factors, Low Birth Weight and Stunting in Early Childhood: Findings from a Longitudinal Study in South Africa

“…The prevalence of LBW in the sample was 14.7% and is closely aligned with recent cohort studies of birthweight in South Africa (Budree et al, 2017 ; Jeena et al, 2020 ). We found that child hunger in the household was significantly associated with low birthweight but adult hunger was not.…”

“…In the South African context, studies of two longitudinal cohorts have observed associations with LBW in mothers who smoke or drink alcohol as well as those with overweight or obese BMI (Budree et al, 2017 ; Jeena et al, 2020 ). An unpublished thesis study among pregnant women in an urban area of South Africa found no association with household food insecurity and low birthweight while another birth cohort study in South Africa found that food insecurity was associated with lower infant gestational age (Zar et al, 2019 ).…”

Association between paracetamol use during pregnancy and perinatal outcomes: Prospective NISAMI cohort

“…According to previous studies, preeclampsia is a risk factor for the development of perinatal outcomes [ 36 , 37 ] and the use of paracetamol during pregnancy increases the risk of preeclampsia [ 34 ]. In addition, the analyzes were not adjusted for other factors that increase the risk of perinatal outcomes, such as smoking [ 38 , 39 ] and the use of drugs of abuse [ 40 , 41 ] during pregnancy, because the number of pregnant women with these habits in the study was very small. In addition, some covariates such as chronic diseases, acute diseases, history of PTB, and history of LBW were not included because a large number of data were missing.…”

Subcortical brain volumes in young infants exposed to antenatal maternal depression: Findings from a South African birth cohort

“…However, only one pregnant woman reported antidepressant use (citalopram) at enrolment, in line with the very limited access to psychiatric services in underserved communities in the South African population ( Seedat et al, 2008 ). The present study used a lenient definition of the exclusion criterion preterm birth (1 week below the standard definition of 37 weeks gestation; World Health Organization (1997) ) to account for the relatively high frequency of preterm births in South Africa ( Chawanpaiboon et al, 2019 , Jeena et al, 2020 ). While early brain development following AMD exposure in children born late preterm is epidemiologically relevant, especially in LMIC settings, sensitivity analyses were conducted to ensure the findings also applied to term infants.…”