Maternal socio-demographic, medical and nutritional predictors of low birth weight neonates delivered in a civil unrest setting: A case study of Bosaso general hospital, North Eastern Somalia

Abstract

Background Low birth weight (LBW) defined as a newborn weighing less than 2.5 kilograms (kg) is a leading predictor of morbidity and mortality in either childhood or adulthood. The prevalence and predictors of LBW in Somalia are scarce. This study determined the maternal socio-demographic, medical, and nutritional predictors of delivering LBW neonates in Bosaso Hospital, Somalia. Methods This cross-sectional study of 1074 randomly selected mothers who delivered babies in Bosaso general Hospital from November 2022 to April 2023. A neonate was considered to be LBW if it weighed less than 2.5kg. Data for predictor variables were collected from mothers or by reviewing antenatal and postnatal registers. The association between predictor variables and LBW was tested by multivariate logistic regression analysis using STATA 15 by reporting an adjusted odds ratio (AOR) and 95% confidence interval (CI). A statistical test was considered significant at p < 0.05. Results The prevalence of LBW was 18%. Mothers with the following social demographic characteristics were likely to deliver LBW neonates: teenagers, AOR 1.3 (95%CI:1.2–1.5); residing in internally displaced persons (IDP) camp, AOR 1.2(95% C1:1-1.9); no formal education, AOR 1.4(95%CI:1.2–1.5); unemployed, AOR 1.2(95%CI:1.1–1.3); divorced, AOR 1.3 (95% CI:1.1–1.4); and widowed, AOR 1.3 (95%CI:1.2–1.5). Women with the following medical factors were likely to deliver LBW neonates: having less than 8 ANC visits, AOR 1.2 (95%CI:1.1–1.5); primigravida, AOR1.2 (95%CI:1.1–1.6), history of delivering a LBW, AOR 1.2 (95% CI:1.1–1.4); history of preterm birth, AOR 1.6(1.3–1.8); birth interval less than 3 years, AOR 1.2(95% CI: 1.3–1.4); malaria during pregnancy, AOR 1.3(95%CI:1.1–1.6). Women with the following medical factors were less likely to deliver LBW neonates: Having the 1st ANC visit in the 1st trimester, AOR 0.6(0.3–0.7); using an insecticide-treated mosquito net, AOR 0.5(95%CI: 0.2–0.6); swallowed sulfadoxine-pyrimethamine under directly observed treatment (DOT), AOR 0.6 (95% CI: 0.2–0.8), and DOT with deworming tablets, AOR 0.6(95%CI:0.2–0.7). Mothers with the following nutritional characteristics were likely to deliver LBW neonates: maternal height < 150cm, AOR 1.2 (95% CI: 1.1–1.3); anemia at full term, AOR 1.4(95%CI: 1.3–1.7); mid-upper arm circumference < 23 cm, AOR 2.1(95% CI: 1.2–2.3). Mothers who received iron-folic acid supplementation, AOR 0.4(95%CI: 0.2–0.7), had a lower risk of delivering LBW neonates. Conclusion In Bosaso general hospital, delivering a LBW neonate was likely to be among pregnant mothers who: were teenagers, stunted, residing in IDP camps, unemployed, divorced or widowed, primigravida, had attended < 8 ANC visits, no formal education, with a history of preterm birth or LBW, birth interval < 3years, malaria during pregnancy, were anemia and wasted at term.