Quality of Antenatal Care and Its Dose–response Relationship With Birth Weight in a Maternal and Child Health Training Institute in Bangladesh

Abstract

Four hundred and sixty-five pregnant women and their newborn babies were studied at a maternal and child health training institute in Dhaka, Bangladesh, between July 2002 and June 2003 with the objective of (1) examining the relationship between birth weight and maternal factors, and, if there was a dose-response relationship between quality of antenatal care and birth weight, (2) predicting the number of antenatal visits required for women with different significant characteristics to reduce the incidence of low-birth-weight babies. The study revealed that 23.2% of the babies were of low birth weight according to the WHO cut-off point of <2500 g. Mean birth weight was 2674.19+/-425.31 g. A low birth weight was more common in younger (<20 years) and older (> or =30 years) mothers, the low-income group and those with little or no education. The mean birth weight of the babies increased with an increase in quality of antenatal care. The babies of the mothers who had 6+ antenatal visits were found to be 727.26 g heavier than those who had 1-3 visits and 325.88 g heavier than those who had 4-5 visits. No significant relationship was found between number of conception, birth-to-conception interval, BMI at first visit, sex of the newborn and birth weight. Further, from multiple regression analysis (stepwise), it was revealed that number of antenatal visits, educational level of the mother and per capita yearly income had independent effects on birth weight after controlling the effect of each variable. Using multiple regression analysis, the estimated number of antenatal visits required to reduce the incidence of low-birth-weight babies for women with no education and below-average per capita income status was 6; the number required for women with no education and above-average per capita income status was 5; and that for women with education and with any category of income status was 4 visits. So there is a need to stratify women according to their income and educational status so that, along with other measures, the required number of antenatal visits can be estimated beforehand to reduce the incidence of low-birth-weight babies.

Independent and Joint Effects of Prenatal Zinc and Vitamin A Deficiencies on Birthweight in Rural Sidama, Southern Ethiopia: Prospective Cohort Study

“…Unlike several studies that witnessed the beneficial effect of ANC in reducing the burden of LBW [9], [40], [41], the current study did not observe parallel findings. This might have to do with the inferior quality of ANC in the locality where only 42% and 76% of the ANC attendants received iron supplementation and nutrition education, respectively.…”

Providers adherence to essential contents of antenatal care services increases birth weight in Bahir Dar City Administration, north West Ethiopia: a prospective follow up study

“…This study also found that there was an increase in birth weight as educational status of pregnant women increased from no education or primary education to secondary education and above. This is also supported by studies conducted in Bangladesh and Beirut [ 26 , 27 ]. In contrary to maternal education that had positive association to birth weight, multi parity or grand multi parity of mothers and older age of the mother (≥ 35 years) had negative association with birth weight.…”

Risk Factors for Low Birth Weight in South West Trinidad: A Case-Control Study

“…The Maternal and Child Health Manual of Trinidad and Tobago deals specifically with these variables and it is ideally suggested that the first clinic visit be before 16 completed weeks and that there should be at least nine clinic visits (21). In this study, there was a significant correlation between birthweight and the number of visits as supported by recent research (42). There was no such correlation with week of first/booking visit as also shown in the Kramer meta analysis (25).…”