Risk Factors for Low Birthweight in the Public-hospitals at Peshawar, NWFP-Pakistan

Overview

Journal BMC Public Health

Publisher Biomed Central

Specialty Public Health

Date 2008 Jun 6

PMID 18533023

Citations 62

Authors

Sareer Badshah

Linda Mason

Kenneth McKelvie

Roger Payne

Paulo Jg Lisboa

Affiliations

Soon will be listed here.

Abstract

Background: Low birthweight is a widely used indicator of newborn health. This study investigates the association of birthweight <2.5 kg (LBW) with a wide range of factors related to geo-demographics, maternal health and pregnancy history in public hospitals at Peshawar, North West Frontier Province (NWFP) Pakistan. It is noted that that Low birthweight may arise for two different reasons, one related to gestational age and the other corresponding to births that are small for gestational age (SGA).

Methods: Data on geo-demographics, maternal health indicators, pregnancy history and outcome scores for newborn babies and their families (n = 1039) were collected prospectively between August and November 2003 in a cross-sectional survey of four public hospitals in Peshawar, NWFP-Pakistan. Crude and adjusted odds ratios were used to investigate the factors affecting incidence of LBW, by multivariate logistic regression. Gestational age was included as an explanatory variable therefore the additional covariates identified by model selection are expected to account for SGA.

Results: The main geo-demographic risk factors for SGA identified in this study, controlling for gestational age of less than 37 weeks, are maternal age, nationality and consanguinity. Presentation with anaemia and the history of previous abortion/miscarriage were also found to be significant independent factors. The adjusted odds ratio for gestational age showed the largest effect in explaining the incidence of LBW. The next highest odds ratio was for maternal age below 20 years. The explanatory model included two pairwise interactions, for which the predicted incidence figures for LBW show an increase among the Tribal area with presentation of anaemia, and among full term babies with their mothers having a previous history of abortion/miscarriage.

Conclusion: In addition to gestational age, specific factors related to geo-demographics (maternal age, consanguinity and nationality), maternal health (anaemia) and pregnancy history (abortion/miscarriage) were significantly associated with the incidence of LBW observed at the four hospitals surveyed in Peshawar. These results indicate that cultural factors can adversely affect the incidence of SGA in this area of Pakistan.

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References

Khan S . Abortion: a major contributor to maternal ill health. J Pak Med Assoc. 2005; 55(7):269. View

Grant J, Bittles A . The comparative role of consanguinity in infant and childhood mortality in Pakistan. Ann Hum Genet. 1997; 61(Pt 2):143-9. DOI: 10.1046/j.1469-1809.1997.6120143.x. View

Rahman A, Lovel H, Bunn J, Iqbal Z, Harrington R . Mothers' mental health and infant growth: a case-control study from Rawalpindi, Pakistan. Child Care Health Dev. 2003; 30(1):21-7. DOI: 10.1111/j.1365-2214.2004.00382.x. View

Lone F, Qureshi R, Emmanuel F . Maternal anaemia and its impact on perinatal outcome in a tertiary care hospital in Pakistan. East Mediterr Health J. 2005; 10(6):801-7. View

Saleem S, Fikree F . Induced abortions in low socio-economic settlements of Karachi, Pakistan: rates and women's perspectives. J Pak Med Assoc. 2001; 51(8):275-9. View

Williams R, Creasy R, Cunningham G, Hawes W, NORRIS F, Tashiro M . Fetal growth and perinatal viability in California. Obstet Gynecol. 1982; 59(5):624-32. View

de Onis M, Blossner M, Villar J . Levels and patterns of intrauterine growth retardation in developing countries. Eur J Clin Nutr. 1998; 52 Suppl 1:S5-15. View

Karim S, Bakhtawar I, Butta A, Jalil M . Effects of first and second trimester vaginal bleeding on pregnancy outcome. J Pak Med Assoc. 1998; 48(2):40-2. View

Fikree F, BERENDES H . Risk factors for term intrauterine growth retardation: a community-based study in Karachi. Bull World Health Organ. 1994; 72(4):581-7. PMC: 2486602. View

10.

Hussain R, Bittles A . The prevalence and demographic characteristics of consanguineous marriages in Pakistan. J Biosoc Sci. 1998; 30(2):261-75. DOI: 10.1017/s0021932098002612. View

11.

Hynes M, Sheik M, Wilson H, Spiegel P . Reproductive health indicators and outcomes among refugee and internally displaced persons in postemergency phase camps. JAMA. 2002; 288(5):595-603. DOI: 10.1001/jama.288.5.595. View

12.

King P, Duthie S, Li D, Ma H . Obstetric outcome among Vietnamese refugees in Hong Kong: an age-matched case-controlled study. Int J Gynaecol Obstet. 1990; 33(3):203-10. DOI: 10.1016/0020-7292(90)90002-3. View

13.

Machado C, Hill K . Early Infant Morbidity in the City of São Paulo, Brazil. Popul Health Metr. 2003; 1(1):7. PMC: 270079. DOI: 10.1186/1478-7954-1-7. View

14.

Aziz S, Billoo A, Samad N . Impact of socioeconomic conditions on perinatal mortality in Karachi. J Pak Med Assoc. 2002; 51(10):354-60. View

15.

Borja J, Adair L . Assessing the net effect of young maternal age on birthweight. Am J Hum Biol. 2003; 15(6):733-40. DOI: 10.1002/ajhb.10220. View

16.

Andersson L, Sundstrom-Poromaa I, Wulff M, Astrom M, Bixo M . Implications of antenatal depression and anxiety for obstetric outcome. Obstet Gynecol. 2004; 104(3):467-76. DOI: 10.1097/01.AOG.0000135277.04565.e9. View

17.

Bhutta Z, Khan I, Salat S, Raza F, Ara H . Reducing length of stay in hospital for very low birthweight infants by involving mothers in a stepdown unit: an experience from Karachi (Pakistan). BMJ. 2004; 329(7475):1151-5. PMC: 527694. DOI: 10.1136/bmj.329.7475.1151. View

18.

Peduzzi P, Concato J, Kemper E, Holford T, Feinstein A . A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol. 1996; 49(12):1373-9. DOI: 10.1016/s0895-4356(96)00236-3. View

19.

Honeyman M, Bahl L, Marshall T, Wharton B . Consanguinity and fetal growth in Pakistani Moslems. Arch Dis Child. 1987; 62(3):231-5. PMC: 1778308. DOI: 10.1136/adc.62.3.231. View

20.

Malamitsi-Puchner A, Tzala L, Minaretzis D, Michalas S, Aravantinos D . Preterm delivery and low birthweight among refugees in Greece. Paediatr Perinat Epidemiol. 1994; 8(4):384-90. DOI: 10.1111/j.1365-3016.1994.tb00477.x. View