Factors Associated With Low-birth-weight at Mandera County Referral Hospital, Mandera, Kenya

Abstract

Background: A birth weight of less than 2500g, irrespective of gestational age, is referred to as "low birth weight." Each year, WHO estimates that Low birth weight affects 20 million newborns worldwide (representing 15 percent of all births), the majority of which occur in under developed nations (95.6%). Low birth weight is prevalent in 9.76 percent of babies born in Africa's Sub-Saharan region, and it is predicted to be 11 percent in Kenya (WHO & UNICEF). On the other hand, the KDHS 2014 revealed an 8% low-birth-weight rate. Study Objective: To determine the socio-demographic, obstetric, medical, and foetal factors associated with low-birth weight at Mandera county referral hospital. Methodology: A facility-based un-matched case control study was carried out at Mandera County Referral Hospital between the 11th of August 2022 and the 14th of January 2023. The study looked at maternal (socio-demographic, obstetric, and medical) factors as well as fetal factors that were linked to low birth weight. In this study, 87 women who delivered neonates weighing <2500g (cases) were compared to 261 women who delivered neonates weighing ≥ 2500g (controls) at ≥ 28 weeks of gestation. The results were analyzed using SPSS version 25 for descriptive and inferential analysis. The statistical significance was considered with p-value < 0.05 at 95% confidence interval for two tail tests. Results: Out of a total of 1552 deliveries, 149 were low birthweight, resulting in a 9.6% LBW prevalence. After determining eligibility, N = 348 mothers (87 cases and 261 controls) were recruited. The risk of LBW was high among women with hypertensive disorder in pregnancy (aOR = 4.191, 95% CI: 1.211 – 17.023, p = 0.031), history of low birthweight (aOR = 6.737, 95%: 1.213 – 37.420, p = 0.029), a history of preterm births (aOR = 10.329, 95% CI: 1.383 – 77.134, p = 0.023), antepartum hemorrhage (aOR = 15.013, 95% CI: 1.192 – 52.483, p = 0.038), multiple gestation (aOR = 15.790, 95% CI: 1.654- 150.74, p = 0.017), and preterm births (aOR = 15.851, 95% CI: 21.052 – 137.61, p < 0.001). After adjusting for the odds ratio, other factors such as spouse employment status (p = 0.784), ANC attendance (p = 0.703), having unplanned pregnancy (p = 0.933), anemia (p = 0.406), UTI (p = 0.136), fetal xviii congenital anomalies (p = 0.315), stillbirth (p = 0.371), and inter-pregnancy interval < 6 months (p = 0.972) had no statistically significant association with LBW. Conclusion: The prevalence of LBW was 9.6% at Mandera County Referral Hospital. Significant determinants of LBW identified included hypertensive disorder in pregnancy, preterm birth, antepartum hemorrhage, multiple gestation, preterm birth history, and LBW history. As a result, proper antenatal care and surveillance to identify and manage those risk factors for LBW is recommended.