Sage Journals: Discover world-class research

Abstract

Background:

Birth weight is one of the major determinants of perinatal survival, infant morbidity, and mortality. There are only few published reports on assessment of low birth weight in Ethiopia and the determinants of low birth weight have not been well characterized.

Objective:

The aim of this study was to assess determinants of low birth weight among live birth newborns delivered at public hospitals in Gamo Gofa Zone, South Ethiopia.

Methods:

Institution-based case control study was conducted from February 25 to April 25, 2018 and consecutively selected 60 cases and 240 controls were enrolled in this study. The data were collected using face-to-face interview and review of medical records. Moreover, we have measured the newborns’ birth weight using a standard weight scale and mother’s mid-upper arm circumference using a standard World Health Organization mid-upper arm circumference measuring tape. Statistical analysis of the data was done using SPSS version 21.

Results:

A total of 300 newborns were included in the study. Late antenatal care booking (adjusted odds ratio = 1.87, confidence interval = [1.32–2.6]), birth interval <2 years (adjusted odds ratio = 0.385, confidence interval = [0.176–0.83]), anemia (adjusted odds ratio = 4.4, confidence interval = [1.84–10.5]), mid-upper arm circumference <23 cm (adjusted odds ratio = 7.99, confidence interval = [3.5–20.3]), nutritional counseling (adjusted odds ratio = 5.85, confidence interval = [2.14–14.8]), and husband smoking (adjusted odds ratio = 4.73; confidence interval = [1.42–15.7]) were found to be determinant factors of low birth weight.

Conclusion:

Most of the determining factors of low birth weight were preventable. Therefore, clinical and public health interventions should target on those determinant factors to prevent its adverse effects.

Keywords

Determinants low birth weight Ethiopia

Introduction

Birth weight is the first weight of the newborn obtained after birth. It is one of the major determinants of perinatal survival, infant morbidity, and mortality as well as the risk of developmental disabilities and illnesses in future.^1,2 Low birth weight (LBW) has been defined by the World Health Organization (WHO) as weight at birth of less than 2500 g (5.5 pounds). Annually, more than 20 million infants are born with LBW in the world. The prevalence of LBW in developing countries (16.5%) is more than twice the prevalence in developed regions (7%).^3,4

Africa is a continent that has high rates of children born with LBW and most recent studies have shown a high rate of child mortality. It is expected that in sub-Saharan Africa, LBW represents 14.3% that is approximately twice the rate of LBW in European country.⁵

In Ethiopia, according to Federal Minster of Health National New Born and Child Survival Strategy Summary report, the prevalence of LBW was found to be 20%.⁶ Studies conducted in different parts of the country found different prevalence rates of LBW. Accordingly, studies conducted in Addis Ababa, Gondar, and Tigray showed that the prevalence of LBW was 8.8%, 11.2%, and 14.6%, respectively.^7–9

Several studies have shown that LBW was significantly associated with maternal residence, marital status, age at first pregnancy, bad obstetrics history, maternal nutritional status, inter-pregnancy interval, antenatal care (ANC) follow-up, pregnancy-induced hypertension, anemia at pregnancy, chat chewing, and cigarette smoking.^10–12

Study on determinant factors of LBW is important for planning child health care services and to improve the survival of LBW babies. However, there are only few published studies in Ethiopia on the assessment of LBW¹³ and there is paucity of information related to the determining factors of LBW. Even the available studies did not address the broader determinants of LBW.^13,14 Factors like maternal nutritional status, maternal chronic diabetes, and Rh factor of the mothers have been well explained by the majority of available studies.^13,15–18 Possible determinants of LBW will vary across the geographical location.¹⁸ Thus, the aim of this study was to assess determinants of LBW among live birth newborns delivered at public hospitals in Gamo Gofa Zone, South Ethiopia.

Materials and methods

This study was conducted in Gamo Gofa Zone, South Ethiopia. The capital city of Gamo Gofa Zone is Arba Minch, which is located 505 km away from Addis Ababa and 275 km South West of Hawassa, capital city of South Ethiopia. According to 2007 National Census, the total population of Gamo Gofa zone is 2,019,687.¹⁹ Estimated number of women of reproductive age (15–49 years) is 470,587, estimated number of live birth is 69,881, and the skilled delivery rate is 51.2%. In this zone, there are two general hospitals, four primary hospitals, 73 health centers, and 471 health posts.¹⁹ The study was conducted from February 25 to April 25, 2018.

A hospital-based case control study design was conducted in selected hospitals of Gamo Gofa zone, South Ethiopia. Sixty LBW babies (cases), who were delivered in the three hospitals during the study period were selected consecutively and a total of 240 babies with normal birth weight (controls) were also selected. Cases which occurred in the selected hospitals were included in the sample until the necessary number has been reached. However, following each case four controls were selected on the same day. When there were more than four eligible controls after each case, only four controls were selected randomly. Moreover, when there were multiple birth cases or controls, one of the cases or controls was selected randomly. Congenital anomalies, still birth, and mothers who were not volunteered to participate in the study were excluded from this study.

The number of cases and controls was calculated using Epi Info Version 7 by taking power at 80%, odds ratio of 2.9, two-sided significant level at 0.05, and proportion of controls with exposure as 11.6.²⁰ Two general and one primary hospital were selected based on the availability of pregnant women from all parts of the zone. The total samples were allocated to the selected hospitals proportionally using the hospitals’ number of live birth in the last quarter of the preceding year as reference. Accordingly, 50 (10 cases and 40 controls) participants from Chencha primary Hospital, 150 (30 cases and 120 controls) participants from Arba Minch General Hospital, and 100 (20 cases and 80 controls) participants from Sawula General Hospital were selected.

The data were collected using pretested structured questionnaire by trained midwives and nurses. Data extraction sheet and questionnaire related to sociodemographic characteristics, obstetrics-related factors, medical history, and nutritional status were prepared after reviewing differently related literatures^20–24 (refer “Supplemental material”). Questionnaire related to behavioral factors were adapted and customized from the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST).²⁵ Data on behavioral and sociodemographic factors of the participants were collected by face-to-face interview. Information on medical and obstetrics history were extracted from medical records using data extraction sheet. Measurement of maternal mid-upper arm circumference (MUAC) was made without clothes using a standard WHO MUAC measuring tape. The new born weight was measured within 1 h after birth using a standard weighing scale by trained personnel. Based on the birth weight, a new born with weight less than 2500 g is considered as LBW.²⁶

ANC visit was classified on the basis of minimum recommended visits as having four or more visits and less than four visits. Inter-pregnancy interval was collected and classified as <2 years and ⩾2 years based on WHO recommendations.²⁷

Mothers who got any advice related to nutrition and diet by health professionals during pregnancy was taken as “yes” for nutritional counseling question. Maternal iron and folic acid intake was assessed by asking the mothers whether or not she had taken it for at least 3 months. Mid-upper circumference was categorized as <23 and ⩾23 cm using Food and Nutrition Technical Assistance III (FANTA III) cut of point.²⁸ Chronic medical illness was defined as a pre-existing medical illness of the mother that was documented in hospital medical records with an onset prior to the current pregnancy. Maternal anemia was diagnosed when hemoglobin level was below 11 g/dL.²⁹ Mothers who ever used cigarettes, chat, and alcohol (beer, wine, tella, areke, etc.), and husbands who ever smoked cigarettes at least weekly was considered as “yes” for the purpose of this study.³⁰

To assure data quality, 1-day training was given on data collection process for all data collectors and supervisors. The collected data were checked for completeness by principal investigator and supervisors each day. Pretest was done on 5% of the sample that were not included in the main study. Then, necessary modifications of the questionnaire and data extraction sheet were undertaken.

Data were entered into EPI info version 7 and exported in to SPSS version 21 for analysis. Descriptive statistics was computed to present sociodemographic and other characteristics of the study participants. Binary logistic regression analysis was also performed to identify associated factors of LBW. Variables with p value <0.25 in the bivariate analysis were further tested using multivariate logistic regression analysis. The results of the analysis were presented with texts and tables. A p value <0.05 was considered as statistically significant.

Ethical clearance was obtained from Institutional Review Board (IRB) of Arba Minch University. The IRB had reviewed the study protocol and approved with ethical approval reference number IRB/81/2010. Then, permission letter to conduct the study was obtained from the hospital administration office. The respondents were informed about the purpose of the study and data were collected after obtaining written informed consent from the study participants. Confidentiality of the information was maintained throughout the study.

Results

Sociodemographic characteristics

A total of 300 (60 cases and 240 controls) newborns were included in this study with 100% response rate. The mean (± SD) weight of the newborn was 2076 g ± 308.16 g for cases and 3264.17 g ± 513.47 g for controls. Among the mothers of the newborns, majority of the cases (68.3%) and controls (73.3%) were within the age range of 20–34 years. The mean age of the mothers was 28 ± 7 years for both groups. Majority of the cases (60%) and controls (62.1%) were urban residents (Table 1).

Table 1.

Sociodemographic and obstetric characteristics of mother who gave birth at the selected hospitals of Gamo Gofa Zone, South Ethiopia, 2018.

Variables	Categories	Cases (N = 60)n/N (%)	Controls (N = 240)n/N (%)
Age in years	<20	6 (10)	17 (7.1)
	20–34	41 (68.3)	176 (73.3)
	⩾35	13 (21.7)	47 (19.6)
Residence	Rural	24 (40)	91 (37.9)
Marital status	Married	53 (88.3)	224 (93.3)
Marital status	Others	7 (11.7)	16 (6.7)
Educational status	Illiterate	13 (21.7)	31 (12.9)
	Primary school	18 (30)	101 (42.1)
	High school	14 (23.3)	46 (19.2)
	Certificate and above	15 (25)	62 (25.8)
Occupational status	House wife	31 (51.7)	137 (57.1)
Occupational status	Employee	29 (48.3)	103 (42.9)
Monthly income in ETB	<1000	25 (41.7)	69 (28.7)
Monthly income in ETB	⩾1000	35 (58.3)	171 (71.3)
Parity	Primipara	28 (46.7)	88 (36.7)
Parity	Multipara	32 (53.3)	152 (63.3)
History of stillbirth	Yes	13 (21.7)	19 (7.8)
History of preterm birth	Yes	13 (21.7)	17 (7.1)
History of abortion	Yes	6 (10)	27 (11.3)
Rh factor of the mother	Negative	16 (26.7)	14 (5.8)
ANC visit	Yes	36 (60)	206 (85.8)
Time to start first ANC ^a	First trimester	15 (41.66)	136 (66.0)
	Second trimester	14 (38.88)	57 (27.66)
	Third trimester	7 (19.44)	13 (9.55)
Number of ANC visit ^a	<4	21 (58.33)	47 (22.81)
Number of ANC visit ^a	⩾4	15 (41.66)	159 (77.18)
Gestational age	<37 weeks	16 (26.7)	14 (5.8)
Gestational age	⩾37 weeks	44 (73.3)	226 (94.2)
Types of gestation	Multiple	7 (11.7)	3 (1.3)
Types of gestation	Singleton	53 (88.3)	237 (98.8)
Birth interval ^b	<2 years	14 (43.75)	32 (21)
Birth interval ^b	⩾2 years	18 (56.25)	120 (79)

ETB: Ethiopian Birr; ANC: antenatal care; Rh: Rhesus factor.

N = 36 for cases and N = 206 for control.

N = 32 for cases and N = 152 for control.

Obstetrics-related characteristics

Majority of cases (53.3%) and controls (63.3%) were multipara, 18.3% of cases and 7.8% of controls had history of still birth, 21.7% of cases and 7.1% of controls had history of preterm birth, and 10% of cases and 11.3% of controls had history of abortion. Regarding to the Rh factor of the mothers, 26.7% of cases and 5.8% of controls had negative Rh factor. About 60% of cases and 85.8% of controls had ANC follow up (Table 1).

Medical- and behavioral-related characteristics

In this study, 15% of cases and 7.5% of controls had history of chronic diseases, 28.7% of cases and 15% of controls had drunk alcohols, 16.7% of cases’ husband and 5.4% of controls’ husband used cigarette (Table 2).

Table 2.

Medical, behavioral, and nutritional profiles of mothers who gave birth at the selected hospitals of Gamo Gofa Zone, South Ethiopia, 2018.

Variable	Categories	Cases (N = 60)n/N (%)	Controls (N = 240)n/N (%)
Chronic illness	Yes	9 (15)	18 (7.5)
Anemia	Yes	27 (45)	29 (12.1)
Smoking cigarettes	Yes	5 (8.3)	6 (2.5)
Chat chewing status	Chewer	9 (15)	15 (6.3)
Alcohol drinking	Yes	17 (28.3)	36 (15)
Husband’s cigarette use	Yes	10 (16.7)	13 (5.4)
Nutritional counseling	Yes	33 (55)	208 (86.7)
Iron and folic acid supplement	Yes	33 (55)	202 (84.2)
MUAC (cm)	<23	28 (46.7)	27 (11.3)
MUAC (cm)	⩾23	32 (53.3)	213 (88.7)

MUAC: mid-upper arm circumference.

Nutrition-related factors

Regarding to the nutritional status, 55% of cases and majority of controls (86.7%) had got nutritional counseling. About 53.3% of cases and 88.7% of controls had MUAC ⩾ 23 cm (Table 2).

Factors associated with LBW

Variables like marital status, monthly income, parity, history of preterm birth, maternal Rh factor, ANC visit, time start ANC visit, number of ANC visit, gestational age, types of gestation, birth interval, nutritional counseling, iron and folic acid supplementation, MUAC, anemia, history of chronic illness, maternal smoking status, chat chewing, alcohol drinking, and husband smoking status had a value of p < 0.25 and were included in multivariable analysis (Table 3). After adjusting for those variables in multivariable analysis; late ANC booking (adjusted odds ratio (aOR) = 1.87, confidence interval (CI) = [1.32–2.6]), birth interval < 2 years (aOR = 0.385, CI = [0.176–0.83]), anemia (aOR = 4.4, CI = [1.84–10.5]), MUAC < 23 cm (aOR = 7.99, CI = [3.5–20.3]), nutritional counseling (aOR = 5.85, CI = [2.14–14.8]), and husband smoking (aOR = 4.73; CI = [1.42–15.7]) were independent determinants of LBW (Table 4).

Table 3.

Bivariable logistic regression results of mothers who gave birth at the selected hospitals of Gamo Gofa Zone, South Ethiopia, 2018.

Variables	Categories	COR [95% CI]	p value
Age in years (Ref. ⩾ 35)	<20	1 [0.327–3.35]	0.947
	20–34	0.91 [0.455–1.84]	0.803
Residence (Ref. urban)	Rural	1.17 [0.65–2.08]	0.590
Marital status (Ref. others)	Married	1.98 [0.76–5.10]	0.157
Educational status (Ref. ⩾ certificate)	Illiterates	1.7 [0.73–4.09]	0.209
	Primary school	0.74 [0.34–1.56]	0.427
	High school	1.26 [0.55–2.86]	0.584
Occupational status (Ref. house wife)	Employee	1.24 [0.70–2.19]	0.450
Monthly income in ETB (Ref. ⩾1000)	<1000	1.77 [0.98–3.17]	0.055
Parity (Ref. multipara)	primipara	1.51 [0.85–2.67]	0.156
History of stillbirth (Ref. No)	Yes	2.61 [1.68–5.83]	0.019
History of preterm birth (Ref. No)	Yes	3.62 [1.65–7.97]	0.001
History of abortion (Ref. No)	Yes	1.14 [0.44–2.90]	0.780
Rh factor of the mother (Ref. Rh +ve)	Rh negative	5.87 [2.67–12.89]	<0.001
ANC visit (Ref. yes)	No	4 [2.14–7.59]	<0.001
Time to start first ANC (Ref. first trimester)	Second trimester	2.26 [1.02–4.98]	0.043
Time to start first ANC (Ref. first trimester)	Third trimester	5.86 [1.97–17.36]	0.001
No. of ANC visit (Ref. ⩾4)	<4	4.7 [2.26–9.90]	<0.001
Gestational age (Ref. ⩾37 weeks)	<37 weeks	5.87 [2.67–12.89]	<0.001
Types of gestation (Ref. Singleton)	Multiple	10.4 [2.61–41.67]	0.001
Birth interval (Ref. ⩾2 years)	<2 years	2.9 [1.31–6.49]	0.009
Chronic illness (Ref. No)	Yes	2.18 [0.92–5.12]	0.075
Anemia (Ref. No)	Yes	5.95 [3.14–11.28]	0.001
Smoking cigarettes (Ref. No)	Yes	3.54 [1.04–12.04]	0.042
Chat chewing (Ref. non-chewers)	Chewers	2.65 [1.09–6.38]	0.030
Alcohol drinking (Ref. No)	Yes	2.24 [1.15–4.35]	0.017
Husband’s cigarette use (Ref. No)	Yes	3.49 [1.4,8.41]	0.005
Nutritional counseling (Ref. Yes)	No	5.31 [2.83–9.98]	<0.001
Iron and folic acid supplement (Ref. Yes)	No	4.34 [2.35–8.04]	<0.001
MUAC (Ref. ⩾ 23 cm)	<23 cm	6.9 [3.61–13.17]	<0.001

ETB: Ethiopian Birr; COR: crude odds ratio; CI: confidence interval; ANC: antenatal care; Rh: Rhesus factor; Ref.: reference category; MUAC: mid upper arm circumference.

Table 4.

Factors associated with low birth weight among mothers who delivered at the selected hospitals of Gamo Gofa Zone, South Ethiopia, 2018 (n = 300).

Variables	Category	aOR [95%CI]	p value
Time to start first ANC (Ref. first trimester)	Second trimester	1.06 [0.57–1.67]	0.256
Time to start first ANC (Ref. first trimester)	Third trimester	1.87 [1.32–2.65]	0.001*
Birth interval (Ref. <2 years)	⩾2 years	0.385 [0.176–0.83]	0.015*
Anemia (Ref. no.)	Yes	4.4 [1.84–10.5]	0.001*
Nutritional counseling (Ref. yes)	No	5.85 [2.14–14.8]	0.001*
MUAC (Ref. ⩾23 cm)	<23 cm	7.99 [3.5–20.3]	<0.001*
Husband’s cigarette use (Ref. no)	Yes	4.73 [1.42–15.7]	0.012*

MUAC: mid-upper arm circumference; aOR: adjusted odd ratio; CI: confidence interval; ANC: antenatal care.

p < 0.05.

Discussion

The odds of LBW was 1.87 times higher for newborns from mothers who had late antenatal booking as compared to newborns from mothers who had ANC booking early. This finding is supported by the study conducted in Nepal and Addis Ababa, Ethiopia.^8,25,31 This might be due to the fact that early antenatal booking enables early prevention, detection, and management of different risk factors for adverse pregnancy outcome like LBW.

Newborns from mothers who had birth interval of 2 or more years were less likely to be LBW as compared to their counterpart. This finding is in concurrent with another study conducted in India, Bale, and Addis Ababa, Ethiopia.^20,30,32 This might be due to short inter-pregnancy interval that do not provide a mother with sufficient time to recover from the nutritional burden and stress of the previous pregnancy. This leads to maternal nutrition depletion. It also associated with maternal iron and folic acid depletion which compromises the mother’s ability to support fetal growth and development which in turn increases the risks of preterm birth, growth restriction, and LBW in the subsequent pregnancies.^33–35

The odds of LBW was 4.4 times higher in newborns from anemic mothers as compared to newborns from none anemic mothers. This finding is supported by the study conducted in India and Debre Markos, Ethiopia.^12,32 Anemia could impair oxygen and nutrient delivery to the fetus and delay normal intra-uterine growth and also influencing placental angiogenesis.^36,37 However, the current finding is in contrast to the study conducted in Debre Birhan.¹⁸ This discrepancy may be due to difference in data collection techniques and study population. Our study techniques was both prospective and retrospective whereas the study conducted in Debre Birhan was used only card review. Also our study tried to address diverse population from different geographic areas. On the contrary, the study in Debre Birhan was conducted in a single urban hospital.

The odd of LBW was 5.85 times higher for newborns from mothers who didn’t get nutritional counseling than newborns from mothers who were counseled for nutrition. This finding is in agreement with the study conducted in Bahir Dar, Dessie, and Japan.^21,38,39 Nutritional requirement increases in quality as well as in quantity during pregnancy.⁴⁰ Thus, nutritional counseling and support during pregnancy have paramount importance for better pregnancy outcomes.

The odds of LBW among newborns from mothers who had MUAC < 23 cm were higher compared to those newborns from mothers who had MUAC ⩾ 23 cm. This finding was consistent with other study conducted in Indonesia and Bahir Dar.^33,35 This could be due to the fact that fetal development in uterus directly depends on the level of maternal nutritional condition. When mothers had nutritional deficiency, intra-uterine growth of the fetus will be restricted and leads to LBW.^41,42

The odds of LBW for newborns from mothers who had smoker husband were 4.73 times higher as compared to newborns from mothers who had non-smoker husband. This result was supported by study conducted in Pakistan and Addis Ababa.^30,43 This is due to the fact that smoking has adverse effects on the developing fetus by increasing level of nicotine and carbon monoxide in the blood which result in deficiency of oxygen and nutrient delivery to the growing fetus.^44–46

This study assesses the determinants of LBW among live birth newborns delivered at hospitals. However, the present study still had some limitations. Information on some maternal factors like pre-pregnancy BMI, weight gain, data on dietary intake, and wealth index was not included. We tried to explore behavioral factors with self-reporting. The respondent may not give the correct answer due to fear, shame, and feeling of guilt. This may lead to information bias and it may results in underestimation of the hypothesized relationship between exposure and outcome. Also, this study is hospital based and hence further large-scale community based studies are needed to explore other determinant factors of LBW.

Conclusion

Many studies confirm that LBW remains a major public health problem in developing countries. This study also evidence that, time to start first ANC visit, birth spacing, anemia, nutritional counseling, and MUAC and husband history of cigarette use were significantly associated with LBW. Most of the factors are modifiable and the risk of LBW can be prevented by targeting clinical and public health interventions on those determinant factors. As a recommendation, further large-scale community-based study is needed to explore other determinant factors of LBW.

Supplemental Material

Questionnaire – Supplemental material for Determinants of low birth weight among live birth newborns delivered at public hospitals in Gamo Gofa Zone, South Ethiopia: Unmatched case control study

Supplemental material, Questionnaire for Determinants of low birth weight among live birth newborns delivered at public hospitals in Gamo Gofa Zone, South Ethiopia: Unmatched case control study by Alemu Basazin Mingude, Woiynshet Gebretsadik, Dresilgn Misker and Gashaw Garedew Woldeamanuel in SAGE Open Medicine

Footnotes

Acknowledgements

The authors thank all data collectors for their cooperation in data collection and all the women who participated in the study.

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by Arba Minch University. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Ethical approval

Ethical approval for this study was obtained from Institutional Review Board (IRB) of ArbaMinch University, ArbaMinch, Ethiopia with approval reference number IRB/81/2010.

Informed consent

The written informed consent was obtained from all subjects before the study.

ORCID iDs

Alemu Basazin Mingude

Gashaw Garedew Woldeamanuel

Supplemental material

Supplemental material for this article is available online.

References

Wardlaw

. Low birth weight: country, regional and global estimates. New York: UNICEF, 2004.

Gebregzabiherher

Haftu

Weldemariam

, et al. The prevalenceand risk factors for low birth weight among term newborns in Adwa General Hospital, Northern Ethiopia. Obstet Gynecol Int 2017; 2017: 2149156.

UNICEF. New York: Strategic Information Unit, Division of Policy and Planning, UNICEF, 2009.

World Health Organization. Causes of mortality country based report. Geneva: World Health Organization, 2014.

Tchamo

Prista

Leandro

. Low birth weight, very low birth weight and extremely low birth weight in African children aged between 0 and 5 years old: a systematic review. J Dev Orig Health Dis 2016; 7(4): 408–415.

FMOH. National newborn and child survival strategy document brief summary. 2015, https://www.unicef.org/ethiopia/media/391/file/Child%20Survival%20Strategy%20in%20Ethiopia%20.pdf

Adane

Ayele

Ararsa

, et al. Adverse birth outcomes among deliveries at Gondar University hospital, Northwest Ethiopia. BMC Pregnancy Childbirth 2014; 14(1): 90.

Mulatu

Zepre

Betre

, et al. Magnitude and factors associated with low birth weight among new born in selected public hospitals of Addis Ababa, Ethiopia, 2016. Glob J Med Res 2017, https://medicalresearchjournal.org/index.php/GJMR/article/view/1405

Gebremedhin

Ambaw

Admassu

, et al. Maternal associated factors of low birth weight: a hospital based cross-sectional mixed study in Tigray, Northern Ethiopia. BMC Pregnancy Childbirth 2015; 15(1): 222.

10.

Ghimire

Phalke

, et al. Determinants of low birth weight: a case control study in Pravara Rural hospital in Western Maharashtra, India. Int J Sci Res 2014; 3: 243–245.

11.

Zenebe

Awoke

Birhan

. Low birth weight & associated factors among newborns in Gondar town, North West Ethiopia: institutional based cross-sectional study. Indo Glob J Pharm Sci 2014; 4(2): 74–80.

12.

Gebrehawerya

Gebreslasie

Admasu

, et al. Determinants of low birth weight among mothers who gave birth in Debremarkos Referral Hospital, Debremarkos Town, East Gojam, Amhara Region, Ethiopia. Neonat Pediatr Med 2018; 4(1): 145.

13.

Girma

Fikadu

Agdew

, et al. Factors associated with low birthweight among newborns delivered at public health facilities of Nekemte town, West Ethiopia: a case control study. BMC Pregnancy Childbirth 2019; 19: 220.

14.

Lake

OlanaFite

. Low birth weight and its associated factors among newborns delivered at WolaitaSodo University Teaching and Referral Hospital, Southern Ethiopia, 2018. Int J Pediatr 2019; 2019: 4628301.

15.

Zeleke

Zelalem

Mohammed

. Incidence and correlates of low birth weight at a referral hospital in Northwest Ethiopia. Pan Afr Med J 2012; 12: 4–8.

16.

Tema

. Prevalence and determinants of low birth-weight in Jimma zone, south West Ethiopia. East Afr Med J 2006; 83: 366–371.

17.

Zerfu

Umeta

Baye

. Dietary diversity during pregnancy is associated with reduced risk of maternal anemia, preterm delivery, and low birth-weight in a prospective cohort study in rural Ethiopia. Am J Clinnutr 2015; 103(6): 1482–1488.

18.

Hailu

Kebede

. Determinants of low birth weight among deliveries at a referral Hospital in Northern Ethiopia. Biomed Res Int 2018; 2018: 8169615.

19.

Gamo Gofa Zone Health Department. Annual health coverage and implementation report. Arba Minch, Ethiopia: Gamo Gofa Zone Health Department, 2017.

20.

Demelash

Motbainor

Nigatu

, et al. Risk factors for low birth weight in Bale zone hospitals, South-East Ethiopia: a case-control study. BMC Pregnancy Childbirth 2015; 15(1): 264.

21.

Semira

Hassen

Wakayo

. A health facility based case-control study on determinants of low birth weight in Dassie town, Northeast Ethiopia: the role of nutritional factors. Nutr J 2018; 17(1):103.

22.

Mahumud

Sultana

Sarker

. Distribution and determinants of low birth weight in developing countries. J Prev Med Public Health 2017; 50(1): 18–28.

23.

Getnet

Nigusie

Mengistu

, et al. Determinants of low birth weight among neonates born in Amhara Regional State Referral Hospitals of Ethiopia: unmatched case control study. BMC Res Notes 2018; 11: 447.

24.

Sharma

Giri

Timalsina

, et al. Low birth weight at a term and its determinants in tertiary hospitals of Nepal: a case control study. PLoS ONE 2015; 10: e0123962.

25.

Henry-Edwards

Humeniuk

Ali

, et al. The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): guidelines for use in primary care (Draft version 1.1 for field testing). Geneva: World Health Organization, 2003.

26.

World Health Organization. International statistical classification of diseases and health related problems, vol 2. 10th revision. Geneva: World Health Organization, 2010.

27.

World Health Organization. WHO technical consultation report on birth spacing.Geneva: World Health Organization, 2005.

28.

Tang

Chung

Dong

, et al. Determining a global mid upper arm circumference cutoff to assess malnutrition in pregnant women. Washington, DC: FHI 360/Food and Nutrition Technical Assistance III Project (FANTA), 2016.

29.

WHO/UNICEF/UNU. Iron deficiency anemia: assessment, prevention, and control. Geneva: World Health Organization, 2001.

30.

Dendir

Deyessa

. Substance use and birth weight among mothers attending public hospitals: a case control study. Ethiop J Health Dev 2017; 31(1): 27–35.

31.

Bhaskar

Deo

Neupane

, et al. A case control study on risk factors associated with low birth weight babies in Eastern Nepal. Int J Pediatr 2015; 2015: 807373.

32.

Deshpande

Phalke

Bangal

, et al. Maternal risk factors for low birth weight neonates: a hospital based case control study in rural area of Western Maharashtra, India. Natil J Community Med 2011; 2(3): 394–398.

33.

Michael

Joseph

. Effect of inter pregnancy interval on adverse pregnancy outcomes in northern Tanzania: a registry-based retrospective cohort study. BMC Pregnancy Childbirth 2016; 16: 140.

34.

Gordon

Jill

Richard

. Interpregnancy interval and risk of preterm birth and neonatal death: retrospective cohort study. BMJ 2003; 327: 313.

35.

Smits

Esse

. Short interpregnancy intervals and unfavourable pregnancy outcome: role of folate depletion. Lancet 2002; 359(9307): 2074–2077.

36.

Stangret

Wnuk

Szewczyk

, et al. Maternal hemoglobin concentration and hematocrit values may affect fetus development by influencing placental angiogenesis. J Matern Fetal Neonatal Med 2017; 30(2): 199–204.

37.

Jwa

Fujiwara

Yamanobe

, et al. Changes in maternal hemoglobin during pregnancy and birth outcomes. BMC Pregnancy Childbirth 2015; 15: 80.

38.

Kidane

. The link between contents and perceived quality of antenatal carewith low birth weight among term neonates in public healthfacilities of Bahir Dar Special Zone, North west Ethiopia, 2015, http://localhost:80/xmlui/handle/123456789/11919

39.

Tamura

Hanaoka

Ito

, et al. Different risk factors for very low birth weight, term-small-for-gestational-age, or preterm birth in Japan. Int J Environ Res Public Health 2018; 15(2): 369.

40.

Irene

Arianna

. The importance of maternal nutrition for health. J Pediatr Neonat Individ Med 2015; 4(2): e040220.

41.

Sebayang

Dibley

Kelly

, et al. Determinants of low birthweight, small-for-gestational-age and preterm birth in Lombok, Indonesia: analyses of the birthweight cohort of the SUMMIT trial. Trop Med Int Health 2012; 17(8): 938–950.

42.

Kathleen

Drora

. Maternal nutrition and birth outcomes. Epidemiol Rev 2010; 32: 5–25.

43.

Rozi

Butt

Zahid

, et al. Association of tobacco use and other determinants with pregnancy outcomes: a multicentre hospital-based case–control study in Karachi, Pakistan. BMJ Open 2016; 6(9): e012045.

44.

Martinez

Wright

Tausing

. The effect of paternal smoking on the weight of new born whose mother is did not smoke. Am J Public Health 1994; 84(9): 1489–1491.

45.

Ashford

Hahn

Hall

, et al. The effects of prenatal secondhand smoke exposure on preterm birth and neonatal outcomes. J Obstet Gynecol Neonatal Nurs 2010; 39(5):525–535.

46.

Lambers

Clark

. The maternal and fetal physiologic effect of nicotine. Semin Perinatol 1996; 20(15): 115–126.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.03 MB

Determinants of low birth weight among live birth newborns delivered at public hospitals in Gamo Gofa Zone,South Ethiopia: Unmatched case control study