Decomposing low birth weight inequality in Lesotho: A distributional analysis using hybrid Fairlie and recentred influence function methods on multiple indicator cluster survey 2018.

Socioeconomic Disparities in Adverse Birth Outcomes: A Systematic Review

ObjectiveA large proportion of neonatal deaths in India are attributable to low birth weight (LBW). We report population-based distribution and determinants of birth weight in Bihar state, and on the...

Socioeconomic disparities in birth weights (BWs) are associated with lifelong differences in health and productivity. Understanding socioeconomic disparities in BW is presently of concern to develop public health interventions that promote a good start in life in Northwest China. In the study, our objective is to investigate the socioeconomic disparities in low and high BW from 2010 to 2013 in this region.Those single live births were recruited using a stratified multistage sampling method in Shaanxi province from August to December 2013. Data were collected with a structured questionnaire and a review of birth certificates. Socioeconomic status (SES) was stratified based on the calculated household wealth index. Prevalence differences (PDs) and concentration indices (CIs) were used to depict the SES inequality of low BW (LBW) and macrosomia.Information for 28722 single live births born were obtained in Shaanxi province. From 2010 to 2013, the overall rates of LBW decreased, and the difference in LBW across differing SES groups decreased by 0.7% (boys, 0.4%; girls, 0.8%). From 2010 to 2013, the overall rates of macrosomia increased by 14.3% (boys, 17.5%; girls, 7.8%), whereas the PDs in macrosomia across various SES groups remained unchanged. From 2010 to 2013, concentration indices for SES inequalities in LBW and macrosomia confirmed the results shown by differences in prevalence. Compared with mothers of high SES, those in low SES group were significantly older, less educated, engaged in farming with less availabile healthcare, and engaged in unhealthy lifestyles (eg, exposure to secondhand smoke) during pregnancy, regardless of the baby's sex.From 2010 to 2013, in Shaanxi province, the negative association between socioeconomic status and LBW weakened. Rates of macrosomia were higher in those of high SES, but the SES disparities varied insignificantly over the same time. Our findings may provide valuable insights to direct healthcare policies for pregnant women to reduce inequalities in health, quality of life, and productivity for their children as they age into adulthood.

Sub-Saharan Africa continues to face significant challenges with low birth weight (LBW). Factors such as antenatal care (ANC) utilization and socioeconomic status play critical roles in birth outcomes. It is therefore imperative to understand these relationships, which are crucial to developing tailored, workable interventions to improve maternal and child health outcomes in Ghana. This study aimed to examine the association between ANC utilization patterns, socioeconomic disparities, and low birth weight outcomes among women in Ghana. The study included 6,965 observations, with 4,056 complete cases. Due to substantial missingness in key variables (LBW, adequate ANC), a monotone missing data pattern consistent with Missing at Random (MAR) was observed. Multiple Imputation by Chained Equations (MICE) was employed using Fully Conditional Specification across 20 imputed datasets. Survey-weighted logistic regression was performed on each imputed dataset, with estimates pooled via Rubin's Rules. Model fit was assessed using the Hosmer-Lemeshow goodness-of-fit test. The slope index of inequality was calculated to examine socioeconomic disparities. The prevalence of LBW was 10.0% in complete cases and 19.2% in imputed data. Socioeconomic inequality analyses revealed significant pro-rich gradients in ANC utilization. The disparities were more pronounced for optimal ANC (8 + visits; SII: 0.431; RII: 1.538) than adequate ANC (4 + visits; SII: 0.203; RII: 1.224). LBW was disproportionately concentrated among women of lower socioeconomic status (SII: -0.159; RII: 1.172). The adjusted multivariable model showed inadequate ANC (aOR: 1.97; 95% CI: 1.34-2.90), suboptimal ANC (aOR: 1.73; 95% CI: 1.27-2.36), and poor wealth status (aOR: 1.79; 95% CI: 1.18-2.72) were independently associated with higher odds of LBW. ANC visit frequency and household wealth are independently associated with LBW among Ghanaian women. These findings underscore the need for targeted interventions to improve ANC attendance and address socioeconomic disparities to reduce the burden of LBW in Ghana.

Low Birth Weight and Congenital Heart Disease: Current Status and Future Directions

Background: low birthweight is associated with increased childhood morbidity and mortality particularly in Nigeria where poverty levels are also high, and most individuals are found in low socioeconomic class. There is now growing evidence that low birth weight could be reduced through access to good maternal antenatal health care. This review deals with the role of maternal antenatal health care delivery in lowering neonatal birthweight, especially in mothers who belong to low socioeconomic class. Methods: One hundred and sixty six mother-neonatal pairs were selected using systematic random sampling method. Maternal socioeconomic class was estimated using oyedeji scoring model and neonatal birthweight was determined using bassinet weighing scale. Results: All mothers 166 (100%) had antenatal care. Out of 166 neonates in this study, 84 (50.6%) neonates were males and 105 (63.3%) had normal birthweight. Sixty-nine (41.6%) mothers had primary education, 81 (48.8%) were unemployed and 111 (66.9) had low socioeconomic class. Nineteen neonates (11.4%) had low birthweight and mean birthweight of neonates whose mothers belong to low socioeconomic class was slightly lower than those of high socioeconomic class. This was however not significant (p = 0.459). Association between maternal socioeconomic class and neonatal birthweight was also not significant (p = 0.565). Conclusion: Maternal antenatal health care services are crucial for reduction in number of low birthweight in neonates across maternal socioeconomic classes.

Introduction: The high prevalence of Low Birth Weight (LBW) due to Preterm Birth (PTB) and Intrauterine Growth Restriction (IGUR) still persist a challenge in India. This happens due to poor and infrequent utilisation of Antenatal Care (ANC) service. Aim: To assess the difference of PTB and LBW in mothers, who availed ANC at a tertiary care hospital against those who availed ANC at other healthcare facility. Materials and Methods: This cross-sectional study was conducted at Gynaecology Department in Sir Sundarlal Hospital, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India. The data was obtained from the delivery register maintained at the Labour Room of the Department. The age of the mother, place where ANC services availed, birth weight of the newborn and the gestational age were recorded on a master chart. The newborn were considered LBW, if birth weight was <2500 gm, PTB if birth occurred <37 completed weeks of gestation and Intrauterine Growth Restriction (IUGR), if birth weight was below the expected weight at birth for the gestational age. The prevalence of PTB, LBW and mean with SD of LBW were obtained. The association of PTB and LBW with place of ANC services availed was judged using Chi-square test. The 95% confidence interval of the prevalence was obtained by using logit transformation. Results: Out of total 2420 deliveries, 1858 mothers and their newborn were analysed. The mean age of mothers was 26.4±4.3 years. Half (50.1%) of the mothers had taken ANC at SS Hospital and the rest at other healthcare facilities. The prevalence of LBW and PTB babies were 29.2% (95% CI: 27.1-31.3) and 28.8% (95% CI: 26.7-30.9), respectively. Overall, both PTB and LBW were found to be significantly associated with the place of ANC services. Prevalence of LBW born in mothers who received ANC at tertiary care hospital was 19.4%; while it was 39.0% in those receiving at other healthcare facilities. The prevalence of PTB and LBW was more than 1.6 times and twice in those taken ANC at other health care facilities than those at TCH irrespective of gestational age. Among the PTB, the LBW were 42.2% in mothers receiving ANC at the Tertiary Care Center (TCH) against 65.6% in those receiving at other healthcare facilities. Among the full-term deliveries also, the LBW born were 13.1% in mothers receiving ANC at tertiary care as against 24.3% in those receiving at other healthcare facilities. Conclusion: The mothers seeking ANC services at other healthcare facilities need education about the advantage of ANC by the service providers, for timely and better adherence to ANC.

Low birth weight (LBW) is one of the most crucial problem related to neonatal mortality and infant mortality. The LBW is defined as babies born with a birth weight less than 2500 grams. LBW does not only contribute to neonatal morbidity, but may lead to neonatal mortality. This study aim to determine the influence of maternal and child health services (MCH) services to neonatal death among LBW babies in Aceh province, Indonesia.This study is observational study with mix method, using quantitative (Unmatched case control study) and qualitative (case study). The study was conducted between 2011-2015 in 8 district/municipality in Aceh Province, Indonesia. Total sample for quantitative study was 500 neonates (1:1), 250 neonates who died in neonatal period (case) and 250 LBW neonates who survived in the neonatal period (control group). Meanwhile, the total sample for qualitative study was 22, there were 12 (mother) and 10 (midwife).The result of A simple logistic regression analysis for MCH factors found that 4 of 7 variable were significant association with neonatal death among LBW (P value < 0.05), these variables include: Antenatal care (ANC), place of delivery, level of health facilities and neonatal visit. Multiple logistic regression found the ANC has a strongest influence on neonatal death among LBW babies in Aceh Province (OR=3.6; 95% CI: 2.3-5.7). The LBW neonates who were born to mothers who received number of ANC equal to or less than 3 times had a 3.6 times higher risk of death, than neonates who were born to mothers who received ANC ≥ 4 times. The appropriate of health services in health facilities are needed to reduce the NMR and improve the health of neonate.

Background: Child health remains a global priority, emphasized in India’s National Health Policy 2017 and the Sustainable Development Goals (SDGs). This study aims to determine LBW prevalence in institutional deliveries, assess socio-demographic and maternal determinants, and examine links between maternal anthropometry and neonatal outcomes. Material and methods: This prospective observational study was conducted in the Department of Pediatrics, Government Medical College, Kota, to determine the prevalence and determinants of LBW among institutional deliveries. Data was collected from 422 primigravida mothers with singleton pregnancies. Maternal anthropometric measurements (weight, BMI, height), socio-demographic variables, and infant birth weight and length were recorded and analyzed. Results: Results revealed significant associations between lower maternal weight, BMI, and height and increased risk of low birth weight (LBW). Socio-economic disparities were evident, with mothers from lower SES categories more likely to have LBW infants. Maternal education level, antenatal care visits, and occupation also showed a notable influence on birth weight, reflecting the multifactorial nature of LBW. Conclusion: The study highlights the importance of routinely monitoring maternal anthropometric parameters during pregnancy. Addressing socio-economic disparities through targeted public health interventions is crucial to improving neonatal outcomes. Maternal anthropometry remains a simple, portable, and cost-effective method for assessing maternal and fetal health. Keywords: anthropometry; BMI; antenatal care; birth weight; socioeconomic status

Previous studies have suggested that a population's entire birth weight distribution may be shifted towards higher or lower birth weights, and that optimal birth weight may be lower in populations with a lower average birth weight. We evaluated this hypothesis for seven western European countries. We obtained data on all singleton births (N = 1,372,092) and extended perinatal deaths (stillbirths plus neonatal deaths; N = 7,900) occurring in Finland, Sweden, Norway, Denmark, Scotland, the Netherlands, and Flanders (Belgium) in 1993-1995. We assessed whether countries differed in the mode of their birth weight distribution and in the birth weight associated with the lowest perinatal mortality, and then correlated the two. Substantial international differences were found in the mode of the birth weight distribution, which ranged between 3384 gm in Flanders and 3628 gm in Finland. The position of the minimum of the perinatal mortality curve also differed considerably, ranging between 3755 gm in Flanders and 4305 gm in Norway. There was a strong relation between the two: for every 100 gm increase in modal birth weight, optimal birth weight was 170 gm higher (95% confidence interval = 104-236 gm). Our results confirm those of previous studies that compared two populations. To improve the identification of small babies at high risk of perinatal death, population-specific standards for birth weight should be developed and used.

BackgroundMost U.S. studies that report racial/ethnic disparities in increased risk of low birth weight associated with air pollution exposures have been conducted in California or northeastern states and/or urban areas, limiting generalizability of study results. Few of these studies have examined maternal racial/ethnic groups other than Non-Hispanic Black, non-Hispanic White and Hispanic, nor have they included paternal race. We aimed to examine the independent effects of PM2.5 on birth weight among a nationally representative sample of U.S. singleton infants and how both maternal and paternal race/ethnicity modify relationships between prenatal PM2.5 exposures and birth outcomes.MethodsWe used data from the Early Childhood Longitudinal Study, Birth Cohort (ECLS–B), a longitudinal nationally representative cohort of 10,700 U.S. children born in 2001, which we linked to U.S.EPA’s Community Multi-scale Air Quality (CMAQ)-derived predicted daily PM2.5 concentrations at the centroid of each Census Bureau Zip Code Tabulation Area (ZCTA) for maternal residences. We examined relationships between term birthweight (TBW), term low birthweight rate (TLBW) and gestational PM2.5 pollutant using multivariate regression models. Effect modification of air pollution exposures on birth outcomes by maternal and paternal race was evaluated using stratified models. All analyses were conducted with sample weights to provide national-scale estimates.ResultsThe majority of mothers were White (61%). Fourteen percent of mothers identified as Black, 21% as Hispanic, 3% Asian American and Pacific Islander (AAPI) and 1% American Indian and Alaskan Native (AIAN). Fathers were also racially/ethnically diverse with 55% identified as White Non-Hispanic, 10% as Black Non-Hispanic, 19% as Hispanic, 3% as AAPI and 1% as AIAN. Results from the chi-square and ANOVA tests of significance for racial/ethnic differences indicate disparities in prenatal exposures and birth outcomes by both maternal and paternal race/ethnicity. Prenatal PM2.5 was associated with reduced birthweights during second and third trimester and over the entire gestational period in adjusted regression models, although results did not reach statistical significance. In models stratified by maternal race and paternal race, one unit increase in PM2.5 was statistically significantly associated with lower birthweights among AAPI mothers, -5.6 g (95% CI:-10.3, -1.0 g) and AAPI fathers, -7.6 g (95% CI: -13.1, -2.1 g) during 3rd trimester and among births where father’s race was not reported, -14.2 g (95% CI: -24.0, -4.4 g).ConclusionsThese data suggest that paternal characteristics should be used, in addition to maternal characteristics, to describe the risks of adverse birth outcomes. Additionally, our study suggests that serious consideration should be given to investigating environmental and social mechanisms, such as air pollution exposures, as potential contributors to disparities in birth outcomes among AAPI populations.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12940-022-00856-w.

Birth weight is a crucial determinant of the developmental potential of the newborn. Birth weight is the body weight of a baby at its birth. The range of normal is between 2.5 and 4.5 kilograms (5.5 and 9.9 lb). On average, babies of south Asian and Chinese heritage weigh about 3.26 kilograms (7.2 lb). Abnormal newborn weights are associated with negative effects on the health and survival of the baby and the mother. World Health Organization has defined low birth weight as birth weight less than 2,500 grams. Giving birth to a low-birth-weight infant is influenced by several factors. This study aimed to identify key determinants that influence the frequency of normal and low birth weight in Salah Al-Deen general Hospital in Tikrit city-Iraq . This study is a Cross- sectional study, was conducted in obstetric department in Salah Al-Deen general hospital during the period from 1st Feb to the 31st of August 2020. The study sample included full term babies (gestational age 37-42 week) chosen by using a convenient sampling method selecting 197 delivered babies with their mothers. Data collection done by face-to-face interview, using the structured questionnaire developed by the researcher include the following information: Information regarding the mother included demographic variables, reproductive health, medical and obstetrical history and antenatal care visits, use of ferrous sulfate and other supplements during pregnancy. Birth weight was measured at birth, to the nearest 50 g, with the nude infant lying on the available scale. Zero adjustment of the scale was frequently done to ensure accuracy of the readings. Birth weight was categorized into two as low birth weight (birth weight < 2500 grams), and normal birth weight (birth weight ≥ 2500 grams) . The current study showed that prevalence of low birth weight was (2.4%), macrosomia (15.6%) and normal birth weight was (82%). The study showed that the low birth weight was higher among primigravida (3.4%), than multigravida women (1.7%) and that the low birth weight was higher among 1st and 2nd birth order (3.4%), (6.7%) respectively while it was (0%) among the 3rd baby order. Previous history of Diabetes Mellitus was associated with 0(0%) low birth weight babies and (2.6%) of those women without Diabetes Mellitus had low birth weight babies. Those with history of iron deficiency anemia was more prone to had babies with low birth weight (3.1%), versus those without history of iron deficiency anemia (1.3%). Those with history of hypertension more prone to had babies with low birth weight (4%), versus those without history of iron deficiency anemia (2.2%). The current study showed that those with ferrous sulfate supplements had lower proportion of babies with low birth weight (1.2%), versus those without supplements (7.7%), this relation statistically significant . This study has demonstrated that the younger maternal age, mother with diabetes mellitus, hypertension and irregular antenatal care had babies with lower birth weight. Previous history of low birth weight also is a predisposing factor for low birth weight.

Socioeconomic disparities in adverse birth outcomes in the Philippines

The author conducted an ecological study to examine prefectural differences in ENMR and the related factors in Japan, using two new indicators; birth weight (BW) adjusted ENMR and expected ENMR by BW distribution. Correlate analysis of data from national vital statistics and some indicators of medical care services among 47 prefectures edited by the Ministry of Health and Welfare, Japan were conducted. BW-adjusted ENMR and expected ENMR by BW, as well as other indicators, were prepared for statistical analysis. Crude and BW-adjusted ENMRs were significantly correlated with ENMRs for low birth weight (LBW) and very low birth weight (VLBW) early neonates (p<0.01). The number of Obstetrics and Gynecology (OB/GYN) physicians was negatively correlated with BW adjusted ENMR. Crude and BW-adjusted ENMRs were affected mainly by LBW and VLBW early neonate specific ENMR, but not by the rate of LBW. The variation of ENMR among prefectures in Japan is attributable to the number of OB/GYN physicians. The present findings suggest that emphasis should be laid upon enhancement of regional perinatal care systems.

ObjectivesTo determine the association of geographic distribution, and birth weight with sociodemographic factors of the maternal and newborn child of hilly region (lower altitude) and mountain region (high altitude) of...