Determinants of low birth weight in the children of adolescent mothers: a hierarchical analysis.

Gabriella Pinto Belfort,Lidiane Da Silva Pessoa,Cláudia Saunders,Marta Maria Antonieta De Souza Santos,Sonaly Petronilho Heidelmann,Juliana Rebelo Dias

doi:10.1590/1413-81232018238.13972016

Gabriella Pinto Belfort, Lidiane Da Silva Pessoa + Show 4 more

Open Access

https://doi.org/10.1590/1413-81232018238.13972016

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Abstract

This study aimed to identify the determinants of low birth weight (LBW) amongst children of adolescent mothers through a hierarchical approach in a cross-sectional study of 751 adolescents attended at a public hospital in Rio de Janeiro. Sociodemographic data, prenatal care, and biological and maternal obstetric conditions were analyzed. Possible determinants of LBW were identified in the bivariate analysis and then hierarchical logistic regression models were tested, considering as taggered hierarchy of distal, intermediate, and proximal levels. Variables with p < 0.05 at each level of analysis were kept in the model, and the adjusted odds ratio (OR) and 95% confidence interval (CI) were estimated. The prevalence of low birth weight was 10%. The determinants of LBW were: distal level - non-acceptance of pregnancy (OR = 10.19, 95% CI = 1.09 to 39.53); intermediate level - having fewer than six prenatal consultations (OR = 4.29; 95% CI = 1.55 to 11.83) and not having standardized nutritional care (OR = 3.18; 95% CI = 1.18 to 8.55); and proximal level - preterm delivery (OR = 10.19, 95% CI = 2.12 to 49.01). The determinants of LBW were maternal characteristics, prenatal care, and birth conditions, which contain certain modifiable social characteristics.

Highlights

According to the World Health Organization (WHO)[1], low birth weight (LBW), defined as weight at birth of less than 2,500 grams, is a determinant of fetal and neonatal mortality and morbidity, developmental deficit, cognitive impairment, and increased risk of chronic noncommunicable diseases in adulthood.[2]Overall estimates indicate that the prevalence of LBW is about 15%, with 96.5% of cases occurring in developing countries, especially among the most vulnerable populations.1The main causes of this outcome are preterm birth, intrauterine growth retardation, and fetal malnutrition.[1]
Ten percent of the newborns had LBW and 13% were born premature; 751 adolescents and their respective children were included in the study
The mean age of the adolescent mothers at birth was 17.5 years ± 1.6; 64% had completed their elementary education, 52% did not work, 68% were single, 62% declared themselves to be non-white, 64% had a per capita income that was below the minimum wage, 52% were residents of the south zone of Rio de Janeiro, and 89% had access to adequate sanitation

Summary

Introduction

According to the World Health Organization (WHO)[1], low birth weight (LBW), defined as weight at birth of less than 2,500 grams, is a determinant of fetal and neonatal mortality and morbidity, developmental deficit, cognitive impairment, and increased risk of chronic noncommunicable diseases in adulthood.[2]. Overall estimates indicate that the prevalence of LBW is about 15%, with 96.5% of cases occurring in developing countries, especially among the most vulnerable populations.1The main causes of this outcome are preterm birth, intrauterine growth retardation, and fetal malnutrition.[1] In Brazil, there are significant regional variations in the prevalence of low birth-weight infants. The study of LBW amongst the infants of adolescent mothers calls for complex hierarchical models to study its determinants and interrelationships

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