Factors associated with small size at birth in Nepal: further analysis of Nepal Demographic and Health Survey 2011

Vishnu Khanal,Yun Zhao,Rajendra Karkee,Kay Sauer

doi:10.1186/1471-2393-14-32

Abstract

BackgroundThe global Low Birth Weight (LBW) rate is reported to be 15.5% with more than 95% of these LBW infants being from developing countries. LBW is a major factor associated with neonatal deaths in developing countries. The determinants of low birth weight in Nepal have rarely been studied. This study aimed to identify the factors associated with small size at birth among under-five children.MethodsData from the 2011 Nepal Demographic and Health Survey (NDHS) were used. The association between small size at birth and explanatory variables were analysed using Chi-square tests (χ2) followed by logistic regression. Complex Sample Analysis was used to adjust for study design and sampling.ResultsA total of 5240 mother- singleton under five child pairs were included in the analysis, of which 936 (16.0%) children were reported as small size at birth. Of 1922 infants whose birth weight was recorded, 235 (11.5%) infants had low birth weight (<2500 grams). The mean birth weight was 3030 grams (standard deviation: 648.249 grams).The mothers who had no antenatal visits were more likely (odds ratio (OR) 1.315; 95% confidence interval (CI) (1.042-1.661)) to have small size infants than those who had attended four or more antenatal visits. Mothers who lived in the Far-western development region were more likely to have (OR 1.698; 95% CI (1.228-2.349)) small size infants as compared to mothers from the Eastern development region. Female infants were more likely (OR 1.530; 95% CI (1.245-1.880)) to be at risk of being small than males.ConclusionOne in every six infants was reported to be small at birth. Attendance of antenatal care programs appeared to have a significant impact on birth size. Adequate antenatal care visits combined with counselling and nutritional supplementation should be a focus to reduce adverse birth outcomes such as small size at birth, especially in the geographically and economically disadvantaged areas such as Far-western region of Nepal.

Highlights

The global Low Birth Weight (LBW) rate is reported to be 15.5% with more than 95% of these LBW infants being from developing countries
This study aimed to identify factors associated with small size at birth based on the recent 2011 Nepal Demographic and Health Survey (NDHS).The small size at birth is used as a proxy for low birth weight given that only less than a half of mothers were able to report the birth weight of their children [9,12]
This study found that one in every six infants in Nepal was small size at birth as reported by mothers, and that three factors: (1) antenatal visits, (2) sex of child, and (3) the development region were significantly associated with birth size

Summary

Introduction

The global Low Birth Weight (LBW) rate is reported to be 15.5% with more than 95% of these LBW infants being from developing countries. Low birth weight (LBW) increases the risk of neonatal deaths and further increases the likelihood of developing cerebral palsy and the risk of infection (sepsis) [2,3]. The National Neonatal Health Strategy [11] of Nepal noted that there is an on-going need for further research in the area With this background, this study aimed to identify factors associated with small size at birth based on the recent 2011 Nepal Demographic and Health Survey (NDHS).The small size at birth is used as a proxy for low birth weight given that only less than a half of mothers were able to report the birth weight of their children [9,12]

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