Abstract
BackgroundLow birthweight (LBW) and preterm birth (PB) remain the leading cause of morbidity and mortality in neonates worldwide. The aim of this study was to identify maternal demographic and antenatal factors associated with PB and LBW among low socio-economic communities.MethodsPregnant women (n = 1099) were recruited in the first trimester into the Mother and Child in the Environment (MACE) birth cohort in Durban, South Africa. Maternal factors such as demographic information, health status, residential area, occupational, personal and environmental smoking and biomass fuel use were obtained through standardised interviews, while clinical status was obtained in each trimester and antenatal information on HIV status and treatment, syphilis and conditions such as pregnancy induced hypertension, diabetes etc. was extracted from the antenatal assessments. Key outcomes of interest were preterm birth and low birthweight. The latter data was obtained from the clinical assessments performed by midwives at delivery. Logistic regression models identified factors associated with PB and LBW.ResultsOf the 760 live births, 16.4 and 13.5% were preterm and LBW, respectively. Mothers who delivered by caesarean section had an increased odds of having LBW babies (Adjusted odds ratio (AOR): 1.7; 95% CI: 1.1–2.7) and PB (AOR: 1.7, 95% CI: 1.1–2.7) versus normal vaginal deliveries. Mothers > 30 years (AOR: 1.8, 95% CI: 1.1–2.9) and current smokers (AOR: 2.7, 95% CI: 1.3–5.8) had an increased odds of having PB babies. Compared to younger mothers and non-smokers respectively. An effect of PB and LBW was seen among mothers with high BMI (25.0–29.9 kg/m2) (PB: AOR: 0.5, 95% CI: 0.3–0.9 and LBW: AOR: 0.5, 0.5, CI: 0.3–0.8), and obese BMI (> 30 kg/m2) (PB: AOR: 0.5, 95% CI: 0.3–0.9 and LBW: AOR: 0.4, CI: 0.2–0.7). Maternal HIV (PB AOR: 1.4 and LBW AOR: 1.2) and history of sexually transmitted infections (PB AOR: 2.7 and LBW AOR: 4.2) were not statistically significant.ConclusionMaternal age, cigarette smoking and caesarean delivery were associated with LBW and PB. Findings highlight the need of maternal health interventions to improve new-born health outcomes.
Highlights
Low birthweight (LBW) and preterm birth (PB) remain the leading cause of morbidity and mortality in neonates worldwide
Maternal age, cigarette smoking and caesarean delivery were associated with LBW and PB
In sub-Saharan Africa, adverse pregnancy outcomes including spontaneous abortion, PB, LBW, intrauterine growth retardation (IUGR), small for gestational age (SGA) babies, stillbirths and babies with congenital anomalies are triggered by a broad spectrum of obstetric risk factors such as hypertension, gestational diabetes, tuberculosis and sexually transmitted infections (HIV/Acquired Immunodeficiency Syndrome (AIDS) and syphilis) [3,4,5,6]
Summary
Low birthweight (LBW) and preterm birth (PB) remain the leading cause of morbidity and mortality in neonates worldwide. In sub-Saharan Africa, adverse pregnancy outcomes including spontaneous abortion, PB (defined as birth prior to 37 weeks of gestation), LBW (defined as birthweight < 2500 g), intrauterine growth retardation (IUGR), small for gestational age (SGA) babies, stillbirths and babies with congenital anomalies are triggered by a broad spectrum of obstetric risk factors such as hypertension, gestational diabetes, tuberculosis and sexually transmitted infections (HIV/AIDS and syphilis) [3,4,5,6] Factors such as poverty, maternal malnutrition, unhealthy living conditions (ambient air pollution and poor sanitary conditions) and tobacco smoke exposure can play a role in the prevalence of adverse birth outcomes [3,4,5,6]. In the province of KwaZulu-Natal (KZN), approximately 180 maternal deaths for every 10,000 live births, and 70 neonatal deaths for every 1000 live births are seen [8]
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