Risk factors for low birth weight among rural and urban Malaysian women

Satvinder Kaur,Slyvia E Badon,Hamid Jan Jan Mohamed,Dhivyalosini Maykanathan,Rohana Abdul Jalil,Choon Ming Ng,Hip Seng Yim

doi:10.1186/s12889-019-6864-4

Satvinder Kaur, Slyvia E Badon + Show 5 more

Open Access

https://doi.org/10.1186/s12889-019-6864-4

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Abstract

BackgroundLow birth weight prevalence in Malaysia remains high. Socioeconomic background may lead to differences in physical activity and maternal nutritional status, which may play an important role in birth outcomes.MethodsThis prospective cross-sectional study aimed to identify rural-urban differences in risk factors for low birth weight among women in Malaysia. Pregnant women at ≥20 weeks of gestation in urban and rural Malaysia (n = 437) completed questionnaires on sociodemographic characteristics and physical activity. Weight and middle-upper arm circumference were measured. Infant birth outcomes were extracted from medical records.ResultsThe overall prevalence of low birth weight infants was 6.38%. Rural women had more low birth weight infants than urban women (9.8% vs 2.0%, p = 0.03). Findings showed rural women were less sedentary (p = 0.003) and participated in more household/caregiving activities (p = 0.036), sports activities (p = 0.01) and less occupational activity (p < 0.001) than urban women. Logistic regression revealed that older age (OR = 1.395, 95% Cl = 1.053 to 1.846), low parity (OR = 0.256, 95% Cl = 0.088–0.747) and low middle-upper arm circumference (OR = 0.738, 95% Cl = 0.552 to 0.987) increased the risk of low birth weight infants in rural, but not in urban women.ConclusionsWe observed differences in risk factors for low birth weight between urban and rural pregnant women. Age, malnutrition and low parity were risk factors for low birth weight among rural pregnant women. Our findings suggest that rural pregnant women with low nutritional status should be encouraged to monitor their middle-upper arm circumference consistently throughout pregnancy. Improving nutritional status in rural pregnant women may reduce the risk of low birth weight infants in this population.

Highlights

Low birth weight prevalence in Malaysia remains high
We demonstrated that pregnant women from urban areas had higher level of education compared to pregnant women in rural areas, consistent with past studies in developing countries [8]
In this study, we identified low Middle-upper arm circumference (MUAC), low parity, and greater maternal age as risk factors for low birth weight (LBW) in rural, but not urban, pregnant women in Malaysia

Summary

Introduction

Low birth weight prevalence in Malaysia remains high. Women from developing countries especially from Asia are more prone to give birth to infants with low birth weight (LBW) as compared to women from developed countries [1]. Infant birth weight has a strong role in determining short- and long-term health, reducing the prevalence of LBW should be given much importance. There are many risk factors for LBW including poor maternal nutrition and lifestyle factors (alcohol, tobacco use, drug abuse), In urban and rural areas in Malaysia, the prevalence of LBW was 9.5 and 10.0% respectively [2]. Rural women have lack of access to antenatal care [7], lower nutrition awareness [8] and poor diet quality [9] compared to urban women

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