Risk Factor For Low Birth Weight Research Articles

Study of Factors Associated with Low Birth Weight in the Bounkiling Health District in 2020 (Senegal)

<i>Introduction</i>: Neonatal mortality is particularly high in developing countries. Low birth weight (LBW) is a major public health problem in both developing and developed countries. It accounts for a significant proportion of neonatal deaths. The aim of this study was to determine the factors associated with the occurrence of low birth weight in the Bounkiling health district in 2020. <i>Methodology</i>: This was a retrospective case-control study of the various factors associated with low birth weight, based on women's delivery records from maternity units in the Bounkiling health district throughout 2020. Mothers' socio-demographic characteristics, obstetrical and medical history, and information on the health status of the newborn in the case group (weight less than 2,500 grams) were compared with those in the control group (weight greater than or equal to 2,500 grams). Bivariate and multivariate analyses were performed using Épi info 7 software to identify risk factors associated with LBW. <i>Results</i>: The study showed that low birth weight accounted for 97.05% of LBW, the sex ratio was 0.87 in favor of girls, the Apgar score at birth was not good (below 7) for 31.43% of newborns. Teenage mothers accounted for 17.08%. Women with no schooling accounted for 71.34%, and those living in households with a monthly income of less than 50,000 CFA francs per month were 63.71%. Results of the multivariate analysis showed that the risk factors for LBW (p < 0.05) were female sex of the newborn (AOR=1.59 with CI=1.07 - 2.35), Apgar score at birth (AOR=2.79 with CI=1.77 - 4.41), young maternal age under 19 (AOR=2.42 with CI=1.43- 4.12), household income under 50,000 CFA francs, (AOR=1.97 with CI=1.27-3.04), maternal history of low birth weight (AOR=3.62 with CI=2.02-6.50), physical labor during pregnancy (AOR=1.80 with CI=1.20 - 2.69). <i>Conclusion</i>: Improving neonatal health through a reduction in LBW will depend on intensifying the implementation of strategies focused on adolescent reproductive health, strengthening communication with adolescent girls and community leaders on the issue of early marriage and pregnancy, improving pregnancy monitoring at health facilities and raising the socio-economic level of women through their empowerment.

THE CORRELATION BEETWEEN MOTHER'S NUTRITIONAL STATUS AND PARITY WITH THE INCIDENT OF LOW BIRTH WEIGHT (LBW) AT A PUBLIC HEALTH CENTER SURABAYA

Background: One of the highest causative factors of neonatal death in Indonesia is low birth weight (LBW), around 7,150 (35.3%) cases. Even though the trend of LBW incidents in East Java is decreasing, in the city of Surabaya itself the death rate due to LBW has increased from 31 deaths to 51 deaths. Simomulyo Public Health Center was ranked first with the highest incidence of LBW in Surabaya with 45 cases in 2019. Even though there was a decrease in cases in 2020, the death rate actually increased from 1 death to 4 deaths. WHO (2017) defines LBW as babies born weighing ≤ 2500 gr. Nutritional status and parity are two of the many risk factors for LBW. Knowing the causal relationship with the occurrence of LBW is important to do at the public Health Center as a first step in preventing LBW in the future. Method: This research is quantitative with an analytical observational design using a cross-sectional approach. Samples were taken using probability sampling techniques, namely random sampling. The total samples taken were 96 samples. Result: The results of the research was found that there was a relationship between nutritional status and the incidence of LBW with a value of p=0.005 (p<0.05) and the relationship between parity and the incidence of LBW with a value of p=0.001 (p < 0.05). Conclusion: there is a correlation between nutritional status and parity and the incidence of LBW at the Simomulyo Public Health Center Surabaya.

Proportion of Low Birth weight and Associated Maternal Risk Factors in a Developing Country, Bangladesh

Introduction: Though the health situation of Bangladesh has been improved substantially over the years, the low birth weight (LBW) rate is still pretty high. LBW has been associated with high probability of infection, malnutrition, mental deficiencies and behavioural and learning problem in later life. The principle focus of this study was to ascertain the proportion of LBW and its associated maternal risk factors identification. Materials & methods: It was a cross-sectional type of descriptive study done at two tertiary level hospitals – Rajshahi Medical College Hospital and Islami Bank Medical College Hospital. A total of 270 mothers were interviewed within 1 month of their delivery. The purposively selected participants were asked about their socio-demographic characters and other associated factors related to birth of the babies. Weights of the babies at birth were documented from hospital records. Result: Proportion of LBW was found 28.1% with no significant sex variation. Majority of the LBW babies were found in mothers of 15-20 years of age group. Mothers’ educational qualifications, occupations, early age pregnancy and type of pregnancy were associated significantly for LBW. Less than 37 weeks of gestational age of baby, home delivery, NVD were also significant risk factors of LBW. Residence and sex of neonate were not significantly associated with LBW. Conclusion: Proportion of LBW in tertiary care hospitals were found 28.1%. Early maternal pregnancy, lower gestational age, higher parity, NVD and home delivery played an important role in the incidence of LBW. TAJ 2023; 36: No-2: 207-214

Association of Eicosapentaenoic and Docosahexaenoic Acid Intake with Low Birth Weight in the Second Trimester: The Japan Pregnancy Eating and Activity Cohort Study.

This study examined the association of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) intake during the second trimester with low birth weight (LBW) in pregnant Japanese women and was conducted in conjunction with the Japan Pregnancy Eating and Activity Cohort (J-PEACH) study. The study included 504 pregnant women from four Japanese sites. During the second trimester (14-27 weeks), the participants filled out a self-administered questionnaire assessing the frequency of DHA and EPA supplement intake in the past month, as well as a brief-type self-administered diet history questionnaire (BDHQ). The analysis involved data from two time points: responses to the BDHQ and infant data at birth. In total, 471 and 33 participants were classified into the normal birth weight and LBW groups, respectively. The participants were divided into high-, medium-, and low-intake groups based on their total dietary and EPA and DHA supplementary intakes. The Cochran-Armitage trend test was used to analyze the data; the prevalence of LBW was higher in the low-intake group (p = 0.04). There was no significant sex-based trend (p = 0.27 and p = 0.35). In Japanese women, low dietary and supplementary EPA and DHA intake until the second trimester were risk factors for LBW.

Population attributable fraction of low birth weight risk factors in Japan

Population attributable fraction of low birth weight risk factors in Japan

Risk factors of low birth weight among neonates at A Tertiary Care Hospital Karachi.

Objective: To determine frequency and risk factors of low birth weight (LBW) among neonates at a tertiary care hospital in Karachi, Pakistan. Study Design: Cross-sectional study. Setting: Neonatal Intensive Care Unit (NICU) of National Institute of Child Health. Period: December 2022 to May 2023. Material & Methods: Neonates newly admitted in NICU were enrolled into study. In accordance with World Health Organization criteria, LBW was defined as birth weight <2500 grams. Clinical and demographic details of mothers were retrieved. Frequency and risk factors of LBW among neonates were noted. Results: In a total of 212 neonates, 117 (55.2%) were boys. Mode of delivery was spontaneous vaginal delivery in 118 (55.7%) cases. The median maternal age was 25.5 (IQR=22-30) years. There were 172 (81.1%) cases that were pre-booked. Median birth weight was 2.8 (IQR=2.5-3.1) grams. The frequency of LBW was noted in 45 (21.2%). On multivariable regression model, maternal age, education, antenatal care visit, birth interval, presence of hypertension and anemia during pregnancy were found to be independent (p<0.05) predictors of LBW. Conclusion: The frequency of LBW among neonates admitted in NICU was high. Maternal age, educational status, antenatal care, birth interval, hypertension and anemia were independent predictors of LBW.

Maternal risk factors for low birthweight and macrosomia: a cross-sectional study in Northern Region, Ghana

BackgroundAbnormal birthweights are critical public health challenges accountable for most non-communicable diseases and perinatal mortalities. Regardless of the myriad of mixed evidence on maternal factors responsible for abnormal birthweight globally, most of these findings are attained from urban and rural settings. This study serves as one of the key pieces of evidence in view of the increasing prevalence of abnormal birthweight particularly in some parts of semi-rural Ghana. The study, therefore, aims to estimate the prevalence of abnormal birthweight and identify some possible maternal risk factors for abnormal birthweight in Northern Ghana.MethodsA retrospective cross-sectional study was conducted in Savelugu municipality from February–March 2022. A total of 356 mothers aged 16–46 years, having a neonate and attending postnatal care service, were recruited as study participants. Data were collected from maternal and child health record books and through structured interviews. To identify the maternal risk factors for abnormal birthweight, chi-square/Fischer’s exact test and multinomial logistic regression were employed as bivariate and multivariate analyses, respectively, at 95% confidence level.ResultsPrevalence rates of low birthweight and macrosomia were 22.2% and 8.7%, respectively. Maternal anaemia in first trimester (AOR 3.226; 95% CI 1.372–7.784) and third trimester (AOR 23.94; 95% CI 7.442–70.01) of gestation was strong predictors for low birthweight. Mothers belonging to minority ethnic groups (AOR 0.104; 95% CI 0.011–0.995); mothers who had ≥ 8 antenatal care visits (AOR 0.249; 95% CI 0.103–0.602); and mothers having neonates whose birth length > 47.5 cm (AOR 0.271; 95% CI 0.113–0.651) had reduced odds for low birthweight. Alternatively, mothers with gestational weeks ≥ 42 (AOR 23.21; 95% CI 4.603–56.19) and mothers from the richest households (highest socioeconomic homes) (AOR 14.25; 95% CI 1.638–23.91) were more likely to birth to macrosomic infants.ConclusionThe prevalence rates of low birthweight and macrosomia were relatively high. Anaemia in the first and third trimesters was strong determinants of low birthweight. Being minority ethnic group, frequency of antenatal visits, and childbirth length reduced the risk of low-weight births. Advanced gestational age and socioeconomic status of mothers were also predictors of macrosomia. Hence, nutrition counselling, community health education, and promotion of lifestyle improvement coupled with strengthening of health service delivery are recommended interventions.

The Prevalence of Low Birth Weight Among Newborn Babies and Its Associated Maternal Risk Factors: A Hospital-Based Cross-Sectional Study.

Background Low birth weight (LBW) is at the forefront of 100 core health issues that are used as indicatorsto assess the global nutrition monitoring framework as reported by the World Health Organization (WHO). Several factors could contribute to LBW, which essentiallyincludeintrauterine growth retardation and premature delivery/birth. Moreover, LBW predisposes neonates to several developmental disturbances including both physical and mental disorders. Given that LBW is more common in poor and developing countries, there is not much reliable data that could be used to formulate strategies for controlling this problem. This study, therefore, attempts to assess the prevalence of LBW among newborn babies and its associated maternal risk factors. Methods This hospital-based cross-sectional study was carried out between June 2016 and May 2017 (one year) and included 327 LBW babies. A predefined and prevalidated questionnaire was used to obtain data for the study. The data collected includedage, religion,parity, birth spacing, pre-pregnancy weight, weight gain during pregnancy, height, mother's education, occupation, family income, socioeconomic status, obstetric history, previous history of stillbirths and abortions, and history of any LBW baby. Results The prevalence of LBW was noted to be 36.33%. The occurrence of LBW babies was predominant among mothers who were aged <19 years (62.26%) and >35 years (57.14%). Grand multipara women showed the highest rates (53.70%) of LBW babies. Additionally, LBW was predominantly noticed among newborns (46.66%) with a birth spacing of <18 months, those born to mothers with pre-pregnancy weight of <40 Kg (94.04%), mothers with a height of <145 cm (83.46%), mothers who gained <7 kg during the pregnancy (82.20%), illiterate mothers (43.75%), and mothers who were agricultural workers (63.76%). Other maternal factors that could predispose to LBW included lower monthly income (66.25%), low socioeconomic status (52.90%), less number of antenatal visits (59.65%), low blood hemoglobin (100%), history of strenuous physical activities (48.66%), smoking and/or tobacco chewing habit (91.42%), alcoholism (66.66%), lack of iron and folic acid supplementation during pregnancy (64.58%), history of stillbirths (51.51%), and mothers suffering from chronic hypertension, preeclampsia, and eclampsia(47.61%), and tuberculosis (75%). Religion-wise, Muslim mothers revealed the highest prevalence (48.57%) of LBW, followed by Hindus(37.71%) and Christians (20%). The mother's age, pre-pregnancy weight, weight gain during pregnancy, height of the mother, hemoglobin concentration, weight of the baby, and length of the newborn(p≤0.05) couldinfluence the health of the newborn. However, maternal infections, previous bad obstetrics history, presence of systemic illnesses, and protein and calorie supplementation (p≥0.05) had no significant impact on birth weight. Conclusions The results showed that multiple factors are responsible for LBW. Maternal factors such as weight, height, age, parity, weight gained during pregnancy, and anemia during pregnancy could predispose to delivering LBW babies. Additionally, other risk factors for LBW identified in this study were the literacy level of mothers, occupation, family income, socioeconomic status, antenatal care, strenuous physical activity during pregnancy, smoking/tobacco chewing, alcohol/toddy consumption, and iron and folic acid supplementation during pregnancy.

The relationship between maternal health and neonatal low birth weight in Amman, Jordan: a case-control study

This study aimed to examine the relationship between maternal health during pregnancy and low birth weight (LBW), as well as the impact of COVID-19 on the socio-economic status of pregnant women and its effect on LBW. The study was conducted in Amman, Jordan, and included 2260 mothers who visited Abu-Nusair comprehensive health center between January and December 2020. A matched case-control design was used with 72 cases and 148 controls selected for data collection through medical records and face-to-face interviews. Results showed that factors such as a monthly income of 400 JD or less, living with an extended family, exposure to passive smoking, maternal weight gain of 6-10 kg, maternal anemia, maternal hypertension, delivery by cesarean section, and previous history of LBW newborns were positively associated with an increased risk of LBW. Conversely, factors such as a monthly income above 700 JD, living with a core family, daily intake of iron, calcium, and vitamin D, prenatal visits, healthy food intake, and planning for pregnancy were associated with a lower risk of LBW. COVID-19 infection and its effects on work, family finances, antenatal care visits, and food supply were also positively linked with LBW. In conclusion, socioeconomic status, maternal health, COVID-19, and its impacts were significant risk factors for LBW.

Association Between Carbon Emission and Low Birth Weight in Mainland China.

The aim of this study is to investigate the relationship between carbon emission and low birth weight (LBW). A nested case-control study was contacted in mainland China. Multilevel logistic regression was used to estimate the effect of carbon emission on LBW. Generalized additive mixed effect model was performed to assess no-linear trend between LBW and carbon emission. Carbon emission was a risk factor for LBW (odds ratio, 1.182; 95% confidence interval, 1.011-1.383). Carbon emissions from power, residence, aviation, and transport department were risk factors for LBW (all P < 0.05). Moreover, generalized additive mixed effect model has shown that the risk of LBW decreased first and then increased as carbon emissions increased. Our study initially found that carbon emission may be a risk factor for LBW.

Domestic violence against pregnant women is a potential risk factor for low birthweight in full-term neonates: A population-based retrospective cohort study.

Domestic violence's most frequently reported outcomes are preterm delivery and low birthweight, both of which are the strongest correlates of mortality and morbidity. Several studies have shown that pregnant women with domestic violence during pregnancy were more likely to deliver low-birthweight and preterm neonates. However, there has been no consensus on associations between domestic violence and low-birthweight and preterm delivery. To examine the impact of domestic violence on birthweight stratified by preterm or full-term delivery, a population-based retrospective cohort study was conducted that linked four national databases in Taiwan. A total of 1,322 subjects associated with a report of domestic violence during pregnancy were compared with 485,981 subjects without any record of reported domestic violence. The percentage of low birthweight in the group exposed to domestic violence was significantly higher than in the unexposed group with full-term delivery (4.9% vs. 3.3%, p = 0.001). Multivariable logistic regression analysis showed that pregnant women exposed to domestic violence had an OR of 1.37 (95% CI 1.05, 1.79) for low birthweight in full-term delivery. However, domestic violence was not significantly associated with low birthweight in preterm delivery. Screening for intimate partner violence in the perinatal health care system should be seen as especially important for women who have had full-term low-birthweight neonates.

MATERNAL FACTORS ASSOCIATED WITH LOW BIRTH WEIGHT NEWBORN IN A TERTIARY CARE CENTRE OF SOUTHERN RAJASTHAN

Objective: Low birth weight is defined as weight at birth of &lt;2500 g as per the World Health Organization. Low birth weight (LBW) newborns have higher risk of morbidity and mortality during perinatal period. The aim of the study was to ascertain the maternal factors leading to low birth weight in newborns. Methods: A cross-sectional study was done for a period of 1 year. Mothers delivering term LBW babies from singleton pregnancy were taken as cases and mothers with term, normal weight newborns from singleton pregnancy were termed as control group. Babies with congenital malformations, still births, and multiple gestations were excluded from the study. Written consent for the study in local language from each subject was taken. Institutional ethical clearance was obtained. Results: One thousand two hundred and fifty-six babies were born during the study period and out of these 258 babies were weighing &lt;2.5 kg thus the incidence of LBW &lt;2.5 kg was 20.54%. Young maternal age (&lt;30 years) and multi parity (≥3) had significantly increased LBW incidence of 28.7% and 32%, respectively. Pregnancy complications such as anemia and pre-eclampsia had significantly increased incidence of LBW newborn of 33.455 and 29.1%, respectively. Conclusion: Pregnancy-related anemia and hypertension are an important risk factor for LBW. Young maternal age pregnancy and poor ante natal visits also contribute toward LBW.

Incidence and Risk Factors for Low Birthweight and Preterm Birth in Post-Conflict Northern Uganda: A Community-Based Cohort Study.

Background: Annually, an estimated 20 million (13%) low-birthweight (LBW) and 15 million (11.1%) preterm infants are born worldwide. A paucity of data and reliance on hospital-based studies from low-income countries make it difficult to quantify the true burden of LBW and PB, the leading cause of neonatal and under-five mortality. We aimed to determine the incidence and risk factors for LBW and preterm birth in Lira district of Northern Uganda. Methods: This was a community-based cohort study, nested within a cluster-randomized trial, designed to study the effect of a combined intervention on facility-based births. In total, 1877 pregnant women were recruited into the trial and followed from 28 weeks of gestation until birth. Infants of 1556 of these women had their birthweight recorded and 1279 infants were assessed for preterm birth using a maturity rating, the New Ballard Scoring system. Low birthweight was defined as birthweight <2.5kg and preterm birth was defined as birth before 37 completed weeks of gestation. The risk factors for low birthweight and preterm birth were analysed using a multivariable generalized estimation equation for the Poisson family. Results: The incidence of LBW was 121/1556 or 7.3% (95% Confidence interval (CI): 5.4–9.6%). The incidence of preterm births was 53/1279 or 5.0% (95% CI: 3.2–7.7%). Risk factors for LBW were maternal age ≥35 years (adjusted Risk Ratio or aRR: 1.9, 95% CI: 1.1–3.4), history of a small newborn (aRR: 2.1, 95% CI: 1.2–3.7), and maternal malaria in pregnancy (aRR: 1.7, 95% CI: 1.01–2.9). Intermittent preventive treatment (IPT) for malaria, on the other hand, was associated with a reduced risk of LBW (aRR: 0.6, 95% CI: 0.4–0.8). Risk factors for preterm birth were maternal HIV infection (aRR: 2.8, 95% CI: 1.1–7.3), while maternal education for ≥7 years was associated with a reduced risk of preterm birth (aRR: 0.2, 95% CI: 0.1–0.98) in post-conflict northern Uganda. Conclusions: About 7.3% LBW and 5.0% PB infants were born in the community of post-conflict northern Uganda. Maternal malaria in pregnancy, history of small newborn and age ≥35 years increased the likelihood of LBW while IPT reduced it. Maternal HIV infection was associated with an increased risk of PB compared to HIV negative status. Maternal formal education of ≥7 years was associated with a reduced risk of PB compared to those with 0–6 years. Interventions to prevent LBW and PBs should include girl child education, and promote antenatal screening, prevention and treatment of malaria and HIV infections.

The Effect of Gestational Weight Gain on Low Birth Weight, Case-Control Study in Northeast Amhara Regional State, Ethiopia, 2019

Background: Intrauterine growth and development are one of the most vulnerable periods in the human life cycle that contribute to appropriate fetal development. Therefore, this study aimed to assess the effect of gestational weight on low birth weight (LBW).&#x0D; Methods: A case-control study was conducted from June 30, 2018, to January 1, 2019, in seven governmental hospitals in the northeast Amhara region on 451 participants(150 cases and 301 controls).&#x0D; Results: Inadequate gestational weight gain increases the risk of LBW by four times (AOR: 4.2, 95% CI: 2.4, 6.4). Anemic mothers were 3 times (AOR: 3.2, 95%CI: 2.5, 5.1) more likely to give birth to LBW newborns than non-anemic women. Mothers with a height of less than 150 cm were 2 times more likely to deliver low birth weight babies than their counterparts (AOR:2.1, 95% CI: 1.5,4.4). The odds of LBW delivery were 3.5 times (AOR: 3.5, 95% CI: 2.3, 5.3) higher for mothers with poor dietary diversity than for mothers with good dietary diversity.&#x0D; Conclusion: Inadequate gestational weight gain during pregnancy was found to be a risk factor for LBW. Additionally, anemia, short stature, and poor dietary diversity were also risk factors for LBW. Therefore, selectively targeted interventions such as improving maternal nutrition, anemia prevention, and proper maternal weight monitoring during pregnancy are needed.

Association between Water Fluoride Levels and Low Birth Weight: National Health and Nutrition Examination Survey (NHANES) 2013-2016.

Background: Excessive fluoride consumption affects reproductive and child health. We examined the association between levels of fluoride in drinking water and birth weight, in the National Health and Nutrition Examination Survey 2013–2016, after adjusting for known risk factors Low Birth Weight (LBW) including age, smoking, and socio-demographic variables including education, food security, health care access, and health status. Methods: The study included 7147 and 6858 women with complete birth weight and water fluoride data, respectively. Linear regression models evaluated the association between water fluoride and birth weight across racial/ethnic groups. The odds of delivering an LBW infant (<2500 g) compared to an infant weighing ≥ 2500 g, as well as the odds of delivering a Very Low Birth Weight (VLBW, <1500 g) infant compared to an LBW infant were explored in separate logistic regression models. Results: Women with LBW infants were exposed to significantly higher levels of water fluoride compared to those with normal birth weight infants. Our findings suggest a significant association between excess water fluoride exposure (>0.7 ppm) and LBW weight in Hispanic women, independent of established LBW risk factors. In logistic regression models, Hispanic women exposed to increased levels of water fluoride were 1.5 times more likely to give birth to an LBW infant and 3.5 more likely to give birth to a VLBW infant. Conclusion: Taken together, these findings can inform public health education strategies that highlight water fluoride as a potential risk factor during pregnancy in Hispanic women. More research is needed to confirm these findings.

Effectiveness of Integrated Maternal Nutrition Intervention Package on Birth Weight in Rwanda.

Inadequate maternal nutrition before and during pregnancy is a principal risk factor for poor fetal development, resulting in low birth weight (LBW) and subsequently, poor child growth. Most studies focus on the impact of nutritional interventions after birth while only a few interventions consider integrated nutrition service packages. Therefore, there is limited evidence on whether integrated maternal nutrition interventions have a positive effect on birthweight. Thus, a post-program quasi-experimental study was carried out to determine the effectiveness of the integrated maternal nutrition intervention package on low birth weight in Rwanda. A total of 551 mother–baby pairs from the intervention and 545 controls were included in the analysis. Data regarding socio-demographic, maternal anthropometric parameters, and dietary diversity were collected using a structured questionnaire. Birth weight was assessed right after delivery, within 24 h. Logistic regression, linear regression, and path analysis were fitted to determine the effectiveness of the intervention on birth weight. The study found that the intervention reduced LBW by 66.99% (p < 0.001) and increased average birth weight by 219 g (p < 0.001). Logistic regression identified reduced risk of LBW among the intervention group (AOR = 0.23; 95%CI = 0.12–0.43; p < 0.001). It was also observed that the direct effect of the intervention on birth weight was 0.17 (β = 0.17; p < 0.001) and the main indirect mediator was maternal MUAC (β = 0.05; p < 0.001). Moreover, maternal passive smoking exposure and MUAC < 23 cm were found as risk factors for LBW. This study has demonstrated that an integrated maternal nutritional intervention package can significantly reduce LBW in low-income settings and should, therefore, be considered to improve birth weight.

Risk Factors Associated with The Incidence of Low Birth Weight (LBW) at Haji Makassar Hospital in January-December 2018

Low birth weight babies (LBW) are newborns whose body weight at birth is less than 2,500 grams regardless of gestational age. In 2015, the incidence of LBW in Makassar City was 690 cases. By knowing the risk factors for LBW, health workers and government can perform the targeted intervention in groups with a high risk to reduce the incidence of LBW. This paper analyzes the correlation between parity, maternal age, maternal occupation, maternal education, severe preeclampsia, premature rupture of membranes, and multiple pregnancies with the incidence of LBW. This study was analytical survey research with a cross-sectional approach. It was conducted at Haji Makassar Hospital for one month, using medical record data (secondary data). The population was 955 people who gave birth at the Haji Makassar Hospital in January-December 2018. Furthermore, the sample was 496 respondents with a purposive sampling technique. The bivariate analysis utilized the chi-square test. There was a significant correlation between parity (p=0.000), severe preeclampsia (p=0.000), and multiple pregnancies (p=0.000) with the incidence of LBW. Meanwhile, there was no significant association between maternal age (p=0.134), maternal occupation (p=0.398), maternal education (p=0.306), and premature rupture of membranes (p=0.956) with the incidence of LBW. In conclusion, risk factors for LBW are parity, severe preeclampsia, and multiple pregnancies. Meanwhile, unrelated factors with LBW are maternal age, maternal occupation, maternal education, and premature rupture of membranes.

AB0497 IMMUNOLOGICAL DISEASE ACTIVITY PARAMETERS AT CONCEPTION ARE RISK FACTORS FOR PRETERM BIRTH AND LOW BIRTH WEIGHT IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

BackgroundWomen with systemic lupus erythematosus (SLE) are known to have more difficulty in achieving a successful pregnancy than healthy women. They have a higher risk for adverse pregnancy outcomes (APOs) including preterm birth (PB), low birth weight (LBW). (1,2). Many reports revealed that these APOs are related to uncontrolled high disease activity (3,4). Therefore, it is important for SLE women who hope to conceive to control disease activity strictly. However, it is not clear to what extent disease activity should be strictly controlled, including serum parameters such as complement levels and anti-dsDNA antibodies.ObjectivesThe purpose of this study was to determine whether disease activity parameters at conception could be a risk factor for PB or LBW among APOs in patients with SLE.MethodsDisease activity parameters including SLEDAI score, LLDAS achievement rate, serum complement levels (C3, C4, CH50), and anti-dsDNA antibody titer were retrospectively collected from medical records. We then collected information related to each APOs (PB and LBW), and analyzed the association with disease activity parameters.ResultsThe subjects were 60 pregnancies of 45 patients. As for a comprehensive disease activity index at conception, SLEDAI score or the rate of LLDAS achievement became risk factors for PB (both of p&lt;0.01, Table 1), and SLEDAI score was also a risk factor for LBW (P=0.04, Table 1). Analysis of immunological disease activity parameters showed that low C3 or high titer of anti-dsDNA antibody were risk factors for PB (P=0.03 and 0.01, respectively, Table 1). In the logistic regression analysis of PB, the cut-off levels of C3 and anti-dsDNA antibody were 62 mg/dl and 5.4 IU/ml, respectively (Figure 1 [1]-A, [1]-D). The risk of PB was significantly higher in the cases with low serum C3 and high anti-dsDNA antibody titer at conception (P=0.02).Similarly, low C3 or CH50 were risk factors for LBW (P=0.02 and 0.03, respectively, Table 1). Logistic regression analysis for LBW showed the cut-off level of C3 as 87 mg/dl, and CH50 as 41.8 IU/ml (Figure 1 [2]-A, [2]-C). Cases with low C3 and low CH50 were at higher risk for LBW (P=0.03).Table 1.Association between disease activity parameters and PB or LBWPreterm birth (PB)Low birth weight (LBW)PB (+)(n = 14)PB (-)(n = 46)P valueLBW (+)(n = 23)LBW (-)(n = 37)P value Achievement of LLDAS, n (%)##5 (41.7)30 (71.4)0.0912 (63.2)23 (65.7)1.00 Achievement of LLDAS without a glucocorticoid dose, n (%)##5 (41.7)37 (88.1)&lt; 0.01*13 (68.4)29 (82.9)0.31 SLEDAI score#3.5±2.91.1±1.3&lt;0.01*2.3±2.11.3±2.00.04* C3, mg/dl#77.3±19.094.7±21.20.03*80.5±16.396.7±22.70.02* C4, mg/dl#16.1±9.019.2±6.30.1617.6±6.319.1±7.40.56 CH50, IU/ml#37.3±10.641.1±8.50.1736.5±6.642.2±9.70.03* Anti-dsDNA antibody, IU/ml#32.5±68.55.5±11.10.01*20.7±55.87.0±12.20.34(Values are presented as mean ± standard deviation or number (%). #Wilcoxon rank sum test; ##Fisher’s exact test; *P &lt; 0.05.)Figure 1.Logistic regression analysis of cut-off value of PB and LBW for C3, C4, CH50 and anti-dsDNA antibody.(ROC curves based on logistic regression analysis of cut-off levels for disease activity parameters, including C3, C4, CH50, and anti-dsDNA antibody titer. [1] showed ROC curves for PB, and [2] showed those for LBW.)ConclusionWe revealed that disease activity parameters of SLE at coception are strongly associated with negative pregnancy outcomes; PB and LBW. These include low serum C3 and CH50 levels and high anti-dsDNA antibody titers. In particular, low serum complement is a risk factor for both PB and LBW. Therefore, it is important to strictly control these disease activity parameters at conception in women with SLE.

A method for identifying critical time windows of maternal air pollution exposures associated with low birth weight in offspring using massive geographic data.

Associations between maternal exposures to air pollutants and low birth weight (LBW) in offspring varied when different exposure windows were considered. Methods used in previous studies lacked flexibility in delineating exposure windows and did not consider time periods before conception, which may restrict the discoveries of critical exposure windows. This study introduces a novel method to identify critical windows of maternal air pollution exposures associated with LBW in offspring using massive georeferenced data. Through a case-control study based on birth data (94,106 LBW cases and 376,424 controls) and air quality monitoring data (367 chemicals) in Texas during 1996-2008, this study used the average ambient concentration measured by the monitoring site closest to the residence location of a mother during a time window as the maternal exposure to a specific chemical during that exposure window. Binary logistic regression was utilized to estimate air pollutant-LBW associations in different exposure windows. The odds ratios (ORs) were adjusted for child's sex, gestational weeks, maternal age, race/ethnicity, and education. The adjusted ORs were plotted against the exposure window series of different sizes for each chemical, aiming at interactively visualizing and exploring the critical exposure windows across multiple temporal scales. This study identifies ten chemicals and seventeen corresponding critical exposure windows where strong air pollutant-LBW associations are detected. The ten identified chemicals are benzaldehyde, sum of Photochemical Assessment Monitoring Stations (PAMS) target compounds, n-undecane, m-tolualdehyde, organic carbon fraction 2 (OC2), ethylene dibromide, valeraldehyde, propionaldehyde, 4-methyl-1-pentene, and zirconium. Nine critical exposure windows involving six chemicals start more than fivemonths prior to conception, seven windows involving five chemicals commence in the second and/or third trimester of pregnancy, and the remaining one window is located in other time periods. The novel method reveals a number of critical time windows of maternal exposure to ten chemicals that are positively associated with LBW in offspring. These ten chemicals were identified as LBW risk factors for the first time. Additional studies with more data are needed to validate the results in the future.

Prevalence and Predictors of Low Birth Weight in a Rural Guatemalan Community.

Background:The intention of our study was to establish the prevalence of low birth weight (LBW) as well as risk factors for LBW in infants born to a convenience sample of women enrolled in a home visitation maternal care program associated with the Center for Human Development in Southwest Trifinio, Guatemala.Methods:This is an observational study analyzing self-reported data from a quality improvement database. We recorded the distribution of birthweights of infants born to women enrolled in Madres Sanas that delivered between October 2018 and December 2019. We grouped women by LBW (<2500g ) and adequate birthweight (≥2500g) infants, and performed bivariate comparisons using sociodemographic, obstetric, and intrapartum data. Using the independent variables shown to have an association with LBW, we then performed a multivariable analysis.Results:There were 226 births among our program participants, 218 with recorded birthweights. The median birthweight was 3175g; 13.8% were LBW (<2500g), higher than Guatemala’s average of 10.9%. Through our bivariate analysis, we determined women with LBW infants were younger, with a median age of 20.8 (IQR [17.8-23.7]) compared to a median age of 23.2 (IQR [19.8-27.3]) among women with infants ≥2500g (P=0.03). Women with LBW infants were also more likely to have fewer than 4 prenatal visits (33.3% vs 19.3%, P=0.04).Conclusion:Two significant findings emerged from our analysis: LBW infants were more commonly born to women who were younger in age and who had received fewer than 4 prenatal visits. These findings are consistent with existing literature on LBW in Latin America. Our study helps to strengthen the data around these associations and gives credence to programming and policy efforts in Latin America that support adequate prenatal care for all and youth education about reproductive health and contraceptive access.