Maternal Determinants of Low Birth Weight: A Case Control Study in a Tertiary Care Hospital, Belgaum, Karnataka

Abstract

Background and objectives: ABSTRACT Low Birth Weight ( LBW ) is an important cause of infant morbidity and mortality and is an important public health problem. There is much controversy regarding the various risk factors implicated in the aetiology of LBW, and the quantitative importance of each. A hospital based case control study was undertaken with the objective of determining the most important risk factors for term LBW after matching for socio-economic variables of the mother and the gestational age of the pregnancy. Methods: The present case-control study was conducted at a tertiary care hospital of Belgaum, Karnataka from 1st January 2009 to 31 iv st December 2009. A total of 250 mothers and their singleton term newborns ( 125 cases and 125 controls) were studied. Mothers were matched for socioeconomic status, occupation, educational status and gestational age of the pregnancy. Odds ratios were calculated, univariate and multiple logistic regression analyses were used to determine the most important maternal determinants of low birth weight. Results: The significant risk factors for LBW on univariate regression were maternal age less than 19 years ( OR 5.54) , residence in a rural area ( OR 2.10) , primiparity ( OR 2.99) , female sex of the baby ( OR 1.79) , pregnancy interval less than 12 months ( OR 7.75) ,complications during pregnancy ( OR 2.51) ,maternal anaemia ( OR 1.72) , inadequate ANC ( OR 2.85) , late registration of pregnancy ( OR 2.29) , maternal height less than 145 cm ( OR 9.03) , maternal weight less than 45 kg ( OR 4.01) iron supplementation for less than 100 days ( OR 3.72) . The significant risk factors on multivariate regression were maternal age less than 19 years ( OR 9.74 ) female sex of the baby ( OR 4.17) , pregnancy interval less than 12months ( OR 5.06) , complications during pregnancy ( OR 4.96) ,maternal weight less than 45 kg ( OR 14.62) , inadequate iron supplementation during pregnancy ( OR 8.25) .The risk factors that were not significant on multiple regression were rural area of residence, primiparity, anaemia, less than 3 ANC visits, late registration of pregnancy, maternal height less than 145 cm Conclusion and interpretation: Measures should be taken to delay the age of marriage of adolescent girls in order to postpone the age of first pregnancy. Complications during pregnancy should be managed promptly. Mothers should be educated on the importance of good nutrition and adequate iron supplementation, and should also be counselled on the use of proper birth spacing methods.