Study of low birth weight babies and their association with maternal risk factors

“Study of low birth weight babies and their association with maternal risk factors.” Sarika M.1, Vishwakarma R.2*, Rao R.3 DOI: https://doi.org/10.17511/ijpr.2020.i07.10 1 Sarika M., Resident, Department of Pediatrics, Kamineni Hospital, LB Nagar, Hyderabad, Telangana, India. 2* Rashmi Vishwakarma, Resident, Department of Pediatrics, Kamineni Hospital, LB Nagar, Hyderabad, Telangana, India. 3 Rajasekhar Rao, Professor, Department of Pediatrics, Kamineni Hospital, LB Nagar, Hyderabad, Telangana, India.


Introduction
Low birth weight is a major public health problem in developing countries including India. The epidemiological observations depicted that infants weighing less than 2500 grams are approximately 20 times more likely to die than heavier babies, closely associated with fetal and neonatal morbidity and mortality. In India, 30-35% of babies are low birth weight and more than half of them are full- With this background, the present study is conducted to know the prevalence of low birth weight among term babies and to find out the maternal risk factors associated with LBW babies. Weight gain was calculated by subtracting the weight of the mother at 12 weeks or before from the weight of the mother at term considering negligible weight gain up to 12 weeks of gestation.

Materials and methods
All the babies were weighed within one hour after birth and birth weight was measured to the nearest 10 grams using a baby weighing scale.         g. Female babies had a significantly higher incidence of low birth weight than male babies. Parity was found to be a significant influence on the incidence of low birth weight. An increase of low birth weight babies was noticed after the 4th parity and the best outcome was also observed at this parity. The higher incidence of low birth weight was found in the 5+ parity. Young mothers (< 20 years) had also a higher incidence of low birth weight and mother's age had no significant effect on the incidence of low The aim was to determine the prevalence of and identify the risk factors for low birth weight deliveries. Using a pre-structured questionnaire, information about the sociodemographic, past obstetric history, and the index pregnancy were obtained. Pre conceptual care, efficient antenatal care, and effective treatment of pelvic infections (which may predispose to preterm births) could reduce the incidence of low birth weight deliveries in Nigeria [12]. Rafati et al studied maternal determinants of giving birth to low-birth-weight neonates which are universally used as an indicator of health status and is an important subject of national concern and a focus of health policy.
Similar studies were done by Sharma M, Mishra S et al, Poudel P et al in whom LBW is associated with a higher risk for childhood mortality and morbidity.
After these studies, it was concluded that the majority of factors that lead to the delivery of LBW neonates are preventable [13][14][15].
Singh G, Anjum F et al also studied the maternal factors which adversely affect the fetus in utero and their impact on the fetus. Maternal factors like age, parity, pre-pregnancy body mass index, hemoglobin levels, bad obstetric history (history of stillbirth/neonatal death in previous pregnancies, three or more spontaneous consecutive abortions), pre-eclampsia, fetal distress, mode of deliveries were studied.
It was concluded that pre-pregnancy maternal body mass index, unbooked status, pre-eclampsia, and bad obstetric history are significant maternal factors resulting in low birth weight babies. Teen-age, illiteracy, poor antenatal care, maternal anemia, and pregnancy-induced medical ailments have a strong association with low birth weight.
To overcome these problems, the mother and child health care services in the country should receive special attention. Dasanayake AP et al evaluated the poor periodontal health of the pregnant woman as a risk factor for low birth weight. Rahman LA et al found an association between pregnancy-induced hypertension and low birth weight; a populationbased case-control study [16][17][18][19].
Darmstadt GL et al did work on evidence-based, cost-effective A combination of universal-i.e. for all settings-outreach and family-community care at 90% coverage averts 18-37% of neonatal deaths.
Most of this benefit is derived from familycommunity care, and a greater effect is seen in settings with very high neonatal mortality.
Reductions in neonatal mortality that exceed 50% can be achieved with an integrated, high-coverage program of universal outreach and familycommunity care, consisting of 12% and 26%, respectively, of total running costs, plus universal facility-based clinical services, which make up 62% of the total cost.
Early success in averting neonatal deaths is possible in settings with high mortality and weak health systems through outreach and family-community care, including health education to improve homecare practices, to create demand for skilled care, and to improve care-seeking.
Simultaneous expansion of clinical care for babies and mothers is essential to achieve the reduction in neonatal deaths needed to meet the Millennium Development Goal for child survival [20][21].
Alexander GR et al like the above study endorsed prenatal care. They took it as means to identify mothers at risk of delivering a preterm or growthretarded infant and to provide an array of available medical, nutritional, and educational interventions intended to reduce the determinants and incidence of low birth weight and other adverse pregnancy conditions and outcomes.
Although the general notion that prenatal care is of value to both mother and child became widely accepted in this century, the empirical evidence supporting the association between prenatal care and reduced rates of low birth weight emerged slowly and has been equivocal [22].
Alderman H et al also advocated that reducing the incidence of low birth weight in low-income countries has substantial economic benefits.
Reducing the incidence of low birth weight not only lowers infant mortality rates but also has multiple benefits over the life cycle.
This study estimates the economic benefits of reducing the incidence of low birth weight in lowincome countries, both through lower mortality rates and medical costs and through increased learning and productivity.
They estimated gains are primarily from increases in labor productivity (partially through more education) and secondarily from avoiding costs due to infant illness and death. Thus there may be many interventions to reduce the incidence of low birth weight that are warranted purely on the grounds of saving resources or increasing productivity. Since low birth weight is the prelude to proteinenergy malnutrition and is generally followed by childhood morbidity and mortality, the problem of low birth weight needs to be tackled by adequate provision of primary health care strengthening of national programs like RCH-II to improve awareness level and health and nutritional status of the mother.
This way healthier infants are produced who have a better chance of surviving and becoming tomorrow's wealth. The results corroborate findings of several other studies, which underscore the association between anthropometric and reproductive variables and birth outcomes

Conclusion
What does the study add to the existing knowledge This study shows that bio-demographic and prenatal care variables have the strongest influence in determining the birth weight of a baby. However, Socio-economic and demographic factors are significantly associated with prenatal care, which is one of the behavioral factors associated with low birth weight. Women and girl child education should be given the desired attention as it has shown to strongly correlate with the risk of LBW. This study provides empirical support for the links that exist between maternal health and infant birth weight: maternal weight and height (anthropometric variables), maternal age, parity, gestational age, initiation of ANC.

Author's contribution
Of 286 mothers studied, a significant association was found between low birth weight and literacy level of mothers, sex of the baby, ANC checkup, the residence of the mother, weight gain of the mother during pregnancy, presence of medical complications like pregnancy-induced hypertension, oligohydramnios.