Socio-demographic characteristics
About 318 babies (108 were low birth weight babies and 210 were babies with a normal weight) were included in the study with 93% response rate. The mean maternal age of all study participants was 26.7 years with standard [SD of ±4.8 years]. Among cases 96 (88.9 %) and among controls 185 (88.1%) of mothers were in the age group of 19-34 years. The ratio of sex among the cases the male to female ratio was 1.25:1 and among controls the male to female ratio were 1.6:1. (Table 1).
Table -1 Socio demographic characteristics of mothers of the study participants in Adama town Public Health Facilities, Oromia Regional state, Ethiopia, 2017.
Maternal characteristics
|
Cases
Number (%)
|
Controls
Number (%)
|
Age of the mother
|
|
|
≤18
|
2 (4.6)
|
2 (1)
|
19-34
|
96 (88.9)
|
185 (88.1)
|
>=35
|
6 (5.6)
|
23 (11)
|
Sex of neonates
|
|
|
Male
|
60 (55.6)
|
129 (61.4)
|
Female
|
48 (44.4)
|
81(38.6)
|
Residency
|
|
|
Urban
|
79 (73.1)
|
177 (84.3)
|
Rural
|
29 (26.9)
|
32 (15.2)
|
Educational level of mother
|
|
|
No formal education
|
28 (25.9)
|
37 (17.6)
|
Grade 1-6
|
24 (22.2)
|
50 (23.8)
|
Grade 7-12
|
32 (29.2)
|
92 (43.8)
|
High school complete and above
|
24 (22.2)
|
27 (12.9)
|
Religion of mother
|
|
|
Orthodox
|
55 (50.9)
|
106 (50.5)
|
Muslim
|
32 (29.6)
|
74 (35.2)
|
Catholic
|
3 (2.8)
|
7 (3.3)
|
Protestant
|
16 (14.8)
|
20 (9.5)
|
Occupation
|
|
|
Income own
|
66 (61.1)
|
168 (80)
|
No income own
|
42 (38.9)
|
42 (20)
|
Marital status
|
|
|
Married and living together
|
102(94.4)
|
205(97.6)
|
Married but not living together
|
6(5.6)
|
5(2.4)
|
Monthly family income
|
|
|
Low
|
44 (40.7)
|
60 (28.6)
|
Middle
|
20 (18.5)
|
63 (30)
|
High
|
38 (35.2)
|
56 (26.7)
|
Factors Associated with Low Birth Weight among Neonates Born in Public Health facilities in adama Town.
Bivariate analysis was done by enter method for socio-demographic factors, reproductive history, maternal life style and anthropometric measurements of the mother with dependent variable. Variables which were significant in bivariate analysis were put in to multiple logistic regression by backward stepwise method and the final factor significantly influencing occurrence of LBW were residency, occupation, parity, birth interval, ANC visit history of Hypertension, maternal MUAC and weight gain during pregnancy remain to be statistically significantly associated with the low birth weight of neonates (Table 2).
Table 2. Logistic Regression Analysis of Factors Affecting Low Birth Weight Neonates in Adama Town Public Health Facilities, East Shoa Zone, Oromia Regional State 2017.
Maternal characteristics
|
Cases
Number (%)
|
Controls
Number (%)
|
COR
|
AOR
|
Sex of neonates
|
|
|
|
|
Male
|
60 (56)
|
128 (61.5)
|
1.274(0.796-2.03)
|
|
Female
|
48 (44)
|
81 (38.9)
|
1
|
|
Age of the mother
|
|
|
|
|
≤18
|
5 (4.7)
|
2 (1)
|
0.208(0.040-1.09)
|
2.49(0.40-15.5)
|
19-34
|
96(89.7)
|
185(88.)
|
1
|
1
|
>=35
|
6 (5.6)
|
23 (11)
|
1.98(0.784-5.05)
|
3.63(0.47-7.79)
|
Residency
|
|
|
|
|
Urban
|
79 (73.1)
|
177 (84.3)
|
1
|
1
|
Rural
|
29 (26.9)
|
32(15.2)
|
2.0(1.15-3.58)
|
1.95(1.0-3.48)
|
Educational level of mother
|
|
|
|
|
No formal education
|
28 (25.9)
|
37 (17.6)
|
0.479 (0.627-2.70)
|
1.97(0.627-3.70)
|
Grade 1-6
|
24 (22.2)
|
50 (23.8)
|
0.312 (0.355 -1.39)
|
1.06(0.59-1.89)
|
Grade 7-12
|
32 (29.2)
|
92 (43.8)
|
0.035 (0.272-0.95)
|
1.39 (0.79-2.4)
|
High school complete and above
|
24 (22.2)
|
27(12.9)
|
1
|
1
|
Religion of mother
|
|
|
|
|
Orthodox
|
55 (50.9)
|
106 (50.5)
|
1.10(0.309-3.92)
|
|
Muslim
|
32 (29.6)
|
74(35.2)
|
1.321 (0.36-4.83)
|
|
Catholic
|
16 (14.8)
|
20 (9.5)
|
.714 (0.17-2.87)
|
|
Others
|
4 (2.9)
|
7 (3.3)
|
1
|
|
Occupation
|
|
|
|
|
Income own
|
66 (61.1)
|
168 (80)
|
1
|
1
|
No income own
|
42 (38.9)
|
42 (20)
|
2.54(1.52-4.25)
|
2.47(1.47-4.16)
|
Marital status
|
|
|
|
|
Married and living together
|
102(94.4)
|
205(97.6)
|
1
|
|
Married but not living together
|
6(5.6)
|
5(2.4)
|
0.41(0.124-1.39)
|
|
Monthly family income
|
|
|
|
|
Low
|
44(40.7)
|
60(28.6)
|
0.92(0.525-1.63)
|
|
Middle
|
20(18.5)
|
63 (30)
|
2.13(1.116-4.09)
|
|
High
|
38(35.2)
|
56(26.7)
|
1
|
|
Mother with residency being rural were almost twice risk of having low bith weight than urban (AOR=1.95 with 95% CI [1.0-3.48] ). Occupation of the mother was assessed by categorizing in to income owned and not income owned in cash; mothers with no income owned had 2.5 times more higher risk of having LBW neonate than comparable groups AOR=2.47 with CI (1.47-4.16).
Regarding obstetric history of the mothers, those who have two or more live births were three time higher risk of having low birth weight neonate than primi parus (AOR=3.45 with CI [1.89-6.32]). Compared to mothers with birth interval of ˃24 months, mothers with birth interval ˂ 24 month had three times higher more likely to have LBW. On the other hand previous history of abortion, gestational age of first antenatal care (ANC) & history of anemia during pregnancy were not found to have association with LBW delivery in this study (Table-3).
Table-3. Association of maternal characteristics with LBW in Adama Town Public Health Facilities, Oromia Regional state, Ethiopia, 2017
Maternal characteristics
|
Cases
Number (%)
|
Controls
Number (%)
|
COR
|
AOR
|
Parity of the mothers
|
|
|
|
|
1
|
71 (65.7%)
|
79 (37.6%)
|
1
|
1
|
>=2
|
33 (30.6%)
|
125 (59.5%)
|
3.40(2.065-5.612)
|
3.45(1.89-6.32)
|
History of abortion
|
|
|
|
|
No
|
84 (77.8%)
|
239 (79.1%)
|
1
|
|
Yes
|
20 (18.5%)
|
63 (20.9%)
|
0.578(0.151-2.218)
|
|
Birth interval
|
|
|
|
|
˂24months
|
51 (47.2%)
|
48 (22.9%)
|
3.09(1.831-5.244)
|
2.68(1.45-4.94)
|
≥24months
|
56 (51.9%)
|
162 (77.1%)
|
1
|
1
|
Mode of delivery of current neonate
|
|
|
|
|
Vaginal delivery
|
93 (86.1%)
|
185 (88.1%)
|
0.91 (0.441-1.89)
|
|
Caesarean section
|
15 (13.9%)
|
24 (11.4%)
|
1
|
|
Gestational age of 1st ANC attendance
|
|
|
|
|
<3months
|
10 (9.3%)
|
12 (5.7%)
|
1
|
|
3-6 month
|
68 (63%)
|
176 (83.8%)
|
2.15(0.890-5.224)
|
|
>6month
|
17 (15.7%)
|
16 (7.6%)
|
0.78 (0.266-2.31)
|
|
ANC visits
|
|
|
|
|
<4 visits
|
59 (54.6%)
|
87 (41.4%)
|
2.64(1.542-4.524)
|
0.40(0.218-0.73)
|
>=4 visits
|
37 (34.3%)
|
118 (56.2%)
|
1
|
1
|
History of anemia
|
|
|
|
|
Yes
|
14 (13%)
|
21 (10%)
|
1.929 (0.870-4.277)
|
|
No
|
36 (33.3%)
|
107 (51%)
|
1
|
|
History of hypertension
|
|
|
|
|
Yes
|
23 (21.3%)
|
22 (10.5%)
|
2.32(1.192-4.540)
|
0.39(0.18-0.87)
|
No
|
82 (75.9%)
|
186 (88.6%)
|
1
|
1
|
History of DM
|
|
|
|
|
Yes
|
12 (11.9%)
|
16 (7.6%)
|
1.64(0.721-3.763)
|
|
No
|
74 (73.3%)
|
181 (86.2%)
|
1
|
|
History of illness
|
|
|
|
|
Yes
|
28 (8.1%)
|
15 (7.1%)
|
0.552-3.027
|
|
No
|
80 (91.9%)
|
195 (92.9%)
|
1
|
|
1= reference
In this study maternal lifestyle or habits like coffee intake, alcohol intake & khat chewing didn’t show significant association with the dependent variable. Logistic regression analysis of maternal anthropometric measurement like MUAC and weight gain during pregnancy showed significant association with occurrence LBW. Depending on UNICEF cut off point for detecting malnutrition in adults; maternal MUAC was classified in to two categories. Mothers who had MUAC ≤ 21cm have 30% more likely to have LBW than their comparable groups (AOR=0.3 with 95% CI (0.159-0.91)) (Table-4).
Table-4. Association of Maternal Lifestyle and Anthropometric Measurement with LBW in Adama Town Public Health Facilities, Oromia Regional State, Ethiopia, 2017
Maternal lifestyle
|
Cases
Number (%)
|
Controls
Number (%)
|
COR
|
AOR
|
Coffee intake of the mothers during pregnancy
|
|
|
|
|
Not take coffee
|
21 (19.4)
|
58 (27.6)
|
1.73(0.941-3.19)
|
|
Once per day
|
31 (28.7%)
|
60 (28.6%)
|
1.25(0.721-2.19)
|
|
Twice and more
|
52 48.1%
|
80 (38.1%)
|
1
|
|
History of alcohol intake
|
|
|
|
|
Yes
|
6 (5.6%)
|
13 (6.2%)
|
0.87(0.324-2.37)
|
|
No
|
101 (93.5%)
|
192 (91.4%)
|
1
|
|
History of khat chewing
|
|
|
|
|
Yes
|
7 (6.5%)
|
5 (2.4%)
|
2.81(0.871-9.08)
|
|
No
|
100 (92.6%)
|
201 (95.7%)
|
1
|
|
Maternal MUAC
|
|
|
|
|
<21
|
48 (44.4%)
|
6 (21.9%)
|
3.07(1.839-5.12)
|
0.38(0.159-0.91)
|
>=21
|
52 (48.1%)
|
153 (72.9%)
|
1
|
1
|
Weight gain during pregnancy
|
|
|
|
|
<6.8kg
|
25 (23.1%)
|
24 (11.4%)
|
3.72(1.749-7.94)
|
0.22(0.096-0.50)
|
≥6.8kg
|
19 (17.6%)
|
68 (32.4%)
|
1
|
1
|
1=reference