Archives of Public Health | |
Role of antenatal care and iron supplementation during pregnancy in preventing low birth weight in Nepal: comparison of national surveys 2006 and 2011 | |
Vishnu Khanal1  Yun Zhao1  Kay Sauer1  | |
[1] School of Public Health, Curtin University, Perth, Australia | |
关键词: Nepal; Low birth weight; Iron supplementation; Antenatal care; | |
Others : 790619 DOI : 10.1186/2049-3258-72-4 |
|
received in 2013-07-22, accepted in 2013-11-25, 发布年份 2014 | |
【 摘 要 】
Background
Low birth weight (LBW) is a major cause of neonatal deaths in developing countries including Nepal. Its social determinants in Nepal have rarely been identified. This study aimed to identify the factors associated with low birth weight among under-five children comparing data from the Nepal Demographic and Health Surveys (NDHS) of 2006 and 2011.
Methods
Pooled data from the Nepal Demographic and Health Surveys (NDHS) of 2006 and 2011 were analysed initially and the two survey data were then compared separately. The association between LBW and socio-demographic and health related factors were analysed using multiple logistic regression analysis with a stepwise backward elimination procedure. Complex Sample Analysis method was used to account for study design and sampling.
Results
A total of 2845 children, 923 children in 2006 and 1922 children in 2011, had their birth weight recorded. The mean birth weight was 3024 (SD = 654.5) grams. A total of 12.1% (95% Confidence interval (CI); 10.6%-13.7%) children had low birth weight (<2500 grams) at the time of birth. Attending antenatal care was found to be consistently associated with low birth weight for the pooled survey data, and both 2006 and 2011 survey data, respectively. Not attending antenatal care increased the odds of having a LBW infant by more than two times [OR 2.301; 95% CI (1.526-3.471)]. Iron supplementation, which is an integral part of antenatal care in Nepal, was also significantly associated with birth weight for combined and individual surveys. Mothers not consuming iron supplementation during their pregnancy were more likely to have LBW infants [OR 1.839; 95% CI (1.282-2.363)]. Residing in the Far-western and Eastern region were also significant risk factors for LBW in the pooled dataset and in 2011 survey.
Conclusions
The current study indicated there was no significant decrease in the LBW prevalence and there is a need of targeted interventions aimed at decreasing the high rate of LBW through increasing antenatal care and consumption of iron supplementation during pregnancy.
【 授权许可】
2014 Khanal et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20140705002057767.pdf | 245KB | download | |
Figure 1. | 27KB | Image | download |
【 图 表 】
Figure 1.
【 参考文献 】
- [1]Romero C, Duke J, Dabelea D, Romero T, Ogden L: Does the epidemiologic paradox hold in the presence of risk factors for low birth weight infants among Mexican-born women in Colorado? J Health Care Poor Underserved 2012, 23:604-614.
- [2]Kramer MS: Determinants of low birth weight: methodological assessment and meta-analysis. Bull World Health Organ 1987, 65:663-737.
- [3]United Nations Children’s Fund, World Health Organization: Low birthweight: country,regional and global estimates. Geneva: United Nations Children’s Fund, World Health Organization; 2004.
- [4]Balci MM, Acikel S, Akdemir R: Low birth weight and increased cardiovascular risk: fetal programming. Int J Cardiol 2010, 144:110-111.
- [5]Anand D, Stevenson CJ, West CR, Pharoah POD: Lung function and respiratory health in adolescents of very low birth weight. Arch Dis Child 2003, 88:135-138.
- [6]Pei L, Chen G, Mi J, Zhang T, Song X, Chen J, Ji Y, Li C, Zheng X: Low birth weight and lung function in adulthood: retrospective cohort study in China, 1948-1996. Pediatrics 2010, 125:e899-e905.
- [7]Sreeramareddy C, Shidhaye R, Sathiakumar N: Association between biomass fuel use and maternal report of child size at birth–an analysis of 2005-06 India demographic health survey data. Bmc Public Health 2011, 11:403. BioMed Central Full Text
- [8]Ministry of Health and Population (MOHP) [Nepal], New ERA, Macro International Inc: Nepal demographic and health survey 2011. Kathmandu [Nepal]: Ministry of Health and Population (MOHP) [Nepal], New ERA and Macro International Inc; 2012.
- [9]Sebayang SK, Dibley MJ, Kelly PJ, Shankar AV, Shankar AH: Determinants of low birthweight, small‒for‒gestational‒age and preterm birth in Lombok, Indonesia: analyses of the birthweight cohort of the SUMMIT trial. Trop Med Int Health 2012, 17:938-950.
- [10]Hueston WJ, Gilbert GE, Davis L, Sturgill V: Delayed prenatal care and the risk of low birth weight delivery. J Community Health 2003, 28:199-208.
- [11]Ministry of Health and Population: Annual report 2009/2010. Kathmandu: Department of Health Services, Ministry of Health and Population, Nepal; 2010.
- [12]Christian P, Khatry SK, Katz J, Pradhan EK, LeClerq SC, Shrestha SR, Adhikari RK, Sommer A, Keith PW: Effects of alternative maternal micronutrient supplements on low birth weight in rural Nepal: double blind randomised community trial. Bmj 2003, 326:571.
- [13]Ministry of Health and Population (MOHP) [Nepal], New ERA, Macro International Inc: Nepal demographic and health survey 2006. Kathmandu [Nepal]: Ministry of Health and Population (MOHP) [Nepal], New ERA and Macro International Inc; 2007.
- [14]Onyiriuka AN: Birthweight of full-term twin infants in relation to sex-pair. Genomic Med, Biomark, Health Sci 2011, 3:123-127.
- [15]Gielen M, van Beijsterveldt CEM, Derom C, Vlietinck R, Nijhuis JG, Zeegers MPA, Boomsma DI: Secular trends in gestational age and birthweight in twins. Hum Reprod 2010, 25:2346-2353.
- [16]Dharmalingam A, Navaneetham K, Krishnakumar CS: Nutritional status of mothers and low birth weight in India. Matern Child Hlth J 2010, 14:290-298.
- [17]Nair NS, Rao RS, Chandrashekar S, Acharya D, Bhat HV: Socio-demographic and maternal determinants of low birth weight: a multivariate approach. Indian J Pediatr 2000, 67:9-14.
- [18]Khanal V, Sauer K, Zhao Y: Exclusive breastfeeding practices in relation to social and health determinants: a comparison of the 2006 and 2011 Nepal demographic and health surveys. Bmc Public Health 2013, 13:958. BioMed Central Full Text
- [19]Khanal V, Adhikari M, Sauer K, Zhao Y: Factors associated with the introduction of prelacteal feeds in Nepal: findings from the Nepal demographic and health survey 2011. Int Breastfeed J 2013, 8:9. BioMed Central Full Text
- [20]WHO expert consultation: Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004, 363:157-163.
- [21]Measure DHS Demographic and health surveys. http://www.measuredhs.com/what-we-do/survey/survey-display-356.cfm webcite
- [22]West BT: Statistical and methodological issues in the analysis of complex sample survey data: practical guidance for trauma researchers. J Trauma Stress 2008, 21:440-447.
- [23]Malla DS, Giri K, Karki C, Chaudhary P: Achieving millennium development goals 4 and 5 in Nepal. BJOG 2011, 118:60-68.
- [24]Vaessen M: The potential of the demographic and health surveys (DHS) for the evaluation and monitoring of maternal and child health indicators. In Demographic evaluation of health programmes. Proceedings of a seminar in Paris; 1996:65-74.
- [25]Ministry of Health and Population (MOHP) [Nepal]: National Safe Motherhood and Newborn Health Long Term Plan (2006-2017). Kathmandu [Nepal]: Ministry of Health and Population (MOHP) [Nepal]; 2006.
- [26]White DE, Fraser-Lee NJ, Tough S, Newburn-Cook CV: The content of prenatal care and its relationship to preterm birth in Alberta, Canada. Health Care Women Int 2006, 27:777-792.
- [27]Panaretto KS, Lee HM, Mitchell MR, Larkins SL, Manessis V, Buettner PG, Watson D: Impact of a collaborative shared antenatal care program for urban Indigenous women: a prospective cohort study. Med J Aust 2005, 182:514-519.
- [28]Villar J, Ba’aqeel H, Piaggio G, Lumbiganon P, Belizán JM, Farnot U, Al-Mazrou Y, Carroli G, Pinol A, Donner A, et al.: WHO antenatal care randomised trial for the evaluation of a new model of routine antenatal care. Lancet 2001, 357:1551-1564.
- [29]Pena-Rosas J, Viteri F: Effects and safety of preventive oral iron or iron + folic acid supplementation for women during pregnancy (Review). Cochrane Database Syst Rev 2009, 4:CD004736.
- [30]Balarajan Y, Subramanian S, Fawzi WW: Maternal iron and folic acid supplementation is associated with lower risk of low birth weight in India. J Nutr 2013, . (ahead of print)
- [31]Basu R, Dasgupta A: Determinants of low birth weight in a block of hooghly, West Bengal: a multivariate analysis. Int J Biol Med Res 2011, 2:838-842.
- [32]Aranda N, Ribot B, Garcia E, Viteri FE, Arija V: Pre-pregnancy iron reserves, iron supplementation during pregnancy, and birth weight. Early Hum Dev 2011, 87:791-797.
- [33]Ribot B, Aranda N, Viteri F, Hernández-Martínez C, Canals J, Arija V: Depleted iron stores without anaemia early in pregnancy carries increased risk of lower birthweight even when supplemented daily with moderate iron. Hum Reprod 2012, 27:1260-1266.
- [34]Alwan NA, Greenwood DC, Simpson NAB, McArdle HJ, Godfrey KM, Cade JE: Dietary iron intake during early pregnancy and birth outcomes in a cohort of British women. Hum Reprod 2011, 26:911-919.
- [35]Cogswell ME, Parvanta I, Ickes L, Yip R, Brittenham GM: Iron supplementation during pregnancy, anemia, and birth weight: a randomized controlled trial. Am J Clin Nutr 2003, 78:773-781.
- [36]Badshah S, Mason L, McKelvie K, Payne R, Lisboa PJG: Risk factors for low birthweight in the public-hospitals at Peshawar, NWFP-Pakistan. Bmc Public Health 2008, 8:197. BioMed Central Full Text
- [37]Khanal V, Sauer K, Zhao Y: Determinants of complementary feeding practices among Nepalese children aged 6-23 months: findings from demographic and health survey 2011. BMC Pediatr 2013, 13:1-13. BioMed Central Full Text
- [38]Carroli G: WHO systematic review of randomised controlled trials of routine antenatal care. Lancet 2001, 357:1565.
- [39]Ministry of Health and Population, Child Health Division [Nutrition Section]: National Nutrition Policy and Strategy. Kathmandu [Nepal]: Ministry of Health and Population, Child Health Division [Nutrition Section]; 2004.
- [40]Khanal S, Jaganath Sharma VSG, Dawson P, Houston R, Khadka N, Yengden B: Community health workers can identify and manage possible infections in neonates and young infants: MINI—a model from Nepal. J Health Popul Nutr 2011, 29:255.
- [41]Ramakrishnan U: Nutrition and low birth weight: from research to practice. Am J Clin Nutr 2004, 79:17-21.