Effect of under-nutrition during pregnancy on low birth weight in Tigray regional state, Ethiopia; a prospective cohort study
Kidanemaryam Berhe1, Lemlem Weldegerima2, Freweini Gebrearegay2
1Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia. kidane0920@gmail.com.
Insights
Pregnant women with under-nutrition, indicated by mid-upper arm circumference less than 23 cm, had a higher incidence of low birth weight. Maternal illiteracy, low income, and poor diet diversity were key risk factors.
Area of Science:
- Maternal and child health
- Nutritional epidemiology
- Public health
Background:
- Maternal under-nutrition significantly impacts birth and neonatal outcomes globally.
- Low birth weight affects millions of children, particularly in low-income countries.
- Longitudinal evidence on pregnancy under-nutrition and low birth weight in Tigray was lacking.
Purpose of the Study:
- To investigate the effect of maternal under-nutrition during pregnancy on low birth weight in Tigray regional state.
- To identify risk factors associated with low birth weight in the study population.
Main Methods:
- A prospective cohort study involving 540 pregnant women was conducted from October 2019 to June 2020.
- Maternal under-nutrition was defined by mid-upper arm circumference (MUAC) < 23 cm.
- Data were collected using structured questionnaires, and analysis employed a log-binomial model.
Main Results:
- The overall incidence of low birth weight was 14%, with 18.4% in the under-nourished group versus 9.8% in the well-nourished group.
- Maternal illiteracy, low monthly income (< $50 USD), lack of latrine utilization, and low diet diversity score (< 5) were significant risk factors.
- The difference in low birth weight incidence between exposed and unexposed groups was statistically significant (p=0.006).
Conclusions:
- Low birth weight incidence was significantly higher in pregnant women with indicators of under-nutrition.
- Maternal illiteracy, low income, poor hygiene (lack of latrine use), and inadequate diet diversity are critical risk factors.
- Strengthening nutritional assessment and interventions, promoting hygiene, and encouraging diverse diets are crucial for prevention.
Background:
Under-nutrition during pregnancy affects birth outcomes and neonatal outcomes. Worldwide, 20.5 million children were low birth weight, mainly in poor countries. However, there is no longitudinal-based evidence on the effect of under-nutrition during pregnancy on birth weight in Tigray regional state. Therefore, this study aimed at investigating the effect of under-nutrition during pregnancy on low birth weight in Tigray regional state.
Methods:
We conducted a prospective cohort study among consecutively selected 540 pregnant women attending antenatal care in hospitals from October 2019 to June 2020. Pregnant women with mid upper arm circumference (MUAC) < 23 cm were exposed and those with MUAC≥23 cm were unexposed. Data on socio-demographic, diet, hygiene and anthropometry measurements were collected using pretested and structured questionnaires. SPSS version 25 was used for analysis. A log-binomial model was used to estimate the adjusted risk ratio and its 95%CI of the risk factors for low birth weight. Multi-collinearity was checked using the variance inflation factor (VIF) at a cut-off point of 8 and there was no multi-collinearity.
Result:
The overall incidence of low birth weight was 14% (95%CI: 11.1, 17.4%). The incidence of low birth weight was 18.4 and 9.8% among the exposed and unexposed women, respectively. The difference in low birth weight incidence between the exposed and unexposed groups was statistically significant (p-value = 0.006). The risk factors of low birth weight were maternal illiteracy (ARR: 1.8, 95%CI: 1.01, 3.3), low monthly family income < 50 US Dollar (ARR: 1.6, 95%CI: 1.07, 2.2), lack of latrine utilization (ARR: 0.47, 95%CI: 0.28, 0.78), and diet diversity score < 5 (ARR: 1.9, 95%CI: 1.05, 2.61).
Conclusion:
Low birth weight was significantly higher among the exposed pregnant women. Maternal illiteracy, low monthly income, lack of latrine utilization, and low DDS were risk factors of low birth weight. It is then important to strengthen nutritional assessment and interventions during pregnancy, with a special attention for illiterate, and low monthly income pregnant women. Again, there has to be a promotion of latrine utilization and consumption of diversified diets.
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