Incidence and Risk Factors for Low Birthweight and Preterm Birth in Post-Conflict Northern Uganda: A Community-Based...

Area of Science:

• Public Health
• Epidemiology
• Maternal and Child Health

Background:

• Globally, millions of low birthweight (LBW) and preterm births (PB) occur annually, with significant data gaps from low-income countries.
• LBW and PB are leading causes of neonatal and under-five mortality, necessitating localized data.
• This study addresses the need for data on LBW and PB incidence and risk factors in Northern Uganda.

Purpose of the Study:

• To determine the incidence of LBW and preterm birth in Lira district, Northern Uganda.
• To identify key risk factors associated with LBW and preterm birth in this population.
• To inform targeted interventions for improving infant health outcomes in the region.

Main Methods:

• A community-based cohort study was conducted within a cluster-randomized trial.
• 1877 pregnant women were recruited and followed from 28 weeks gestation.
• Birthweight and preterm status (using New Ballard Score) were assessed for 1556 and 1279 infants, respectively. Risk factors were analyzed using multivariable generalized estimation equations.

Main Results:

• The incidence of LBW was 7.3% and preterm birth was 5.0%.
• Risk factors for LBW included maternal age ≥35 years, history of a small newborn, and maternal malaria. Intermittent preventive treatment for malaria reduced LBW risk.
• Maternal HIV infection increased preterm birth risk, while maternal education of ≥7 years reduced it.

Conclusions:

• Significant proportions of LBW (7.3%) and preterm births (5.0%) were observed in post-conflict Northern Uganda.
• Maternal malaria, older maternal age, and prior small newborns are risk factors for LBW, with malaria prevention showing protective effects.
• Maternal HIV infection is a risk factor for preterm birth, whereas higher maternal education is protective. Interventions should focus on education, malaria, and HIV management.