Associated Factors with Low Birth Weight in Dire Dawa City, Eastern Ethiopia (2017) PDF

Hindawi BioMed Research International Volume 2019, Article ID 2965094, 8 pages https://doi.org/10.1155/2019/2965094 Research Article Associated Factors with Low Birth Weight in Dire Dawa City, Eastern Ethiopia: A Cross-Sectional Study Alekaw Sema ,1 Firehiwot Tesfaye,2 Yalelet Belay,1 Be...

Hindawi BioMed Research International Volume 2019, Article ID 2965094, 8 pages https://doi.org/10.1155/2019/2965094 Research Article Associated Factors with Low Birth Weight in Dire Dawa City, Eastern Ethiopia: A Cross-Sectional Study Alekaw Sema ,1 Firehiwot Tesfaye,2 Yalelet Belay,1 Bezabh Amsalu,1 Desalegn Bekele,3 and Assefa Desalew 4 1 Department of Midwifery, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia 2 School of Medicine, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia 3 Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia 4 School of Nursing and Midwifery College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia Correspondence should be addressed to Assefa Desalew; [email protected] Received 1 August 2019; Revised 27 October 2019; Accepted 20 November 2019; Published 9 December 2019 Academic Editor: Mittal Suneeta Copyright © 2019 Alekaw Sema et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Low Birth Weight (LBW) is a serious public health concern in low- and middle-income countries. Globally, 20 million, an estimated 15% to 20% of babies were born with LBW, and, of these, 13% were in sub-Saharan Africa. Although the World Health Assembly targeted to reduce LBW by 30% by the end of 2025, little has been done on and known about LBW. To meet the goal successfully and efficiently, more research studies on the problem are vital. Hence, the aim of this study was to determine the prevalence and the associated factors of LBW in Dire Dawa city, eastern Ethiopia. Objective. The purpose of this study was to assess the prevalence and the associated factors of low birth weight in Dire Dawa City, eastern Ethiopia, 2017. Method. A cross-sectional study designed was conducted, and using a systematic sampling technique, 431 mothers who gave birth in the public hospitals in Dire Dawa city from July 01 to August 30, 2018, were selected. Stillbirth and infants with birth defects were excluded from the study. Well-trained data collectors collected the data using a structured questionnaire which was pretested. The data were analyzed using SPSS Version 22.0. The Adjusted Odds Ratio (AOR) with 95% confidence interval (CI) was applied in multivariate logistic regression models, and p value less than 0.05 was considered as statistical significant. Result. The prevalence of low birth weight was 21%. Not received nutritional counseling during antenatal care (AOR 2.03, 95% CI: 1.01, 4.06), preterm birth (AOR 18.48, 95% CI: 6.51, 52.42), maternal smoking (AOR 3.97, 95% CI: 1.59, 9.88), and height of the mother less than 150 cm (AOR 3.54, 95% CI: 1.07, 11.76) were significantly associated with Low birth weight. Conclusion. There was a high prevalence of low birth weight in the study area. Effective dietary counseling and additional diet, implementing proven strategies to prevent preterm birth and avoid smoking during pregnancy might decrease the low birth weight and then enhance child survival. 1. Introduction determinant of infant and childhood morbidity including neurodevelopment impairment such as mental retardation, The burden of low birth weight (LBW) is a serious public cerebral palsy, and learning disability [1, 5, 11, 12]. The health concern in low- and middle-income countries [1, 2]. under-five mortality rate decreased from 91 deaths per 1,000 Globally, more than 20 million (an estimated 15 to 20%) live births in 1990 to 43 per 1,000 in 2015. However, the newborns were LBW, and 13% of them were in sub-Saharan decline in neonatal mortality from 1990 to 2015 was slower Africa (SSA) in 2015 [3–5]. These babies were more likely to than that of postneonatal under-five mortality. die during their first month of life, and those who survived The World Health Organization (WHO) defines LBW as would face lifelong consequences including a higher risk of a birth weight of less than 2,500 grams [2, 4]. LBW continues stunting, low intelligent quotient (IQ), and adult-onset to be an unfinished agenda because it is one of the poor chronic conditions such as obesity, hypertension, and di- pregnancy outcomes; it is a good indicator of the health of an abetes mellitus [5–10]. Furthermore, LBW is a significant infant and is a principal factor that determines the infant’s 2 BioMed Research International physical, survival, and mental growth. It also indicates the takes place in these facilities. Stillbirth and infants with birth past and present health status of the mothers that have defects were not included in this study. caught the attention of WHO [2, 4, 14–16] and still remains the single most important cause of child morbidity and 2.2. Sample Size and Sampling Procedures. The sample size mortality, especially in SSA, where most LBW babies are was determined using a single population proportion for- born [2, 17].Hence, by the end of 2025, World Health mula (n = (Zα/2)2pq/d2) by considering the proportion of Assembly set a policy target to reduce LBW by 30%. Dif- LBW in eastern Ethiopia 21.9% and using 95% CI, 4% ferent strategies have been implemented to reduce newborns marginal error, and 5% of nonresponse rate. The final sample with LBW with the packages of care provided at the prenatal, size was 431. Moreover, the double population proportion antenatal, intranatal, and postnatal period [1, 3, 5, 11]. This formula was used to determine the sample size for the factors would translate into a 3.9% relative reduction per year associated with LBW. Also, this was calculated for some of between 2012 and 2025 and a reduction from approximately the associated factors obtained from different literatures 20 million to about 14 million newborns with LBW at birth using Epi Info statistical software version 7 with the fol- [3, 18]. lowing assumptions: confidence level = 95%, power = 80%, In multiple studies, different factors have been identified the ratio of unexposed to exposed almost equivalent to 1 not as determinant for LBW, and among these are young ma- received dietary counseling 34% (19). This yields 144 par- ternal age at pregnancy, birth order, the family’s income, ticipants. Finally, we selected the largest sample size from the maternal undernutrition, maternal underweight, pregnancy- first objective, which was 431 samples. According to the related complications, preterm birth, chronic medical ill- hospital’s delivery report, about 1,260 mothers give birth per ness, multiple pregnancies, history of previous LBW, in- two months. Hence, the study subjects were selected using a sufficient prenatal care, and maternal smoking [19–22]. systematic sampling technique. The sampling interval (K) In Ethiopia, the issue of LBW and the factors influencing was three. The initial mother was employed using the lottery it have not received much attention. However, the country is method. When the selected study subject did not fulfill the with very high neonatal mortality due to factors associated inclusion criteria, the subsequent mother was included. with LBW and are one of the critical issues that cause babies to suffer from short-term and long-term health conse- quences and mortality [23–26]. 2.3. Data Collection Tool and Quality Control. The data were Although LBW has been reported to account for peri- collected through a face-to-face interview and using a ques- natal morbidity and mortality and extensively explored in tionnaire which was an adapted and modified form different developed countries, in developing countries, including works of the literature and prepared originally in English, Ethiopia, few studies are available on LBW. In order to translated into local languages (Amharic, Afan Oromo, and prevent LBW, an understanding of its main modifiable risk Somali) and then translated back into English for checking the factors is essential, so that health managers and practitioners consistency by different language expertise. Trained midwives may use for plan strategies and implement appropriate and nurses working in the labour ward conducted the interview interventions toward promoting health [22, 27]. Hence, the and anthropometric measurements. The weight of the new- aim of this study was to determine the prevalence and the borns was measured within the first hour of birth using a associated factors of LBW in Dire Dawa City Administra- balanced Seca scale. The measurement scale was always tion, eastern Ethiopia. checked and calibrated before weighing each newborn. Ma- ternal height was measured against a wall using a height scale to the nearest centimeter, and maternal weight was measured by 2. Methods and Materials using a beam balance to the nearest kilogram. To ensure the quality of the data, a two-day intensive training was given for all 2.1. Study Setting, Design, Population, and Period. An in- the supervisors and the data collectors. The data collection stitutional-based cross-sectional study design was conducted process was undertaken with frequent monitoring and su- in Dire Dawa City Administration. It is located 515 kilo- pervision. Finally, double data entry was done to check the meters away from Addis Ababa, the capital of Ethiopia. consistency of the data and minimize the entry errors. According to the 2007 Ethiopian census, an estimated 3,96,423 people were living in the administration. It has 2.4. Operational Definition. Birth weight: the first weight of achieved 100% primary health care access. In terms of the the newborns measured within the first hour after birth. Low distribution of health facilities, there are 2 governmental and birth weight was for those newborns who weighed less than 4 private hospitals, 8 health centers, 5 higher clinics, and 12 2500 g, while those newborns with a birth weight of 2500 g medium clinics in the city. Mothers who gave birth in and above were considered of normal birth weight. Dilchora Referral Hospital and Sabina Primary Hospital from July to August 2018 were included. According to the Dire Dawa City Administration’s health office report, ap- 2.5. Data Processing and Analysis. The data were coded, proximately about 2000 live births happened every two entered into EPI data Version 3.1, and exported to SPSS months in the administration and 58.7% of delivery took Version 22.0 software for analysis. Then, they were sum- place in the health facilities (26). The two hospitals were marized and presented using descriptive statistics. The included because more than two-thirds (1260) of the delivery outcome variables were coded as “1” for LBW whereas “0” BioMed Research International 3 for others. The association between the outcome variables Table 1: Sociodemographic characteristics of mothers delivered at (i.e., LBW) and the independent variables was analyzed governmental hospitals of Dire Dawa City, eastern Ethiopia, 2018 using a binary logistic regression model. The covariates (n 420). which had a p value