Maternal hemoglobin and risk of low birth weight: A hospital-based cross-sectional study in Nepal

Background

Maternal hemoglobin during pregnancy is an important predictor of neonatal outcomes such as birth weight. The newborn weight of an infant is considered a crucial factor for morbidity and mortality. This study aimed to assess the association between maternal hemoglobin concentration and newborn weight at term pregnancy.

Methods

A hospital-based cross-sectional study was conducted at Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal from 14^th April 2018 to 13^th April 2019. Term singleton pregnant women who were admitted for delivery in the labor room of TUTH were included in this study. Maternal characteristics such as age, parity, birth space, ethnicity, education level, dietary habit, body mass index (BMI), and hemoglobin level were recorded. The newborn weight was taken immediately after delivery. The main outcome of this study was the birth weight. The association between hemoglobin level and newborn weight was analyzed using bivariate and multivariable logistic regression analysis.

Results

Of 2,418 term pregnant women, the prevalence of low hemoglobin and high hemoglobin levels were 24% (95% CI: 22-25.4), and 17% (95% CI: 15.7-18.7), respectively. The prevalence of low birth weight (LBW) was 12.9% (95% CI: 11.7-14.4). Multivariable logistic regression analysis showed that those mothers who had low hemoglobin concentration (adjusted Odds Ratio/aOR = 3.77, 95% CI: 2.84-5.01), and high hemoglobin concentration (aOR = 3.07, 95% CI: 2.23-4.24) had higher odds of having LBW compared to mothers having normal hemoglobin level. Mothers with both young age pregnancy (aged 16-20 years) and older pregnancy (aged ≥31 years) (aOR = 1.60, 95% CI: 1.01-2.52) and (aOR = 1.60, 95% CI: 1.06-2.41), respectively had higher odds of LBW compared to mothers aged 21-25 years. Those mothers who attended a primary level of education had higher odds of (aOR = 1.93, 95% CI: 1.05-3.55) LBW compared to those mothers with a higher level of education. Moreover, mothers who belonged to Janajati ethnic group (aOR = 0.47, 95% CI: 0.34-0.65) compared to the Brahmin/Chhetri ethnic group, and mothers with a birth space of more than three years (aOR = 0.63, 95% CI: 0.41-0.97) compared to those who had less than three years of birth spacing and mothers who were overweight/obese (aOR = 0.74, 95% CI: 0.55-0.99) compared to normal nutritional status had lower odds of having LBW.

Conclusions

Our study concludes that both low and high hemoglobin had an increased risk of having low birth weight. Policies and programs can benefit by adopting the findings of this study. More empirical research is critical to understanding the impact of hemoglobin levels on birth weight.

The effect of maternal anaemia on low birth weight among newborns in Northwest Ethiopia

Low birth weight is an indicator of maternal-related multifactorial problems such as malnutrition, illness, and work overload. As a result, low birth weight is associated with maternal anaemia, and both of them were significant public health issues in developing nations. Low birth weight and anaemia are caused by insufficient nutrient intake, which is especially severe during pregnancy. So, this study aimed to assess the effect of maternal anaemia during the late trimester on low birth weight among newborns in Northwest Ethiopia. A systematic random sampling technique was used to select 211 participants for the primary data collection. Face-to-face interviews were used to collect data, while blood samples were collected using standard operating procedures. For further analysis, the data file was imported into Stata version 16 (MP) software. The binary logistic regression model was used to investigate significant factors related to low birth weight. Finally, the statistical significance of the variables was determined using a p value of ≤ 0.05. The prevalence of anaemia among pregnant women in the late trimester and newborns was 34 (16.11%, 95% CI: 11.42, 21.78) and 64 (30.33%, 95% CI: 24.20, 37.01), respectively. The mean ± standard deviation of the newborn babies' weight was 3.19 ± 0.49 kg. The proportion of low birth weight among newborns was 26 (12.32%, 95% CI: 8.20, 17.53%). The independent effect of anaemia on low birth weight was 4.19 times while all other factors were constant (COR = 4.19, 95% CI: 1.70, 10.30). Maternal educational status [unable to read and write (AOR = 10.94, 95% CI: 1.74, 68.58) and attained secondary education (AOR = 8.06, 95% CI: 1.53, 42.36)], and maternal anaemia (AOR = 3.51, 95% CI: 1.29, 9.55) were associated with low birth weight after adjusting with all other variables. In this study, the proportion of low birth weight was high. Here, maternal anaemia alone had a significant independent role in the development of low birth weight. Maternal education status and anaemic conditions were associated with low birth weight among newborns. Early detection and treatment of maternal anaemia during pregnancy is crucial with the usual nutritional-related care.