An Association between Maternal Occupations and Low Birth Weight Infants in Japan from 1995 to 2015

Pooled prevalence and factors of low birth weight among newborns in the top 20 countries with the highest infant mortality: analysis of recent demographic and health surveys

OBJECTIVE

This study aimed to assess the pooled prevalence and factors of low birth weight among newborns in the top 20 countries with the highest infant mortality rates.

DESIGN

We conducted a community-based cross-sectional analysis using data from Demography and Health Surveys across these countries. The final analysis included a weighted sample of 82 430 live births. We employed binary logistic regression to identify predictors of low birth weight, allowing for the interpretation of results as probabilities. This approach enhances the understanding of event likelihood, which is particularly valuable for policymakers. Statistical significance was determined at a 95% CI with p values <0.05.

SETTING

The focus was on the top 20 countries that report the highest infant mortality.

OUTCOME VARIABLE

Low birth weight (binary: Yes/No).

RESULT

The pooled prevalence of low birth weight among newborns was found to be 13% (95% CI: 11% to 14%), showing notable variation across countries, ranging from 5% in Sierra Leone to 25% in Mauritania. Statistically significant factors included maternal age of 15-19 years (adjusted OR (AOR): 1.38; 95% CI: 1.19 to 1.61), lack of formal education among mothers (AOR: 1.36; 95% CI: 1.26 to 1.46), unemployed mothers (AOR: 1.54; 95% CI: 1.46 to 1.63), divorced mothers (AOR: 1.20; 95% CI: 1.10 to 1.36), absence of antenatal care (ANC) visits (AOR: 1.24; 95% CI: 1.10 to 1.39) and one to three ANC visits (AOR: 1.30; 95% CI: 1.22 to 1.38). Other significant factors included a parity of one to two children (AOR: 1.29; 95% CI: 1.21 to 1.39), twin births (AOR: 6.40; 95% CI: 5.68 to 7.26), and female newborns (AOR: 1.21; 95% CI: 1.15 to 1.28).

CONCLUSION AND RECOMMENDATION

The findings indicate that more than 1 out of 10 newborns in these highest infant mortality countries are classified as low birth weight. To mitigate this issue, it is imperative to enhance access to quality healthcare with particular emphasis on ANC and to promote maternal education, especially for younger and less-educated mothers. Increasing the presence of skilled birth attendants and addressing socioeconomic factors, such as women's unemployment, is crucial. Targeted interventions should support divorced women and address risks associated with maternal age, terminated pregnancies and twin births. Additionally, country-specific strategies that focus on female infants can play a significant role in reducing the prevalence of low birth weight and improving neonatal health outcomes.

Maternal occupation and risk of adverse fetal outcomes in Tanzania: A hospital-based cross-sectional study

BACKGROUND

Women constitute a large proportion of the workforce in today's world. Hazardous working environment conditions for these women pose threat to their reproductive health. Despite efforts to address maternal health in Tanzania, the impact of occupational risks during pregnancy remains unclear. We assessed whether maternal occupation during pregnancy is associated with adverse Foetal outcomes.

METHODS

A cross-sectional study was conducted among 400 self-referred post-delivery women at a referral Hospital in Tanzania. Information on socio-demographic characteristics and maternal occupational characteristics was assessed through the use of a pre-tested questionnaire. Questions on physical demanding work and prolonged standing were obtained from the standardized Musculoskeletal Questionnaire. To assess occupational exposure to chemicals, job titles and task descriptions were linked to a job-exposure-matrix, an expert judgment on exposure to chemicals at the workplace. Information relating to obstetric characteristics and pregnancy outcomes was obtained from the medical files and clinic cards. Data was analyzed by using Statistical Package for Social Sciences (SPSS) version 23. Odds ratios >  1 was considered risk while Odds ratios <  1 was considered protective and P value < 0.05 was considered significant.

RESULTS

The mean age was 28.0 ±  6.3. Out of 400 post-delivery women studied, 174 (43.5%) were engaged in various occupations. Agriculture (22.4%) was the most prevalent occupation followed by tailoring (19.0%). Relative to the referent group of other occupations, agriculture workers, had higher adjusted odds ratios of congenital malformation (AOR = 4.5, 95% CI; 1.6-12.8)preterm babies (AOR = 2.8, 95% CI; 1.3-7.9), low birth weight (AOR = 3.1, 95% CI; 1.4-8.4) and low Apgar score (AOR = 3.5, 95% CI; 1.3-9.5). Food vendors: low birth weight (AOR = 8.6, 95% CI; 2.7-24.8) and low Apgar score (AOR = 13.5, 95% CI; 4.5-39.4).

CONCLUSION

Understanding occupational characteristics and their relation to adverse Foetal outcomes is important to formulate appropriate strategies to promote and protect maternal and infant health at work.

Difference in risk of preterm and small-for-gestational-age birth depending on maternal occupations in Japan

OBJECTIVES

In this study, an association between the mother's occupations with preterm and small-for-gestational-age (SGA) births was investigated using national data in Japan, and individual-level birth data from the Report of Vital Statistics: Occupational and Industrial Aspects in the 2015 fiscal year were used. Preterm and SGA birth rates were calculated for each of infant characteristics, and relative risk of each type of maternal occupations (categorized into 12 types) for the outcomes was estimated using a log binomial regression model.

RESULTS

Data of 997,600 singleton births were analyzed. Among maternal occupations, preterm birth rate was highest among carrying, cleaning, packaging, and related workers (5.65%) and lowest among security workers (4.24%). SGA birth rate was highest among manufacturing process workers (5.91%) and lowest among security workers (4.00%). We found significantly elevated risks for preterm birth among manufacturing process workers compared with unemployed mothers, and significantly elevated risks for SGA birth compared with unemployed mothers were observed among sales workers, service workers, and manufacturing process workers. In contrast, security workers had a significantly decreased risk for SGA birth compared with unemployed mothers.

Associations of Prenatal Agricultural Farm Work with Fetal Overgrowth and Pregnancy Complications in State of Arizona Birth Records

OBJECTIVE

The purpose of this study is to examine fetal growth outcomes from agricultural worker households.

METHODS

Using Arizona 2006 to 2013 birth certificates with parental occupation, we identified N = 623,185 live births by agricultural household status. Logistic regression models estimated adjusted odds ratios (aORs) for macrosomia (>4000 g), postterm birth (>41 weeks), low birth weight (<2500 g), preterm birth (<37 weeks), large for GA, small for GA, and 5-minute APGAR (<7).

RESULTS

Newborns of agricultural households (n = 6371) had a higher risk of macrosomia (aOR, 1.15; 95% CI, 1.05-1.26), large for GA (aOR, 1.12; 95% CI, 1.03-1.22), postterm birth (aOR, 1.20; 95% CI, 1.09-1.33), and low 5-minute APGAR (aOR, 1.39; 95% CI, 1.07-1.81), whereas low birth weight (aOR, 0.85; 95% CI, 0.76-0.96) and preterm birth (aOR, 0.82; 95% CI, 0.74-0.92) were inversely related.

CONCLUSIONS

Having an agriculture working parent increased the likelihood of fetal overgrowth and low APGAR.

Analysis of association between low birth weight and socioeconomic deprivation level in Japan: an ecological study using nationwide municipal data

BACKGROUND

Several international studies have indicated an association between socioeconomic deprivation levels and adverse birth outcomes. In contrast, those investigating an association between socioeconomic status and low birth weight using nationwide data are limited in Japan. In this study, we investigated an association between municipal socioeconomic deprivation level and low birth weight by an ecological study.

METHODS

Nationwide municipal-specific Vital Statistics data from 2013 to 2017 were used. We calculated the low birth weight rate and standardized incidence ratio (SIR) for low birth weight for each municipality and plotted them on a Japanese map. Furthermore, the correlation coefficient between them and the deprivation level were calculated. In addition, a spatial regression model including other municipal characteristics was used to investigate an association between low birth weight and the deprivation level.

RESULTS

Municipalities with relatively high SIR for low birth weight were dispersed across all of Japan. The correlation coefficient between the socioeconomic deprivation level and low birth weight rate was 0.196 (p-value < 0.001) among municipalities, and that between the socioeconomic deprivation level and the SIR for low birth weight was 0.260 (p-value < 0.001). In addition, the spatial regression analysis showed the deprivation level was significantly and positively associated with low birth weight.

CONCLUSIONS

The socioeconomic deprivation level and low birth weight were positively associated, and a further study using individual data is warranted to verify reasons for the association.