Risk factors for low birth weight in Lubumbashi, Democratic Republic of the Congo

Abstract Background Globally, 15 million neonates are born prematurely every year, over half in low income countries (LICs). Premature and low birth weight neonates have a higher risk of intraventricular haemorrhage (IVH). There are minimal data regarding IVH in sub-Saharan Africa. This study aimed to examine the incidence, severity and timing of and modifiable risk factors for IVH amongst low-birth-weight neonates in Uganda. Methods This is a prospective cohort study of neonates with birthweights of ≤2000 g admitted to a neonatal unit (NU) in a regional referral hospital in eastern Uganda. Maternal data were collected from interviews and medical records. Neonates had cranial ultrasound (cUS) scans on the day of recruitment and days 3, 7 and 28 after birth. Risk factors were tabulated and are presented alongside odds ratios (ORs) and adjusted odds ratios (aORs) for IVH incidence. Outcomes included incidence, timing and severity of IVH and 28-day survival. Results Overall, 120 neonates were recruited. IVH was reported in 34.2% of neonates; 19.2% had low grade (Papile grades 1–2) and 15% had high grade (Papile grades 3–4). Almost all IVH (90.2%) occurred by day 7, including 88.9% of high grade IVH. Of those with known outcomes, 70.4% (81/115) were alive on day 28 and survival was not associated with IVH. We found that vaginal delivery, gestational age (GA) < 32 weeks and resuscitation in the NU increased the odds of IVH. Of the 6 neonates who received 2 doses of antenatal steroids, none had IVH. Conclusion In this resource limited NU in eastern Uganda, more than a third of neonates born weighing ≤2000 g had an IVH and the majority of these occurred by day 7. We found that vaginal birth, earlier gestation and need for resuscitation after admission to the NU increased the risk of IVH. This study had a high rate of SGA neonates and the risk factors and relationship of these factors with IVH in this setting needs further investigation. The role of antenatal steroids in the prevention of IVH in LICs also needs urgent exploration.

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Prevalence, Risk Factors, and Short-Term Outcomes of Full-Term Low Birth Weight Infants Born at a Tertiary Academic Center: A Prospective Case–Control Study

American Journal of Perinatology ◽

10.1055/s-0040-1722599 ◽

2021 ◽

Author(s):

Heidi K. Al-Wassia ◽

Shahd K. Baarimah ◽

Asmaa H. Mohammedsaleh ◽

Manal O. Alsulami ◽

Ragad S. Abbas ◽

...

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Case Control Study ◽

Case Control ◽

Adverse Outcomes ◽

Chromosomal Anomalies ◽

Short Term ◽

Term Infants ◽

Control Study

Objective Low birth weight (LBW) infants (<2,500 g) continued to be a global health problem because of the associated short- and long-term adverse outcomes. The study aimed to determine the prevalence, risk factors, and short-term outcomes of term LBW infants Study Design A prospective and case–control study. All infants born consecutively from September 1, 2018 to August 31, 2019 were included. Cases, term LBW infants, were 1:1 matched to controls, appropriate for gestational age (AGA) term infants. Major congenital or chromosomal anomalies and multiple pregnancies were excluded. Results The prevalence of term LBW in the studied period was 4.8%. Mothers of term LBW infants had significantly lower body mass index (p = 0.05), gained less weight (p = 0.01), had a history of previous LBW (p = 0.01), and lower monthly income (p = 0.04) compared with mothers of term AGA infants even after adjustment for confounders. A nonsignificant higher number of term LBW infants needed NICU admission, while their need for phototherapy was deemed significant. Conclusion We identified nutritional and socioeconomic maternal factors that are significantly associated with LBW infants and should be targeted during antenatal visits to improve neonatal outcomes. Key Points

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Frequency, risk factors and materno-foetal outcomes among cases of Placenta previa at a tertiary care hospital: a two year study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20192165 ◽

2019 ◽

Vol 8 (6) ◽

pp. 2240

Author(s):

Pamulaparthi Bindu Reddy ◽

Gurram Swetha Reddy

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Tertiary Care Hospital ◽

Placenta Previa ◽

Tertiary Care ◽

Previous History ◽

Morbidity And Mortality ◽

Care Hospital ◽

Early Date

Background: Placenta previa refers to the presence of placental tissue that extends over the internal cervical os. Placenta previa is linked to maternal hypovolemia, anaemia, and long hospital stay and with prematurity, low birth weight, low APGAR score in newborn. So it is very important to identify the condition at an early date to warn the condition thereby reducing the maternal and foetal morbidity and mortality. The present study was aimed to estimate the prevalence of PP, its associated predisposing risk factors and maternal morbidity, mortality and the perinatal outcome.Methods: A prospective observational study for two years was conducted at a tertiary care hospital. Pregnant mothers with >28 weeks of age with H/o ante partum haemorrhage were screened for placenta previa, confirmed by ultra sonography and included in the study. Clinical history, obstetric examination was done and followed up till the delivery. Maternal and foetal outcomes were recorded. Data analyzed by using SPSS version 20.Results: 1.4% incidence of PP was noted, mean age of group was 29.17±1.6 years. Age group of 21-30 years, multiparity Gravida 2-4, previous history of caesarean section and less number of ante natal checkups were significant risk factors and LSCS was most common outcome. Prematurity, low birth weight and APGAR <7 score for 1 minute was common foetal outcomes.Conclusions: Our study strongly suggests foetal surveillance programmes in cases of placenta previa. Measures should be made to bring awareness about PP, in urban slums and to increase medical checkups regularly. Making USG mandatory during every ANC and referral of cases of PP to tertiary care centres would definitely reduce the chances of morbidity and mortality.

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Geospatial analysis of determinants of neonatal mortality in Ghana

BMC Public Health ◽

10.1186/s12889-021-10473-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Duah Dwomoh

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Neonatal Mortality ◽

Neonatal Death ◽

Reproductive Age ◽

Multiple Births ◽

Demographic And Health Surveys ◽

Neonatal Deaths ◽

The Impact

Abstract Background Ghana did not meet the Millennium Development Goal 4 of reducing child mortality by two-thirds and may not meet SDG (2030). There is a need to direct scarce resources to mitigate the impact of the most important risk factors influencing high neonatal deaths. This study applied both spatial and non-spatial regression models to explore the differential impact of environmental, maternal, and child associated risk factors on neonatal deaths in Ghana. Methods The study relied on data from the Ghana Demographic and Health Surveys (GDHS) and the Ghana Maternal Health Survey (GMHS) conducted between 1998 and 2017 among 49,908 women of reproductive age and 31,367 children under five (GDHS-1998 = 3298, GDHS-2003 = 3844, GDHS-2008 = 2992, GDHS-2014 = 5884, GMHS-2017 = 15,349). Spatial Autoregressive Models that account for spatial autocorrelation in the data at the cluster-level and non-spatial statistical models with appropriate sampling weight adjustment were used to study factors associated with neonatal deaths, and a p-value less than 0.05 was considered statistically significant. Results Population density, multiple births, smaller household sizes, high parity, and low birth weight significantly increased the risk of neonatal deaths over the years. Among mothers who had multiple births, the risk of having neonatal deaths was approximately four times as high as the risk of neonatal deaths among mothers who had only single birth [aRR = 3.42, 95% CI: 1.63–7.17, p < 0.05]. Neonates who were perceived by their mothers to be small were at a higher risk of neonatal death compared to very large neonates [aRR = 2.08, 95% CI: 1.19–3.63, p < 0.05]. A unit increase in the number of children born to a woman of reproductive age was associated with a 49% increased risk in neonatal deaths [aRR = 1.49, 95% CI: 1.30–1.69, p < 0.05]. Conclusion Neonatal mortality in Ghana remains relatively high, and the factors that predisposed children to neonatal death were birth size that were perceived to be small, low birth weight, higher parity, and multiple births. Improving pregnant women’s nutritional patterns and providing special support to women who have multiple deliveries will reduce neonatal mortality in Ghana.

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Revisiting Konzo Risk Factors in Three Areas Differently Affected by Spastic Paraparesis in Eastern Democratic Republic of the Congo Discloses a Prominent Role of the Nutritional Status—A Comparative Cross-Sectional Study

Nutrients ◽

10.3390/nu13082628 ◽

2021 ◽

Vol 13 (8) ◽

pp. 2628

Author(s):

Marius Baguma ◽

Espoir Bwenge Malembaka ◽

Esto Bahizire ◽

Germain Zabaday Mudumbi ◽

Dieudonné Bahati Shamamba ◽

...

Keyword(s):

Risk Factors ◽

Nutritional Status ◽

Democratic Republic ◽

Cross Sectional Study ◽

Sectional Study ◽

Cyanide Poisoning ◽

Cross Sectional ◽

High Prevalence ◽

Republic Of The Congo

This comparative cross-sectional study aimed to better understand the respective contributions of protein malnutrition and cassava-derived cyanide poisoning in the development of konzo. We compared data on nutritional status and cyanide exposure of school-age adolescent konzo-diseased patients to those of non-konzo subjects of similar age from three areas in the Eastern Democratic Republic of the Congo. Our results show that konzo patients had a high prevalence of both wasting (54.5%) and stunting (72.7%), as well as of cyanide poisoning (81.8%). Controls from Burhinyi and those from Idjwi showed a similar profile with a low prevalence of wasting (3.3% and 6.5%, respectively) and intermediate prevalence of stunting (26.7% and 23.9%, respectively). They both had a high prevalence of cyanide poisoning (50.0% and 63.0%, respectively), similar to konzo-patients. On the other hand, controls from Bukavu showed the lowest prevalence of both risk factors, namely chronic malnutrition (12.1%) and cyanide poisoning (27.6%). In conclusion, cassava-derived cyanide poisoning does not necessarily coexist with konzo outbreaks. The only factor differentiating konzo patients from healthy individuals exposed to cyanide poisoning appeared to be their worse nutritional status. This further suggests that, besides the known role of cyanide poisoning in the pathogenesis of konzo, malnutrition may be a key factor for the disease occurrence.

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