Prevalence and risk factors of under nutrition among under three children in an urban community in Ludhiana city

Background: Under nutrition is important cause of childhood morbidity and mortality. In India burden of underweight children in under 5 years of age is still 35.7% (NFHS-4) and is 22% in Punjab which is still considered to be a major public health problem. Thus this study was planned to find prevalence and risk factors of under nutrition in under 3 children in urban Ludhiana.Methods: It is community based cross-sectional study conducted in under 3 year children in field practice area of Urban Health Centre under Department of Community Medicine, Dayanand Medical College, Ludhiana. Minimum sample size of 368 was calculated. Data was collected from routine surveillance by ANMs in their visits to area. Under nutrition was taken as weight for age as per standard growth chart used in India (WHO based). Statistical analysis: Microsoft Excel, Chi square test, SPSS.Results: Out of 387 children, 82 (21.2%) were underweight [17 (4.4%) severely and 65 (16.8%) moderately underweight]. Increasing age, partial immunization, low birth weight and high birth order were significantly associated, while gender, type of family, SES, mother’s BMI & literacy and exclusive breast feeding were not significantly associated with prevalence of underweight.Conclusions: Increasing age, partial immunization, low birth weight and high birth order were all significantly associated with underweight. Maternal and child health services need to be strengthened.

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Infant Feeding and Infant Growth

PEDIATRICS ◽

10.1542/peds.74.4.728 ◽

1984 ◽

Vol 74 (4) ◽

pp. 728-762

Author(s):

Jane F. Seward ◽

Mary K. Serdula

Keyword(s):

Developing Countries ◽

Birth Weight ◽

Low Birth Weight ◽

Birth Order ◽

Infant Nutrition ◽

Whooping Cough ◽

Public Health Problem ◽

The United States ◽

Major Public Health Problem ◽

Infant Birth

Growth in infancy is a complex process affected directly or indirectly by numerous interrelated factors. The predominant factors include diet, the nutritional status and health of the mother, and the occurrence of infections. In addition, social factors (family structure and cohesiveness), economic status, cultural practices, and biologic factors—such as the sex of the infant, birth weight, birth order, birth interval, and genetics—may also play a significant role in growth. Nutritional factors may affect growth in infancy both before and after birth. Maternal and infant nutrition are intimately related. For breast-fed infants, nutrition of the mother and that of her young are interrelated from conception until weaning; therefore, dietary intake of pregnant and lactating women is very important.67 Underweight mothers with poor weight gain in the last trimester of pregnancy bear infants with lower mean birth weights.111 Although there are ethnic differences in low birth weight in the United States, the incidence is relatively low.45 In contrast, in developing countries, low birth weight (≤2,500 g), mainly caused by the high proportion of growth-retarded newborns, is a major public health problem.126,138 Infants who have suffered from intrauterine growth retardation remain smaller, on average, than normal babies throughout infancy and early childhood.30,39,44 In developing countries, many nondietary factors also play an important role in determining growth. Infections, particularly gastroenteritis, are among the most important of these factors.91,124 Case-control studies examining factors that differ between malnourished (weight-for-age less than Harvard third or tenth percentile) and adequately nourished children in the second 6 months of life have found significant associations between the following nondietary factors and growth failure: high birth order (greater than six or seven), lower mean maternal age, low maternal weight, children from families in which one or more siblings had died, greater mean number of children less than 5 years old in the home, birth weight less than 2.4 kg, twinning, infections (measles, whooping cough, severe or repeated diarrhea), death of either parent, or a broken marniage.4,96

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Effect of under-nutrition during pregnancy on low birth weight in Tigray regional state, Ethiopia; a prospective cohort study

BMC Nutrition ◽

10.1186/s40795-021-00475-7 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Kidanemaryam Berhe ◽

Lemlem Weldegerima ◽

Freweini Gebrearegay ◽

Amaha Kahsay ◽

Afewerki Tesfahunegn ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Birth Weight ◽

Low Birth Weight ◽

Pregnant Women ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Monthly Income ◽

Under Nutrition ◽

Regional State

Abstract Background Under-nutrition during pregnancy affects birth outcomes and neonatal outcomes. Worldwide, 20.5 million children were low birth weight, mainly in poor countries. However, there is no longitudinal-based evidence on the effect of under-nutrition during pregnancy on birth weight in Tigray regional state. Therefore, this study aimed at investigating the effect of under-nutrition during pregnancy on low birth weight in Tigray regional state. Methods We conducted a prospective cohort study among consecutively selected 540 pregnant women attending antenatal care in hospitals from October 2019 to June 2020. Pregnant women with mid upper arm circumference (MUAC) < 23 cm were exposed and those with MUAC≥23 cm were unexposed. Data on socio-demographic, diet, hygiene and anthropometry measurements were collected using pretested and structured questionnaires. SPSS version 25 was used for analysis. A log-binomial model was used to estimate the adjusted risk ratio and its 95%CI of the risk factors for low birth weight. Multi-collinearity was checked using the variance inflation factor (VIF) at a cut-off point of 8 and there was no multi-collinearity. Result The overall incidence of low birth weight was 14% (95%CI: 11.1, 17.4%). The incidence of low birth weight was 18.4 and 9.8% among the exposed and unexposed women, respectively. The difference in low birth weight incidence between the exposed and unexposed groups was statistically significant (p-value = 0.006). The risk factors of low birth weight were maternal illiteracy (ARR: 1.8, 95%CI: 1.01, 3.3), low monthly family income < 50 US Dollar (ARR: 1.6, 95%CI: 1.07, 2.2), lack of latrine utilization (ARR: 0.47, 95%CI: 0.28, 0.78), and diet diversity score < 5 (ARR: 1.9, 95%CI: 1.05, 2.61). Conclusion Low birth weight was significantly higher among the exposed pregnant women. Maternal illiteracy, low monthly income, lack of latrine utilization, and low DDS were risk factors of low birth weight. It is then important to strengthen nutritional assessment and interventions during pregnancy, with a special attention for illiterate, and low monthly income pregnant women. Again, there has to be a promotion of latrine utilization and consumption of diversified diets.

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Risk factors for low birth weight in a rural community in southern Brazil

Jornal de Pediatria ◽

10.2223/jped.645 ◽

1996 ◽

Vol 72 (6) ◽

pp. 369-373 ◽

Cited By ~ 4

Author(s):

Ricardo Halpern ◽

Earl S. Schaefer ◽

Airton S. Pereira ◽

Ernesto M. Arnt ◽

Jandira Pureza Valente Bezerra ◽

...

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Rural Community ◽

Southern Brazil

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Intraventricular haemorrhage in a Ugandan cohort of low birth weight neonates: the IVHU study

BMC Pediatrics ◽

10.1186/s12887-020-02464-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

R. MacLeod ◽

J. N. Paulson ◽

N. Okalany ◽

F. Okello ◽

L. Acom ◽

...

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Intraventricular Haemorrhage ◽

Sub Saharan Africa ◽

Cranial Ultrasound ◽

High Grade ◽

Odds Ratios ◽

Antenatal Steroids ◽

Eastern Uganda

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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Low Birth Weight Prevalence in Children Diagnosed with Neurodevelopmental Disorders in Dubai

Global Pediatric Health ◽

10.1177/2333794x211031782 ◽

2021 ◽

Vol 8 ◽

pp. 2333794X2110317

Author(s):

Faisal A. Nawaz ◽

Meshal A. Sultan

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Mental Disorders ◽

Low Birth Weight ◽

Neurodevelopmental Disorders ◽

Autism Spectrum ◽

High Birth Weight ◽

Perinatal Risk Factors ◽

Perinatal Risk ◽

The Impact

The aim of this study is to evaluate the prevalence of low birth weight and other perinatal risk factors in children diagnosed with neurodevelopmental disorders. This is one of the first studies in the Arabian Gulf region focused on the contribution of these factors toward the development of various disorders such as attention-deficit/hyperactivity disorder, autism spectrum disorder, and other mental disorders. This descriptive study was based on qualitative data analysis. We reviewed retrospective information from the electronic medical records of 692 patients in Dubai, United Arab Emirates. The prevalence of low birth weight in children with mental disorders was significantly higher as compared to the general population (16% vs 6% respectively). Furthermore, other risk factors, including high birth weight and preterm birth were noted to have a significant association with neurodevelopmental disorders. Future research on the impact of perinatal risk factors will contribute to advancement of early intervention guidelines.

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