Public Health Essay: Factors Associated with Low Birthweight

Abstract

Low birth weight is a global public health concern as it contributes to 70% to 80% of all deaths of children.This amounts to 20 million LBW babies born every year, 96.5% of them in developing countries. LBW is estimated at 6% and is seen as the single greatest challenge facing maternal and child health. Children born with low birth weight (<2500gms) are more likely to experience short and long-term health complications in their life; Ohlsson (2008). Factors associated with LBW among neonates remain unknown, and interventions need to be made to improve a healthy start of life. The chief objective of this study is therefore to determine the factors associated with low birth weight among infants born in the community's hospital. Delivering mothers will be administered with a well-structured questionnaire, which gathers their social-demographic, maternal and nutritional information. This data will be used to determine the risk factors associated with low birth weight among newborns.

Low birth weight is the mass at birth which is less than 2500 grams, measured in the initial hours of life irrespective of the gestational period. According to Alexander (2008), LBW is a primary cause and contributes to about 60% to 80% of all neonatal deaths. Based on epidemiological studies, infants that weigh less than 2500g are 20% more likely to die than normal weight babies. Global prevalence of LBW is 15.5%, which amounts to about 28 million low birth weight infants born each year, 90% of them in developing countries.

Globally about half of the LBW's are born in South Asia, where 30% of all infants born weigh less than 2500 grams at birth. (WHO, 2007)

In sub-Saharan Africa, more than 20% of babies are born with low birth weight (LBW) each year. The proportion of low birth weight varies from country to country. According to the Demographic health survey (DHS 2005), Ethiopia had a rate of 0.6%, Rwanda 1.9%, Senegal 6.5%, and Sierra Leone 25%. In the Sub-Saharan Africa region, low birth weight is often due to malaria and undernourishment in pregnancy. The estimates of low birth weight in Kenya is approximately at 11% (WHO, 2007). The Kenya Demographic Health Survey of 2009 estimates LBW to be 6%. The same survey estimated the prevalence of LBW to be 5.5% in Rift valley province.

Introduction

Low birth weight in a new born is a major reason for neonatal deaths following in severe short-term effects on offspring and also has a long-term impact on health penalties in adult life. According to Lawn (2005), low birth weight results in substantial costs to the health sector and poses a significant burden on the society as a whole. According to WHO(2007), characteristic of low birth weight cases occurs in underdeveloped countries, with rates at 16.5% as compared to industrialized republics, 7%.Also, the LBW rates are intolerable among different states, depending upon several factors such as socioeconomic conditions, malnutrition, education level and health conditions.

Infant's low birth weight is the result of many unified causes.The principal cause for LBW infants is preterm birth. Other reasons for the LBW are poor maternal nutrition status, low gestational weight increase, genetic preparation of mother and stocky maternal build due to mother's childhood diet. Socio-economic conditions, poverty, education level, violence during pregnancy and early matrimonies are also essential causal factors for low birth weight infants (de Berna be', 2004)

Low birth weight persons experience many health difficulties throughout their lives which can cause long and short-term penalties including hypothermia, hypoglycemia, perinatal asphyxia, breathing problems, hyper-bilirubinemia, anemia, reduced nutrition, infection, neurological issues ophthalmologic complications, hearing defects, sudden infant death syndrome, coronary heart illnesses, and immune system problems.

Problem statement

According to Conley (2000), significant costs of low birth weight include infant and neonatal death and morbidity, reduced mental growth and increased risk of long-lasting diseases later in life. LBW individuals experience many health problems throughout their lives which can cause long and short-term costs.It including hypothermia, hypoglycemia, perinatal asphyxia, respiratory problems, anemia, impaired nutrition, infection, neurological problems, hearing impairment, sudden infant death syndrome, coronary diseases of the heart, and immune system problems ;(Khan,2014).

In Kenya for example, the rates of infant mortality are high, raising a public health concern. The risk factors of low birth weight have been noted to also be contributing factors to infant and child morbidity and mortality (KDHS 2014).The contribution of low birth weight to neonatal morbidity and mortality in Kenya cannot be ignored. According to KDHS (2014), neonatal mortality had increased in Rift Valley province by 15% per 1000 live births from the previous demographic health survey conducted in 2009.The cause of this increase remains unknown, and the leading causes of neonatal mortality are similarly unknown.

There is, therefore, need to focus on the risk factors associated with low birth weights among neonates with the aim of reducing neonatal morbidity and mortality. This will also call for more focus being put on how to implement simple, cost-efficient and sustainable solutions to take care of the special needs of newborns.

The findings in this study will be used to create awareness in the community concerning the issue and contribute towards formulating interventions to prevent the low birth weight from a local perspective. The findings will also be disseminated among various stakeholders to stimulate focused intervention programs to reduce the burden of the issue and to institute treatment solutions to care for babies with low birth weights.

General Objective

To determine the risk factors associated with low birth weight among neonates.

Specific research questions

What is the relationship between socio-demographic status and low birth weight?

What are the maternal factors associated with low birth weight among neonates?

What is the relationship between maternal nutritional status and low birth weight?

Literature Review

This chapter reviews some of the studies and explanations of low birth weights among neonates done by scholars. It also explains the various factors related to low birth weights and the effects they have on the health of children in their later life. This chapter will also focus on the conceptual framework together with the variables that are either dependent or independent. It also examines the way by which these variables influence low birth weight prevalence among neonates.

Low birth weight is weight at birth which is less than 2500grams, usually measured in the first hours of life irrespective of the gestation age.Low birth weight is a primary cause and contributes to about 60% to 80% of all neonatal deaths ( Alexander, 2008). According to Conley (2000), infants weighing less than 2500g are 20% more likely to die than normal weight babies. Global occurrence of LBW is 15.5 %, which quantities to about 28 million low birth weight infants born each year, 90% of them in developing republics. Internationally, about half of the LBW's are born in South Asia, where 25% of all babies born weight less than 2500g at birth. The occurrence of LBW is dual in developing countries 16.5%as compared to developed countries 7% (WHO 2010). Also, the LBW rates vary among different countries, depending upon many factors such as social, economic environment, lack of proper nutrition, education level, and health conditions. The occurrence of LBW from 2005 to 2011, in some of these states, is India 28%, Bangladesh 22%, E, Mauritania 34%, Nepal 21% and Pakistan 32% (WHO 2010).Infant's little weight at birth is the result of many interrelated causes. According to Conley (2000), the primary cause for the LBW infants is the preterm birth. Other causes of LBW are poor nutrition status of the mother, low gestational weight gain, the genetic composition of the mother, and short maternal stature due to mother's childhood diet.

Socioeconomic conditions, poverty, education level, violence during pregnancy, and early marriages are also essential contributing factors for low birth weight babies. Infectious agents have potential to penetrate through the uterus and causes inflammation in uterus and placenta. Cytokines are released in response to inflammation by the body immune system resulting in preterm initiation of labor which results in low birth weight. Adolescents when becoming pregnant before their growth is completed faces difficulty in fulfilling their own an infant's nutritional requirements. (De Berna be', 2004).

According to Olsson, (2008) LBW individuals experience many health problems throughout their lives which can cause long and short-term consequences including hypothermia, hypoglycemia, perinatal asphyxia, respiratory problems, hyper-bilirubinemia, anemia, impaired nutrition, infection. According to Conley and Bennet (2000), babies of low birth weight are 35% less likely to advance from high school at an appropriate age. These researchers believe that natural health at infancy affects development, which, in turn, affects socioeconomic status, producing cohorts of poverty and poor health.

According to de Berna be' (2004), causal factors for LBW are multi-layered. They include factors such as maternal age, poor maternal nourishing status, and non-pregnant weight, gestational age, intervals between gravidities, parity, educational status, violence during pregnancy, lack of antenatal care (ANC) and deficient socioeconomic status. For example, low BMI is a reliable indicator for protein-energy undernourishment, which affects fetal growth during gravidity. The nutritional status of a pregnant woman can be affected by many factors including low socioeconomic status, higher parity, and short inter-pregnancy interval.

Birth consequences are often observed as the key overriding adaptable that links social factors such as mother's education to the risk of infant mortality. Social risk factors have been found to meaningfully mediate the belongings of birth outcomes on the long-term cognitive development of low birth weight children (Schiele, 2002). Malnutrition is the most common cause of the reduced growth of the fetus. Nutritional adequacy is reliant on various factors such as mother's food intake, nutrient supply to the placenta and fetus, fetal uptake and nutrient directive, etc. The nutrient needs also vary with gestational age. Poor socioeconomic status worsens the situation coupling up with intergenerational cycle making it hard to break the chain. Malnutrition causes stress to the fetus which is an important risk factor for preterm birth according to Lawn (2004).

Parental education has the noteworthy impact an on the health of the child (Broken, 2002). There are three trails through which mother's teaching might affect the infant's health outcomes: direct gaining of basic medical knowledge from education, health knowledge obtained through literacy and numeracy learned in school and exposure to modern society. The early child health incidences of poverty and pregnancy are multiple and often set a newly born child on a lifelong course of deficiencies in health outcomes. (Ehrenkranz, 2006). According to Ohlsson, (2008) LBW individuals experience many health problems throughout their lives which can cause long and short-term consequences including hypothermia, hypoglycemia, perinatal asphyxia, respiratory problems, hyper-bilirubinemia, anemia, impaired nutrition, infection. According to Conley and Bennet (2000), babies of low birth weight are 35% less likely to advan...