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Determinants of low birth weight in the context of maternal nutrition education in urban informal settlements, Kenya

Published online by Cambridge University Press:  08 October 2018

C. K. Nyamasege*
Affiliation:
Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
E. W. Kimani-Murage
Affiliation:
African Population and Health Research Centre, Nairobi, Kenya Wellcome Trust, London, United Kingdom International Health Institute, Brown University, Providence, RI, USA College of Medical, Veterinary and Life Sciences, Wolfson Medical School Building, University of Glasgow, Glasgow, UK
M. Wanjohi
Affiliation:
African Population and Health Research Centre, Nairobi, Kenya
D. W. M. Kaindi
Affiliation:
Department of Food Science, Nutrition and Technology, University of Nairobi, Nairobi, Kenya
E. Ma
Affiliation:
Global Medical Science Center, Fukushima Medical University, Fukushima, Japan
M. Fukushige
Affiliation:
Department of Clinical Trials and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
Y. Wagatsuma
Affiliation:
Department of Clinical Trials and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
*
*Address for correspondence: C. K. Nyamasege, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan. E-mail [email protected]

Abstract

Inadequate knowledge in maternal nutrition is one of the determinants of low birth weight. However, little evidence is available on whether maternal nutrition counselling alone can influence birth weight among women from low socioeconomic households. This study assessed the effect of prenatal maternal nutritional counselling on birth weight and examined the related risk factors. A cluster randomized controlled trial was conducted to assess the effectiveness of home-based maternal nutritional counselling on nutritional outcomes, morbidity, breastfeeding, and infant feeding practices by the African Population and Health Research Center in two urban informal settlements of Nairobi. The intervention group received monthly antenatal and nutritional counselling from trained community health volunteers; meanwhile, the control group received routine antenatal care. A total of 1001 participants were included for analysis. Logistic regression was applied to determine associations between low birth weight and maternal characteristics. A higher prevalence of low birth weight was observed in the control group (6.7%) than in the intervention group (2.5%; P<0.001). Logistic regression identified significant associations between birth weight and intervention group (adjusted odds ratio (AOR)=0.26; 95% confidence interval (CI), 0.10–0.64); maternal height <154.5 cm (AOR=3.33; 95% CI, 1.01–10.96); last antenatal care visits at 1st or 2nd trimesters (AOR=9.48; 95% CI, 3.72–24.15); pre-term delivery (AOR=3.93; 95% CI, 1.93–7.98); maternal mid-upper arm circumference <23 cm (AOR=2.57; 95% CI, 1.15–5.78); and cesarean delivery (AOR=2.27; 95% CI, 1.04–4.94). Nutrition counselling during pregnancy reduced low birth weight and preterm births, which was determined by women of short stature, early stoppage of antenatal visit, and cesarean delivery.

Type
Original Article
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2018. 

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References

1. United Nations Children’s Fund and World Health Organization. Low Birth Weight: Country, regional and global estimates. 2004; Retrieved 10 October 2017 from http://apps.who.int/iris/bitstream/10665/43184/1/9280638327.pdf.Google Scholar
2. Bhutta, ZA, Darmstadt, GL, Hasan, BS, Haws, RA. Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence. Pediatrics. 2005; 115, 519617.Google Scholar
3. Abu-Saad, K, Fraser, D. Maternal Nutrition and Birth Outcomes. Epidemiol Rev. 2010; 32, 525.Google Scholar
4. Risnes, KR, Vatten, LJ, Baker, JL, et al. Birthweight and mortality in adulthood: a systematic review and meta-analysis. Int J Epidemiol. 2011; 40, 647661.Google Scholar
5. Kramer, MS. Determinants of low birth weight: methodological assessment and meta-analysis. Bull World Health Organ. 1987; 65, 663737.Google Scholar
6. Chiba, T, Ebina, S, Kashiwakura, I. Influence of maternal body mass index on gestational weight gain and birth weight: A comparison of parity. Exp Ther Med. 2013; 6, 293298.Google Scholar
7. World Health Organization. Global strategy for infant and young child feeding. 2003. WHO: Geneva. Retrieved 5 December 2017 from http://www.who.int/nutrition/publications/infantfeeding/9241562218/en/.Google Scholar
8. Akter, SM, Roy, SK, Thakur, SK, et al. Effects of third trimester counseling on pregnancy weight gain, birthweight, and breastfeeding among urban poor women in Bangladesh. Food Nutr Bull. 2012; 33, 194201.Google Scholar
9. Nikièma, L, Huybregts, L, Martin-Prevel, Y, et al. Effectiveness of facility-based personalized maternal nutrition counseling in improving child growth and morbidity up to 18 months: A cluster-randomized controlled trial in rural Burkina Faso. PLoS One. 2017; 12, e0177839.Google Scholar
10. Villar, J, Merialdi, M, Gulmezoglu, AM, et al. Nutritional interventions during pregnancy for the prevention or treatment of maternal morbidity and preterm delivery: an overview of randomized controlled trials. J Nutr. 2003; 133, 1606s1625s.Google Scholar
11. Nair, N, Tripathy, P, Sachdev, HS, et al. Effect of participatory women’s groups and counselling through home visits on children’s linear growth in rural eastern India (CARING trial): a cluster-randomised controlled trial. The Lancet Glob Health. 2017; 5, e1004e1016.Google Scholar
12. Orleans, CT. Promoting the maintenance of health behavior change: recommendations for the next generation of research and practice. Health Psychol. 2000; 19, 7683.Google Scholar
13. Booth, SL, Sallis, JF, Ritenbaugh, C, et al. Environmental and Societal Factors Affect Food Choice and Physical Activity: Rationale, Influences, and Leverage Points. Nutr Rev. 2001; 59, S21S36.Google Scholar
14. Kimani-Murage, EW, Kyobutungi, C, Ezeh, AC, et al. Effectiveness of personalised, home-based nutritional counselling on infant feeding practices, morbidity and nutritional outcomes among infants in Nairobi slums: study protocol for a cluster randomised controlled trial. Trials. 2013; 14, 445445.Google Scholar
15. Beguy, D, Elung’ata, P, Mberu, B, et al. Health &; Demographic Surveillance System Profile: The Nairobi Urban Health and Demographic Surveillance System (NUHDSS). Int J Epidemiol. 2015; 44, 462471.Google Scholar
16. Girard, AW, Olude, O. Nutrition Education and Counselling Provided during Pregnancy: Effects on Maternal, Neonatal and Child Health Outcomes. Paediatr Perinat Epidemiol. 2012; 26, 191204.Google Scholar
17. Kimani-Murage, EW, Griffiths, PL, Wekesah, FM, et al. Effectiveness of home-based nutritional counselling and support on exclusive breastfeeding in urban poor settings in Nairobi: a cluster randomized controlled trial. Global Health. 2017; 13, 90.Google Scholar
18. Kenya Ministry of Health.Taking the Kenya Essential Package for Health to the Community: A Strategy for the Delivery of Level One Services: Ministry of Health (MOH) Kenya. 2006; Retrieved 20 March 2018 from http://www.communityledtotalsanitation.org/sites/communityledtotalsanitation.org/files/community_strategy.pdf.Google Scholar
19. World Health Organization. Infant and Young Child Feeding Counselling: An Integrated Course. 2006. WHO Document Production Services: Geneva. Retrieved 6 December 2017 from http://files.unicef.org/nutrition/files/Facilitator_Guide_September_2011_clean.pdf.Google Scholar
20. Ververs, MT, Antierens, A, Sackl, A, Staderini, N, Captier, V. Which anthropometric indicators identify a pregnant woman as acutely malnourished and predict adverse birth outcomes in the humanitarian context? PLoS Curr. 2013; 5. doi: 10.1371/currents.dis.54a8b618c1bc031ea140e3f2934599c8.Google Scholar
21. Cooley, SM, Donnelly, JC, Walsh, T, et al. The relationship between body mass index and mid-arm circumference in a pregnant population. J Obstet Gynaecol. 2011; 31, 594596.Google Scholar
22. Friis, H, Gomo, E, Nyazema, N, et al. Maternal body composition, HIV infection and other predictors of gestation length and birth size in Zimbabwe. Br J Nutr. 2004; 92, 833840.Google Scholar
23. Jahan, K, Roy, SK, Mihrshahi, S, et al. Short-term nutrition education reduces low birthweight and improves pregnancy outcomes among urban poor women in Bangladesh. Food Nutr Bull. 2014; 35, 414421.Google Scholar
24. National Bureau of Statistics-Kenya, ICF International 2014. KDHS key findings. Rockville, Maryland, USA: KNBS and ICF International. 2014; Retrieved 5 August 2017 from https://dhsprogram.com/pubs/pdf/FR229/FR229.pdf.Google Scholar
25. Kenya National Bureau of Statistics (KNBS) and ICF Macro. Kenya Demographic and Health Survey 2008-09. Calverton, Maryland: KNBS and ICF Macro. 2010; Retrieved 5 August 2017 from https://dhsprogram.com/pubs/pdf/FR308/FR308.pdf.Google Scholar
26. Mutua, MK, Ochako, R, Ettarh, R, Ravn, H, Echoka, E, Mwaniki, P. Effects of low birth weight on time to BCG vaccination in an urban poor settlement in Nairobi, Kenya: an observational cohort study. BMC Pediatrics. 2015; 15, 45.Google Scholar
27. López, LB, Calvo, EB, Poy, MS, del Valle Balmaceda, Y, Cámera, K. Changes in skinfolds and mid-upper arm circumference during pregnancy in Argentine women. Matern Child Nutr. 2011; 7, 253262.Google Scholar
28. Sultana, T, Karim, MN, Ahmed, T, Hossain, MI. Assessment of Under Nutrition of Bangladeshi Adults Using Anthropometry: Can Body Mass Index Be Replaced by Mid-Upper-Arm-Circumference? PLoS One. 2015; 10, e0121456.Google Scholar
29. Assefa, N, Berhane, Y, Worku, A. Wealth status, mid upper arm circumference (MUAC) and antenatal care (ANC) are determinants for low birth weight in Kersa, Ethiopia. PLoS One. 2012; 7, e39957.Google Scholar
30. Abubakari, A, Kynast-Wolf, G, Jahn, A. Maternal Determinants of Birth Weight in Northern Ghana. PLoS One. 2015; 10, e0135641.Google Scholar
31. Aly, H, Hammad, T, Nada, A, Mohamed, M, Bathgate, S, El-Mohandes, A. Maternal obesity, associated complications and risk of prematurity. J Perinatol. 2010; 30, 447451.Google Scholar
32. Ngozi, PO. Pica practices of pregnant women in Nairobi, Kenya. East Afr Med J. 2008; 85, 7279.Google Scholar
33. Luoba, AI, Wenzel Geissler, P, Estambale, B, et al. Earth-eating and reinfection with intestinal helminths among pregnant and lactating women in western Kenya. Trop Med Int Health. 2005; 10, 220227.Google Scholar
34. Shah, PS, Ohlsson, A. Effects of prenatal multimicronutrient supplementation on pregnancy outcomes: a meta-analysis. Can Med Assoc. 2009; 180, E99E108.Google Scholar
35. Han, Z, Lutsiv, O, Mulla, S, McDonald, SD. on behalf of the Knowledge Synthesis G. Maternal Height and the Risk of Preterm Birth and Low Birth Weight: A Systematic Review and Meta-Analyses. J Obstet Gynaecol. 2012; 34, 721746.Google Scholar
36. Ngwira, A, Stanley, CC. Determinants of Low Birth Weight in Malawi: Bayesian Geo-Additive Modelling. PLoS One. 2015; 10, e0130057.Google Scholar
37. Elshibly, EM, Schmalisch, G. The effect of maternal anthropometric characteristics and social factors on gestational age and birth weight in Sudanese newborn infants. BMC Public Health. 2008; 8, 244.Google Scholar
38. Coutinho, PR, Cecatti, JG, Surita, FG, Costa, ML, Morais, SS. Perinatal outcomes associated with low birth weight in a historical cohort. Reprod Health. 2011; 8, 1818.Google Scholar
39. Beguy, D, Elung’ata, P, Mberu, B, et al. Health & Demographic Surveillance System Profile: The Nairobi Urban Health and Demographic Surveillance System (NUHDSS). Int J Epidemiol. 2015; 44, 462471.Google Scholar
40. Mogire, KG. Factors associated with low birth weight deliveries in Pumwani maternity hospital Nairobi Kenya [dissertation]. 2013. Jomo Kenyatta University: Mogire JKUAT.Google Scholar