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This study examined the birth pattern in the Federal Capital Territory (FCT) using the University of Abuja Teaching Hospital (UATH) as a case study. Twenty seven per cent of the new-borns were found to have a low birth weight. Low birth .weight babies were born more to the mothers with age below 20 years (30.8%)\as compared, to.women more than 20.years of age (25.3%). Neonates with a gestation penod of less than 37 weeks were more prone to low birth weight The subjects who were not availing of ANC services had more number of low birth weight babies as compared to those who received ANC services (29.3% and.25.5% respectively). Female babies were more prone to low birth weight as compared to the male babies. The adjusted odds ratios were 1.36 for maternal age less than 20 years, 1.58. for period of gestation, (POG) less than 37 weeks, 1.23 for non-utilizers of ANC and 1:32 for female babies. The authors suggest that marriage beyond 18 years of age for the girls and increase the coverage of ANC to cent per cent for pregnant women may be promoted.
1.1 Background to the study
In 1948, the first World Health Assembly adopted an international definition of prematurity as birth weight of 2.5kilograms or less (UN (2004)). It was however discovered that in developing countries the use of this standard resulted in an unusually high proportion of `premature' babies most of who were not born prematurely (Yilgwanet.al. ,2004). The World Health Organization (WHO) in 1994 then conducted a study on eighteen different countries at different stages of development. This revealed that babies could be classified into three main groups based on their birth weight and gestational age: Small for gestational age, appropriate for age, large for age. Low birth weight was then defined as those babies weighing less than 2.5kilograms within twenty four hours of birth. This group of babies can either be small for age or appropriate for age and they are usually at high risk of dying in their first twenty eight days of life from factors like hypoglycaemia, sepsis, respiratory distress, prematurity etc. In Nigeria, neonatal death (death of an infant in the first twenty eight days of live) contributes about 25% of the total infant mortality with prematurity and low birth weight being the main contributor to these high neonatal deaths(Grange, 2006).
A reduction of at least one-third in the proportion of infants with low birth weight is one of the seven major goals for the current decade of the “A World Fit for Children” programme of the United Nations. Moreover, nutritional deprivation — the major determinant of low birth weight — is a clear obstacle to the attainment of many of the Millennium Development Goals. Monitoring improvements in low birth weight is thus being given high priority within the UN system, as well as by national governments and the international nutrition community.
Although the significance and interpretation of low birth weight has recently been debated, most experts agree that weight at birth is an indicator of a new born's chances for survival, growth, long-term health and psychosocial development. Babies whose birth weight is low as a result of undernourishment face a greatly increased risk of death during their first months and years of life (Bale et.al.,2003, UN, 2000, Allen & Gillespie, 2001). The evidence also suggests that those children who do survive may be more likely to experience health problems throughout their lives; these include impaired cognitive development, as well as diabetes and coronary heart disease in adulthood (Bhargavaet.al., 2004, Barker, 2003). Low birth weight in developing countries occurs primarily because of poor maternal health and nutrition. A variety of socioeconomic, medical, and psychosocial factors are known to increase the risk of low birth weight, but prevention programs aimed at primarily high-risk subgroups have been largely ineffective.
In addition, diseases such as diarrhoea, malaria and respiratory infections, which are common in many developing countries, can significantly impair foetal growth when women become infected during pregnancy (Bale et.al.2003, UN 2000). In Nigeria just like in many developing countries, low birth weight is a significant contributor to the overall infant mortality rate and a major factor in the high neonatal mortality rate currently seen.
This research work however seeks to check for the dependence of birth weight on some factors which may affect it such as parity, maternal height, maternal age, gestation period, and gestation weight using the Chi-Square test of independence, regression analysis to see possible statistical relationships if any exists among the variables in question.
1.2 Statement of Problem
Low birth weight is one of the most serious challenges for mother and child health (MCH) in developing countries. It has a number of public health consequences such as mental retardation, high-risk -of peri-natal and infant mortality as well as morbidity and the very high cost of special care and intensive care unit (ICU). It has been revealed that half of all peri-natal and one-third of all infant deaths occur due to low birth weight.
The infant mortality rate (IMR- rate of mortality cases per thousand live-births) in Nigeria was 67.6 in the year 93-98 as estimated by NFHS-2. It varies from 86.7 in Uttar Pradesh to 16.3 in Kerala. According to NFHS-2, the infant mortality rate was higher among children born to mothers below 20 years than children born to mothers of 20-29 years of age. As per the findings of NFHS-2, infant mortality rate was 93 in case of mothersbelow 20 years as compared to 63 in the case of mothers above 20 years of age. The IMR was more in the case of first child (74.9) in comparison to the third child (61.7). IMR increases as the size of baby decreases. Thus, there was an extra contribution of about 10-15 deaths per thousand births (in IMR) by low birth weight babies.
22.7 per cent of babies-bom each year are LBW as estimated of by the World Summit (98-99). The incidence of low birth weight is still high in Nigeria. Prevention of Low Birth Weight would help in the reduction of high infant morbidity and mortality. It has been observed in some studies that" low birth weight is influenced by certain factors like period of gestation ante-natal care maternal age, parity, anaemia, etc. 42 per cent of the new-boms had low birth weight and 90 per cent of the neonate deaths had occurred in the low birth weight babies, a study in a tribal area revealed.
1.3 Objectives of the study
This current study was conducted with an objective of assessing the .impact of various factors like maternal age, parity, gestational age, ante-natal care, anaemia, etc. on the birth weight of the infant. This relationship might offer some ways and means fornitiating public health measures which may help in increasing the birth weight of the newborns and reducing their morbidity and mortality.
This current study will be conducted with the sole aim of assessing the impact of:
1. Birth-weight on maternal age
2. Birth-weight on Parity
3. Birth weight on Gestational age
4. Birth-weight on Maternal weight
5. Birth weight on Maternal height
6. And finally, to estimate a model which will be able to predict an infant’s birth weight from afore mentioned factors.
1.4 Significance of the study
This research work explores the dependency of child’s birth weight on some factors which may affect it, therefore it will be significant to medical practitioners, maternity specialists and potential parents. It will also be of great benefits to future researchers who wish to explore issues concerning birth weight of a child.
1.5 Scope of the study
The prevalence of low birth weight in Nigeria has been put previously at 16%, 9% and 12% (UNICEF 2001, 2003). Every single day, Nigeria loses about 2,300 under-five year olds. This may be associated with the incidence of low birth weight in the country, thus making the country the second largest contributor to under-five mortality in the whole world (UNICEF, 2008). Hence, the importance of this study cannot be overemphasized; this research paper seeks to investigate some factors which may affect the birth weight from the statistical perspective. This research is however limited to data obtained from the University of Abuja teaching Hospital, Gwagwalada, Abuja.
1.6 Definition of terms
Neonates: This refers to an infant in its first twenty eight (28) days or less than a month.
Birth Weight: This is the body weight of a baby at birth or just after birth.
Gestation Period: this is the time in which the foetus develops in the womb, beginning at fertilization and ending at birth
Preterm Birth: This is the birth of a baby of less than 37 weeks gestationa age.
Posterm: This is a pregnancy that extends to 42 weeks and above.
Premature Birth: this is the birth of a baby before the developing organs are mature enough to allow normal postnatal survival.
Mortality: This is the state of being mortal or being susceptible to birth.
Parity: This is the state of having borne off springs or the number of times a female has given birth.
Morbidity: This is an incidence of ill health, or the rate at which a person falls ill.
1.7 Organization of Study
The study is divided into five chapters. Chapter one deals with the study’s introduction and gives a background to the study. Chapter two reviews related and relevant literature. The chapter three gives the research methodology while the chapter four gives the study’s analysis and interpretation of data. The study concludes with chapter five which deals on the summary, conclusion and recommendation.
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