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Birth weight is an important indicator of child survival, future physical growth and mental development. Twenty million infants world wide representing 15.5% of all births are born with low birth weight, 95.6% of them in developing countries like Nigeria. This study investigates the determinants of birth weight and proposes a statistical model that can be useful in epidemiological studies of birth weight. Data on birth weight, maternal age, gestational age and sex of index baby, on 1023 live births between 2000 and 2001 in a private hospital in Onitsha, Anambra State, were extracted from the hospital’s record. The data were analyzed using multiple regression method, Chi-square and odds ratio. Mean birth weight is 3.24 kg and standard deviation is 0.479. Males significantly weigh more than females. Mean male low birth weight and mean female low birth weight are not significantly different (p > 0.01). So also it is with mean male high birth weight and mean female high birth weight. Mean male normal birth weight is significantly higher than mean female normal birth weight (p = 0.000). This suggests that the factor responsible for the difference in mean male and mean female birth weights must be acting only within the level of normal birth weight. Level of Low Birth Weight is 3.91% and that of high birth weight is 8.50%. Birth weight significantly depends on parity, gestational age and sex of baby, p = 0.000, but not on maternal age, p > 0.01. The proposed model is birthweight ( ) = 0.319 + 0.002(maternal age) + 0.045(parity) + 0.010(gestation age)
- 0.107(sex of baby). The model is adequate. F value is 31.957, p = 0.000. Mothers in their first pregnancies and preterm labours should be handled in medical facilities with trained personnel and adequate equipments to handle low birth weight babies. High birth weight may be an emerging important issue and healthcare providers may well start being aware of it.
1.0 STATEMENT OF THE PROBLEM
More than 20 million infants worldwide representing 15.5% of all births are born with low birth weight, 95.6% of them in developing countries (United Nations Children Fund, 2008). Low birth weight is of public health concern because of the increased morbidity associated with it. The level of low birth weight in developing countries is 16.5% and it is more than double the level in developed regions which is 7% (United Nations Children Fund and WHO, 2004).
The exact number of deliveries in Nigeria is not known. The percentage of low birth weight may not be known but the absolute figure is probably enormous. In developed countries such babies will be a burden on the government but in Nigeria and other developing countries, they are likely to be a permanent burden on the families. With the poor resource setting we have in Nigeria, such burden will worsen the economic fortunes of the poor families.
1.1 SIGNIFICANCE OF THE STUDY
In this era when medicine is emphasizing primary treatment (preventive medicine) epidemiology becomes a veritable tool. Epidemiology of low birth weight is the study of the phenomenon, factors that affect it and the use of the knowledge in managing the phenomenon. Some of the factors known in literature that affect birth weight are modifiable like the social and environmental factors. They can easily change. Some factors are not modifiable and may have statistical relationship with the birth weight as a dependent variable. Gestational age, parity, age of mother and sex of baby are non-modifiable factors. In-depth knowledge of these factors and their relationship with birth weight is necessary for Obstetricians, Pediatricians, Public Health Physicians and Health Policy makers to understand the epidemiology of low birth weight and reduce its prevalence and associated public health
consequences. Literature is scanty in Nigeria including Anambra State. No statistical model has been developed yet to address this issue. This study proposes to examine these factors namely parity, maternal age, gestational age of index pregnancy and sex of index baby and develop an exploratory model of these determinants of birth weight that may be useful in epidemiological studies.
1.2 SCOPE AND LIMITATIONS
Method of multiple regression will be used in model specification. All the 1023 life births obtained in a private hospital between 2000 and 2001 will be used in checking the adequacy of the proposed model. For financial and time constraints, the scope is limited to Nkpor, Onitsha and its environs which form the catchment area of the hospital from which data will be collected.
The general objective of the study is to do a statistical analysis of birth weight and of the independent variables that affect it. The specific objectives are:
1. To determine the association, if any, between birth weight and any of the following variables; parity, age of mother, sex of baby and gestational age.
2. To determine the relationship between parity and age of mother
3. To develop an exploratory model of birth weight with parity, maternal age, sex of baby and gestational age as its determinants.
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