Factors Associated with Lowbirth Weight Babies Delivered in Selected Hospitals in Freetown, Sierra Leone 2019-2020

Abstract

Background: Each year, 15% to 20% of all deliveries are Low Birth Weight (LBW) representing about 20 million babies with 96.5% of these occurring in developing countries. About 60-80% of low birth deliveries contribute to neonatal deaths. For the past few years, the prevalence of LBW in Sierra Leone has not been stable with the Western Area Urban (WAU) district recording about 17.5% prevalence of LBW which is more than the national average of 7%.This study identified factors associated with low birth weight (LBW) babies delivered in five referral hospitals in the WAU district (Freetown), Sierra Leone. Methods: A hospital-based an unmatched 1:2 case-control study was conducted among 438 mothers (146 cases and 292 controls) who delivered singleton live babies from November 2019 to February 2020 in five referral hospitals, WAU district. The hospitals were purposively selected and for each case, two subsequent controls were enrolled in the study. The independent variables where categorised as socio-demographic, obstetric, maternal health/life style factors and the outcome variable is LBW. Mothers’ antenatal cards (ANC) were reviewed and a pre-tested semi-structured questionnaire was administered to the mothers by trained research assistants. Data were entered using SPSS version 22 and analyzed using Stata 15 (Stata Corp, College Station, TX, USA).The association between the independent variables and the outcome variable was estimated using simple and multiple logistic regression analyses at p-value <0.05 and 95% confidence interval. Results: The mean birth weight was 1.9 kilograms ± SD 0.43 for cases and 3.2 kilograms ± SD 0.41 for controls while the pregnant mothers mean age was 24.2 years ± SD 5.80 for cases and 26.1 years ± SD 5.46 for controls. In the multiple logistic regression analysis, risk factors which influenced the delivery of LBW baby included: unemployment (aOR = 2.70, 95% CI 1.22 - 5.99, P = 0.014), being a student (aOR = 2.89, 95% CI 1.00 - 8.31, P = 0.048), anaemia (aOR = 3.54, 95% CI 1.70 - 7.38, P = 0.001), less than two years interpregnancy interval (aOR = 2.64, 95% CI 1.15 - 6.05, P = 0.021), cigarette smoking during pregnancy (aOR = 4.2, 95% CI 1.84 - 9.59, P = 0.001) and taking herbal medicine during pregnancy (aOR = 2.11, 95% CI 1.06 - 4.18, P = 0.033). Conclusion: This study revealed that the potential risk factors for LBW babies among mothers in Sierra Leone include unemployment, being a student, anaemia, less than two years interpregnancy interval, cigarette smoking during pregnancy and taking herbal medicine during pregnancy. Health facility specialists should screen and sensitize mothers on the risk factors of LBW during antenatal sessions.