A research dissertation submitted to Makerere university in partial fulfillment of the requirements for the award of master of obstetrics and Gynaecology

Abstract

Introduction: In Uganda, 12% of infants are born with low birth weight, 14% are born premature and the neonatal mortality has stagnated at 27deaths per 1000 live births. Despite its known increased risks of neonatal mortality, poor cognitive development, impaired immunity,and development of chronic medical conditions, there is scarcity of data on the burden of low birth weight in rural settings where access to health care is limited. This study aimed to determine the prevalence and factors associated with low birth weight among women aged 15-49 delivering at Kiwoko Hospital, a rural setting.Methods: We conducted a facility-based cross-sectional study among 429 eligible participants and used consecutive sampling. Outcome variable was low birth weight and independent variables included: socio-demographic, biological/reproductive, behavioral, and fetal characteristics. We summarized participant characteristics using descriptive statistics. We assessed the association between independent factors and occurrence of LBW using the generalized linear model with family (Poisson), link (log) reporting robust standard error to adjust for over inflated variances Results: The prevalence of low birth weight was 20.7% (95% confidence interval (CI) 17.1-24.9%. Factors associated with LBW were mother’s height (Prevalence ratio: (PR) 0.983 CI 0.976, 0.987 p<0.001), mother's parity (PR: 0.890 CI 0.810, 0.978 p=0.016), number of babies delivered (PR: 3.037 CI 1.798, 4.505 p<0.001), gestational age greater than 37 weeks (PR: 0.101 CI 0.095, 0.224 p<0.001), ANC 1 to 3 visits (PR: 0.630 CI 0.428, 0.976 p=0.038) and > 4 visits (PR 0.463 CI 0.307 0.733 p=0.001) and monthly income of 50,000-150,000 (PR: 0.6470CI 0.428, 0.976 p=0.038) and more than 150,000 (PR: 0.475 CI 0.307, 0.733 p=0.001). Conclusion: For every 10 mothers who delivered from Kiwoko Hospital, two mothers gave birth to LBW babies. Factors associated with LBW included parity, height, gestational age, monthly income and ANC attendance. Recommendations: During ANC visits, HW should identify mothers with multiple pregnancies and educate them about the heightened risk of LBW. Mothers should be encouraged to start ANC early and also have a meaningful employment to earn a living to reduce the prevalence of LBW