Incidence of Low Birthweight in Central Nepal: A Community-Based Prospective Cohort Study
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BRIEF REPORT
Incidence of Low Birthweight in Central Nepal: A Community-Based Prospective Cohort Study Rajendra Karkee • Andy H. Lee • Colin W. Binns Vishnu Khanal • Paras K. Pokharel
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Ó Springer Science+Business Media New York 2014
Abstract Many deliveries in low income countries still take place at home and the newborns are often not weighed. This community-based study ascertained the incidence of low birthweight (LBW) and compared the birthweight between home- and facility-born neonates in central Nepal. A total of 701 pregnant women from the Kaski district were recruited and interviewed. Birthweights of newborns were measured by pan balance in health facility settings immediately after birth, or by local community health volunteers using colour-coded spring balance within 48 h of home birth. Household follow up of participants were undertaken less than 45 days after delivery to record the weight of their infants. Of the 639 postpartum women who took part in the follow up interview, information on birthweight was available from 605 singleton births. Among them, 65 (10.7 %) were born at home. Overall, the mean birthweight was 3,059 (SD 464) g and incidence of LBW was 16.5 % (95 % CI 13.5–19.5 %). However, the home-born infants reported significantly lower (p = 0.009) mean birthweight (2,920, SD 435 g) than their facility-born counterparts (3,078, SD 461 g). This difference in birthweight remained significant
R. Karkee P. K. Pokharel School of Public Health and Community Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal R. Karkee A. H. Lee (&) C. W. Binns Faculty of Health Sciences, School of Public Health, Curtin University, GPO Box U1987, Perth, WA 6845, Australia e-mail: [email protected] V. Khanal Sanjeevani College of Medical Sciences, Butwal, Rupandehi, Nepal
(p = 0.03) after adjustment for maternal and socio-demographic characteristics. Incidence of LBW in central Nepal was quite high. Home-born babies appeared to have lower birthweight and thus their inclusion could provide an accurate estimate of the LBW rate. Keywords Nepal
Birthweight Incidence Home delivery
Introduction Birthweight is an important indicator of neonatal survival and optimal child growth and development. Low birthweight (LBW) infants often experience severe health and developmental difficulties which have enormous costs on healthcare and the society [1, 2]. While neonatal deaths account for a high portion (31–98 %) of child mortality [3], the majority of neonatal deaths occur among LBW infants in developing countries [4]. There has been relatively little reduction in neonatal mortality rate when compared to child and maternal mortality rate over the past decade. In Nepal, neonatal mortality accounts for about two-thirds of child mortality [5] and poses a major challenge for the government to achieve the Millennium Development Goal 4. Many deliveries in low income countries still take place at home and the newborns are often not weighed. In Nepal, for example, 65 % of babies are born at home [6]. W
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