Bezie Meklit Melaku, Tesema Getayeneh Antehunegn, Seifu Beminate Lemma
Department of Public Health, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia.
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences and comprehensive specialized hospital, University of Gondar, Gondar, Ethiopia.
Sci Rep. 2024 Apr 22;14(1):9210. doi: 10.1038/s41598-024-58517-6.
Birth weight significantly determines newborns immediate and future health. Globally, the incidence of both low birth weight (LBW) and macrosomia have increased dramatically including sub-Saharan African (SSA) countries. However, there is limited study on the magnitude and associated factors of birth weight in SSA. Thus, thus study investigated factors associated factors of birth weight in SSA using multilevel multinomial logistic regression analysis. The latest demographic and health survey (DHS) data of 36 sub-Saharan African (SSA) countries was used for this study. A total of a weighted sample of 207,548 live births for whom birth weight data were available were used. Multilevel multinomial logistic regression model was fitted to identify factors associated with birth weight. Variables with p-value < 0.2 in the bivariable analysis were considered for the multivariable analysis. In the multivariable multilevel multinomial logistic regression analysis, the adjusted Relative Risk Ratio (aRRR) with the 95% confidence interval (CI) was reported to declare the statistical significance and strength of association. The prevalence of LBW and macrosomia in SSA were 10.44% (95% CI 10.31%, 10.57%) and 8.33% (95% CI 8.21%, 8.45%), respectively. Maternal education level, household wealth status, age, and the number of pregnancies were among the individual-level variables associated with both LBW and macrosomia in the final multilevel multinomial logistic regression analysis. The community-level factors that had a significant association with both macrosomia and LBW were the place of residence and the sub-Saharan African region. The study found a significant association between LBW and distance to the health facility, while macrosomia had a significant association with parity, marital status, and desired pregnancy. In SSA, macrosomia and LBW were found to be major public health issues. Maternal education, household wealth status, age, place of residence, number of pregnancies, distance to the health facility, and parity were found to be significant factors of LBW and macrosomia in this study. Reducing the double burden (low birth weight and macrosomia) and its related short- and long-term effects, therefore, calls for improving mothers' socioeconomic status and expanding access to and availability of health care.
出生体重显著决定新生儿的即时和未来健康状况。在全球范围内，低出生体重（LBW）和巨大儿的发生率都急剧上升，包括撒哈拉以南非洲（SSA）国家。然而，关于SSA地区出生体重的幅度和相关因素的研究有限。因此，本研究使用多水平多项逻辑回归分析调查了SSA地区出生体重的相关因素。本研究使用了36个撒哈拉以南非洲（SSA）国家的最新人口与健康调查（DHS）数据。总共使用了一个加权样本，其中有207548例有出生体重数据的活产儿。拟合多水平多项逻辑回归模型以确定与出生体重相关的因素。双变量分析中p值<0.2的变量被纳入多变量分析。在多变量多水平多项逻辑回归分析中，报告了调整后的相对风险比（aRRR）及其95%置信区间（CI），以说明关联的统计学意义和强度。SSA地区低出生体重和巨大儿的患病率分别为10.44%（95%CI 10.31%，10.57%）和8.33%（95%CI 8.21%，8.45%）。在最终的多水平多项逻辑回归分析中，母亲教育水平、家庭财富状况、年龄和怀孕次数是与低出生体重和巨大儿都相关的个体水平变量。与巨大儿和低出生体重都有显著关联的社区水平因素是居住地和撒哈拉以南非洲地区。该研究发现低出生体重与到医疗机构的距离之间存在显著关联，而巨大儿与产次、婚姻状况和期望怀孕存在显著关联。在SSA地区，巨大儿和低出生体重被发现是主要的公共卫生问题。在本研究中，母亲教育、家庭财富状况、年龄、居住地、怀孕次数、到医疗机构的距离和产次被发现是低出生体重和巨大儿的重要因素。因此，减轻双重负担（低出生体重和巨大儿）及其相关的短期和长期影响，需要提高母亲的社会经济地位，并扩大医疗保健的可及性和可得性。
