Nepal Development Society, Bharatpur, Chitwan, Nepal.
Menzies School of Health Research, Charles Darwin University, Alice Springs, Australia.
BMC Pregnancy Childbirth. 2024 Sep 20;24(1):612. doi: 10.1186/s12884-024-06807-2.
The prevalence of low birth weight (LBW) has stagnated at approximately 12% for the past 15 years in Nepal, significantly impacting newborn survival. While antenatal care (ANC) visits and iron-folic acid supplementation are recognised as important interventions to reduce LBW, there is a lack of evidence regarding their combined effect. This study aimed to explore the potential synergistic impact of ANC and iron-folic acid supplementation on LBW in Nepal by analyzing data from two national surveys.
The nationally representative Nepal Demographic and Health Surveys of 2016 and 2022 were used, and the pooled dataset was analysed. Birth weight and the prevalence of LBW (i.e. birthweight < 2500 g) were reported using descriptive statistics. The associations among LBW, ANC visits, and iron-folic acid supplementation were examined using logistic regression analyses.
The mean birth weight was 3011 g, with an LBW prevalence of 11.2%. Not attending ANC (Adjusted Odds Ratio (AOR): 1.49; 95% Confidence Interval (CI): 1.14, 1.95) and not consuming iron-folic acid supplements (AOR: 1.43; 95% CI: 1.11, 1.84) were independently associated with a higher likelihood of having LBW. Furthermore, when considering both factors together, mothers who attended less than four ANC visits and consumed iron-folic acid for ≤ 90 days had the higher likelihood of having LBW (AOR: 1.99; 95% CI: 1.35, 2.60) compared to those who did not.
This study highlights that the individual and joint influence of ANC visits and iron-folic acid supplementation on having LBW. These findings underscore the significance of ANC attendance and iron-folic acid supplementation in preventing LBW. Traditionally, these two interventions were primarily considered as maternal survival strategies. However, our findings indicate that these existing interventions could be utilised further for both maternal and newborn survival. Given that these services are offered free of cost and are available near people's homes through the National Safe Motherhood Programme in Nepal, efforts to increase the uptake of these services should be strengthened while emphasising their role in preventing LBW.
过去 15 年来，尼泊尔的低出生体重（LBW）患病率一直稳定在 12%左右，这对新生儿的生存产生了重大影响。尽管产前保健（ANC）就诊和铁叶酸补充被认为是降低 LBW 的重要干预措施，但关于它们联合作用的证据有限。本研究旨在通过分析来自两项全国性调查的数据，探讨尼泊尔 ANC 和铁叶酸补充联合对 LBW 的潜在协同影响。
使用了具有代表性的 2016 年和 2022 年尼泊尔人口与健康调查的数据，并对汇总数据集进行了分析。使用描述性统计报告了出生体重和 LBW（即出生体重<2500 克）的患病率。使用逻辑回归分析检验了 LBW、ANC 就诊和铁叶酸补充之间的关联。
平均出生体重为 3011 克，LBW 患病率为 11.2%。未参加 ANC（调整后的优势比（AOR）：1.49；95%置信区间（CI）：1.14，1.95）和未服用铁叶酸补充剂（AOR：1.43；95%CI：1.11，1.84）与 LBW 的可能性增加独立相关。此外，当同时考虑这两个因素时，与未接受 ANC 就诊少于 4 次且服用铁叶酸少于 90 天的母亲相比，接受 ANC 就诊少于 4 次且服用铁叶酸少于 90 天的母亲更有可能出现 LBW（AOR：1.99；95%CI：1.35，2.60）。
本研究强调了 ANC 就诊和铁叶酸补充对 LBW 的单独和联合影响。这些发现突显了 ANC 就诊和铁叶酸补充在预防 LBW 中的重要性。传统上，这两种干预措施主要被视为母婴生存策略。然而，我们的研究结果表明，这些现有的干预措施可以进一步用于母婴生存。鉴于这些服务是免费提供的，并且可以通过尼泊尔国家安全孕产方案在人们家门口获得，应该加强努力提高这些服务的利用率，同时强调它们在预防 LBW 中的作用。
