Factors Associated with Low Birth Weight among Neonates Born at Thika Level 5 Hospital in Kiambu County, Kenya

Abstract

Low birth weight is a public health concern and one of the strongest single risk factors for early neonatal mortality and morbidity. Neonates with low birth weight (<2500g) have a >20 times greater risk of dying than neonates with a birth weight of >2500g. Global neonatal mortality rate is 17 deaths per 1,000 live births. In 2018, about 22 million newborns (16%) had low birth weight globally. Approximately 97% of LBW occurs in low-and-middle-income countries among the vulnerable populations. South Asia has the highest prevalence of LBW of 28%, followed by Sub-Saharan Africa at 13%, Latin America and the Caribbean at 9%, and 6% in East Asia and the Pacific. Kenya’s low birth weight prevalence stands at 11.5%. The main objective of this study was to assess factors associated with low birth weight among neonates born at Thika Level 5 Hospital, Kiambu County, Kenya. This research sought to determine the prevalence of low birth weight at Thika Level 5 Hospital; establish maternal health factors associated with low birth weight among neonates born at Thika Level 5 Hospital; and determine health facility factors associated with low birth weight at Thika Level 5 Hospital. The target group was mothers who delivered at Thika Level 5 Hospital from July 2020 to August, 2020. Cross sectional mixed methods design was employed. Thika Level 5 Hospital was purposively sampled because of its high prevalence of low birth weight. Quantitative and qualitative studies were conducted. Census (consecutive) sampling was used for the quantitative study while purposive sampling was used for the qualitative study. Data collection tools included an interviewer administered questionnaire, Focus Group Discussion and Key Informant guides. delivery records, check list, and MCH cards. Sample size was determined using Cochran formula. The calculated desired sample size was 210 which was adjusted to 215. Pre-test of the study was done at Machakos Level 5 Hospital. Data was analyzed using Stata statistical software version. Logistic Regression statistical test and logistic regression models were used. The measures of association were reported with a 95% confidence interval. Qualitative data was analyzed using a transcription developed protocol thematic analysis by NVivo version 14. The results indicated that the occurrence rate of low birth weight was 34.88%. This was further classified as: low birth weight (14.00%); very low birth weight (18.60%); and extremely low birth weight (1.40%). Mothers with ≥35 years (OR=13.666, p =0.018) were likely to have low birth weight babies. The second born child (OR=2.981, p =0.025) was at risk of being low birth weight. Meru mothers were likely to bear low birth weight babies. Secondary education (OR=0.350, p =0.048) was a protection against low birth weight. Hypertension (OR=3.393, p=0.038) was a risk of low birth weight. Antenatal clinic (ANC) attendance (OR=0.0683, p=0.037) was a protection against extremely low birth weight. Malaria (OR=51.25, p=0.005) was a risk for extremely low birth weight. Accessibility to a health facility (OR=0.403, p=0.004) offers protection against overall low birth weight and (OR=0.446, p=0.041) very low birth weight.The findings of this research will help to set up an appropriate interventional measures for maternal and infant health; set appropriate strategies to implement ANC and malaria policies; formulation of policies on improvement of health facility accessibility and promotion of health education among women. The findings of this research will also add knew knowledge and provide an opportunity for further research on LBW.