Small size at birth as a predictor of increased risk of childhood morbidity, mortality and malnutrition: Evidence from Bangladesh demographic and health survey
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Abstract
Background & Aim: Physical size or weight at birth of an infant is an important biomarker of current and future health and development of the infant. The aim of this study is to examine the effect of small size at birth – a proxy indicator of low birth weight - on childhood mortality, morbidity and malnutrition in Bangladesh.
Methods & Materials: The data for the study come from the 2014 Bangladesh Demographic and Health Survey. A total of 4,897 live births with information on size at birth as reported by their mothers were included in the analysis. Both descriptive and multivariate statistical techniques were used for data analysis
Results: One in every five live births (20%) was reported to be small in size in Bangladesh. Children born with small size at birth have some distinct characteristics than average size babies. Significantly higher incidence of malnutrition, mortality and morbidity were found among small size babies compared to average size babies. The multivariate analysis identified small size at birth as a significant predictor of childhood malnutrition, mortality and morbidity from diarrhea. Small size infants had 1.6 to 2.2 times higher risk of stunting, wasting or underweight, 1.6 times higher risk of diarrhea and 2.4 times higher risk of death during neonatal period than average size infants.
Conclusion: Health education to parents and special care for small size babies through trained health workers need to be undertaken for improving the health of small size babies. At the same time, appropriate policy should be taken to reduce the incidence of small size babies.
References
(1) World Health Organization (WHO). International statistical classification of diseases and related health problems, tenth revision, World Health Organization, Geneva: 1992.
(2) McCormick M. The contribution of low birth weight to infant mortality and childhood morbidity. New England J Medicine 1985;312:82–90.
(3) Kramer MS. Determinants of low birth weight: methodological assessment and meta-analysis. Bulletin of the World Health Organization 1987; 65:663–737.
(4) United Nations Children's Fund (UNICEF) and World Health Organization (WHO). Low Birthweight: Country, Regional and Global Estimates. New York: UNICEF and Geneva: WHO 2004.
(5) Kliegman RM, Rottman CJ and Behrman RE. (1990). Strategies for the prevention of low birthweight. American journal of Obstetrics and Gynecology, 1990; 162:1073–1083.
(6) Teune MJ, Bakhuizen S, Gyamfi Bannerman C, Opmeer BC, van Kaam AH, et al. A systematic review of severe morbidity in infants born late preterm. American Journal of Obstetrics and Gynecology 2011; 205:374 e371-379.
(7) Fanaroff AA, Stoll BJ, Wright LL, Carlo WA, Ehrenkranz RA, Stark AR, et al. Trends in neonatal morbidity and mortality for very low birthweight infants. Am J Obstet Gynecol 2007;196(2):147e1-8. 2007.
(8) McCall MG, Acheson ED. Respiratory disease in infancy. J Chronic Dis 1968;21:349-59.
(9) Barker DJP, Godfrey KM, Fall C, Osmond C, Winter PD, Shaheen SO. Relation of birth weight and childhood respiratory infection to adult lung function and death from chronic obstructive airways disease BMJ 1991;303: 671-674.
(10) Whitfield JM, Hendrikson H. Prevention of protein deprivation in the extremely low birth weight infant: a nutritional emergency. Proc (Bayl Univ Med Cent). 2006;19(3):229-231.
(11) Murray JLM, Lopez AD. Evidence based health policy: lessons from the global burden of diseases study. Science 1996;274:740-43.
(12) Lawn JE, Cousens S, Zupan J. 4 million neonatal deaths: When? Where? Why? The Lancet, 2005;365(9462), 891-900.
(13) UNICEF. UNICEF Data: Monitoring the Situation of Children and Women. New York 2015; Available from: http://www.data.unicef.org/ nutrition/low‑birthweight
(14) Arifeen SE, Blum LS, Hoque DME, Chowdhury EK, Khan R, Black RE, Victora CG, Bryce J. Integrated management of childhood illness (IMCI) in Bangladesh: Early findings from a cluster-randomised study. Lancet 2004; 364: 1595-602.
(15) Goodburn E, Chowdhury M, Gazi R. Low birth weight in rural Bangladesh. J Trop Pediatr 1994;40(2):123.
(16) Arifeen, 1997 Arifeen SE. Birth weight, intrauterine growth retardation and prematurity:
a prospective study of infant growth and survival in the slums of Dhaka, Bangladesh. Doctor of Public Health dissertation. Johns Hopkins University School of Hygiene and Public Health, Baltimore, 1997.
(17) Bangladesh Bureau of Statistics (BBS) and UNICEF. National Low Birth Weight Survey of Bangladesh, 2003-2004. Planning Division, Ministry of Planning: Dhaka, Bangladesh, 2005.
(18) National Institute of Population Research and Training (NIPORT), Mitra and Associates, and ICF International. Bangladesh Demographic and Health Survey 2014. Dhaka, Bangladesh, and Rockville, Maryland, USA, 2016.
(19) Moreno L, and Goldman N. An assessment of survey data on birth weight. Social Science and Medicine 1990;31(4):491–500.
(20) Boerma JT, Weinstein KI, Rutstein SO, Sommerfelt AE. Data on birth weight in developing countries: Can surveys help? Bulletin of the World Health Organization 1996; 74(2):209–216.
(21) Blanc A, & Wardlaw T. Monitoring low birth weight: An evaluation of international estimates and an updated estimation procedure. Bulletin of the World Health Organization 2005;83:178–185.
(22) Channon AAR. Can mothers Judge the size of their newborn? Assessing the determinants of a mother’s perception of a baby’s size at birth. Journal of Biosocial Science 2011;43:555-573.
(23) Islam MM. Can Maternal Recalled Birth Size be Used as a Proxy Measure of Birth Weight? An Evaluation Based on a Population Health Survey in Oman. Maternal and Child Health Journal 2014;18:1462–1470.
(24) Khanal V, Sauer K, Karkee R and Zhao Y. Factors associated with small size at birth in Nepal: further analysis of Nepal Demographic and Health Survey 2011. BMC Pregnancy and Childbirth 2014;14:14-32.
(25) UNICEF. Monitoring the Situation of Children and Women: Multiple Indicator ClusterSurvey Manual 2005. URL: http:www.childinfo.org/files/Multiple_Indicator Cluster_Survey_Manual_2005.pdf. New York, 2006.
(26) Mbuagbaw L and Gofin R. Can recall of birth size be used as a measure of birth weight in Cameroon? Paediatric and Perinatal Epidemiology 2010;24:383–389.
(27) Rutstein SO, Johnson K. The DHS Wealth Index. In: DHS Comparative Reports 6. Calverton, Maryland: ORC Macro, 2004.
(28) Khan JR, Islam, MM, Awan N, Muurlink O. Analysis of low birth weight and its co-variants in Bangladesh based on a sub-sample from nationally representative survey. BMC Pediatrics, 2018;18:100. https://doi.org/10.1186/s12887-018-1068-0
(29) Sreeramareddy CT, Ramakrishnareddy N, Kumar H, Sathian B, Arokiasamy J. Prevalence, distribution and correlates of tobacco smoking and chewing in Nepal: a secondary data analysis of Nepal demographic and health survey-2006. Substance Abuse Treatment, Prevention and Policy, 2011;6:33-41.
(30) Rahman A, Chowdhury S. Determinants of Chronic Malnutrition among Preschool Children in Bangladesh. J Biosoc Sci 2007;39(2):161-173
(31) Victora CG, Barros CF, Vaughan JP, Teixeira AM. Birthweight and infant mortality: a longitudinal study of 5,914 Brazilian children. Intern J Epidemiol. 1987;16:239-45.
(32) Arifeen et al., 2000; Arifeen SE, Black RE, Caulfield LE, Antelman G, Baqui AH, Nahar Q, Alamgir S, and Mahmud H. Infant growth patterns in the slums of Dhaka in relation to birth weight, intrauterine growth retardation, and prematurity. Am J Clin Nutr 2000;72:1010–7.
(33) Motta ME, Silva GA, Araújo OC, Lira PI, Lima MC. Does birth weight affect nutritional status at the end of first year of life? J Pediatr (Rio J) 2005;81:377‑82.
(34) Borah M, Baruah R. Morbidity status of low birth weight babies in rural areas of Assam: A prospective longitudinal study. Journal of Family Medicine and Primary Care 2015; 4:380-383.
(35) de Onis M, Blossner M, Villar J. Levels and patterns of intrauterine growth retardation in developing countries. Eur J Clin Nutr. 1998;52 (Suppl 1):S5-15.
(36) Mertens TE, Cousens SN, Feachem RG. Evidence of a prolonged association between low birthweight and paediätric diarrhoea in Sri Lanka [abstract]. Trans R Soc Trop Med Hyg 1987; 81:196.
(37) Ashworth A. Effects of intrauterine growth retardation on mortality and morbidity in infants and young children. European Journal of Clinical Nutrition 1998;52 (Suppl 1): S34-41.
(38) Brabin BJ, Premji Z, Verhoeff F. An analysis of anaemia and child mortality. The Journal of Nutrition 2001;131(2S-II):636S–648S.
(39) Gordon JE, Chitkara ID, Wyon JB. Weanling Diarrhoea. Am J Med Sci. 1963;245:345–377.
(40) Yasmin S, Osrin D, Paul E, Costello A. Neonatal mortality of low-birth-weight infants in Bangladesh. Bull World Health Organ 2002;79:608-14.
(41) Ullaha A, Barmana A, Haque J, Khanum M, Barid I. Birthweight and early neonatal health: Bangladesh perspective. Paediatric and Perinatal Epidemiology, 2009;23, 542–547.
(42) Islam MM. Increasing Incidence of Infants with Low Birth Weight in Oman, Sultan Qaboos University Medical Journal, 2015; 15(2): 177-183.
(43) Fauveau V, Wojtyniak B, Mostafa G, Sarder AM, Chakraborty J. Perinatal mortality in Matal, Bangladesh: a community-based study. International Journal of Epidemiology 1990; 19:606–612.
(44) Mercer A, Haseen F, Huq NL, Uddin N, Khan MH, Larson CP. Risk factors for neonatal mortality in rural areas of Bangladesh served by a large NGO programme. Health Policy Plan 2006;21:432-43.
(45) Chowdhury HR, Thompson S, Ali M, Alam N, Yunus M, Streatfield PK. Causes of Neonatal Deaths in a Rural Subdistrict of Bangladesh: Implications for Intervention. J Health Ppoul Nutr 2010;28(4):375-382.
(46) Lawn JE, Cousens S & Zupan J. Four million neonatal deaths: When? Where? Why? Lancet 2005;365: 891–900.
(47) Bryce J, Boschi-Pinto C, Shibuya K, Black RE. WHO Child Health Epidemiology Reference Group. WHO estimates of the causes of death in children. Lancet 2005;365:1147-52.
(48) Islam MM, Masud MS. 2018. Health care seeking behaviour during pregnancy, delivery and the postnatal period in Bangladesh: Assessing the compliance with WHO recommendations. Midwifery 2018; Accepted (in press). DOI: https://doi.org/10.1016/j.midw.2018.04.021
(49) Bang AT, Bang RA, Baitule SB, Reddy HM, Deshmukh MD. Management of birth asphyxia in home deliveries in rural Gadchiroli: the effect of two types of birth attendants and of resuscitating with mouth-to-mouth, tube-mask or bag-mask. J Perinatol 2005; 25(Suppl):S82-91.
(50) Wall SN, Lee AC, Niermeyer S, English M, Keenan WJ, Carlo W. et al. Neonatal resuscitation in low-resource settings: what, who, and how to overcome challenges to scale up? Int J Gynaecol Obstet 2009;107(Suppl 1):S47-62, S63-4.
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| Issue | Vol 4 No 2 (2018) | |
| Section | Original Article(s) | |
| Keywords | ||
| Size at birth Small size Low birth weight Mortality Morbidity Bangladesh | ||
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