Role of antenatal care and iron supplementation during pregnancy in preventing low birth weight in Nepal: comparison of national surveys 2006 and 2011
Categorie(s):
Health
Author(s):
Vishnu Khanal(1,2)*, Yun Zhao(2) and Kay Sauer(2)
Keyword(s):
Antenatal care, Iron supplementation, Low birth weight, Nepal
DOI:
Abstract :
Background: Low birth weight (LBW) is a major cause of neonatal deaths in developing countries including Nepal.
Its social determinants in Nepal have rarely been identified. This study aimed to identify the factors associated with
low birth weight among under-five children comparing data from the Nepal Demographic and Health Surveys
(NDHS) of 2006 and 2011.
Methods: Pooled data from the Nepal Demographic and Health Surveys (NDHS) of 2006 and 2011 were analysed
initially and the two survey data were then compared separately. The association between LBW and socio-demographic
and health related factors were analysed using multiple logistic regression analysis with a stepwise backward elimination
procedure. Complex Sample Analysis method was used to account for study design and sampling.
Results: A total of 2845 children, 923 children in 2006 and 1922 children in 2011, had their birth weight recorded. The
mean birth weight was 3024 (SD = 654.5) grams. A total of 12.1% (95% Confidence interval (CI); 10.6%-13.7%) children
had low birth weight (<2500 grams) at the time of birth. Attending antenatal care was found to be consistently
associated with low birth weight for the pooled survey data, and both 2006 and 2011 survey data, respectively. Not
attending antenatal care increased the odds of having a LBW infant by more than two times [OR 2.301; 95% CI
(1.526-3.471)]. Iron supplementation, which is an integral part of antenatal care in Nepal, was also significantly associated
with birth weight for combined and individual surveys. Mothers not consuming iron supplementation during their
pregnancy were more likely to have LBW infants [OR 1.839; 95% CI (1.282-2.363)]. Residing in the Far-western and Eastern
region were also significant risk factors for LBW in the pooled dataset and in 2011 survey.
Conclusions: The current study indicated there was no significant decrease in the LBW prevalence and there is a need
of targeted interventions aimed at decreasing the high rate of LBW through increasing antenatal care and consumption
of iron supplementation during pregnancy.