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Risk factors of Intrauterine growth retardation: A study in a tertiary hospital of Nepal. Utsav Timalsina , 4 th year Medical Student, Institute of Medicine, Kathmandu, Nepal. Timalsina U, Sharma S, Giri S, Basyal B, Bhandari S, Neupane M. Introduction.
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Risk factors of Intrauterine growth retardation:A study in a tertiary hospital of Nepal UtsavTimalsina, 4th year Medical Student, Institute of Medicine, Kathmandu, Nepal Timalsina U, Sharma S, Giri S, Basyal B, Bhandari S, Neupane M
Introduction Birth weight is an important determinant of an infant’s survival andfuture development. Low Birth Weight (LBW), defined as a weight of less than 2500g atbirth regardless of gestational age. Globally, LBW contributes to 40-60% of newborn mortality. In Nepal, there is high prevalence (11.9 -32%) of LBW.
Research question What are the major factors associated with low birth weight term babies?
Conceptual framework Low Birth Weight • Maternal related factors • Anemia in pregnancy • Maternal weight gain during gestation • Hard physical work • BMI (Height and Weight) • Hypertension • Smoking and alcoholism • Mother related factors • Age of mother at child birth • Smoking and alcoholism • Education of mother • Mother’s occupation • Earning status • Gravida • Parity • Birth spacing • History of abortion • ANC status • Socio-economic • Family type • Family size • Economic status • Caste group • Residence • Food security • Sex determination • Sex of the child
Materials and Methods Case-control study in TribhuvanUniversityHospital, Nepal. • Preterm babies, new born with congenital diseases and twin delivery were excluded. • Powered to detect an odds ratio of 1.8 at two sided significance level of 0.05 and 80%power.
Materials and Methods Mothers were interviewed by medical students with pretested structured questionnaires in Nepali. Informed consent was taken and medical records were observed. Questionnaire were drafted reviewing related articles and standards. Non-stretchable measuring tape and weighing scale were used. Analyses were done using SPSS (version 14) using appropriate tests.
Result Characteristics of the mothers with LBW
Result These factors were not associated with the delivery of LBW babies: History of previous abortions; place of residence rural or urban Education level and occupation of mother or father Cooking food during pregnanacy and type of food consumed during prgnancy Family type and number of family members Number of antenatal check-ups and maternal hemoglobin level (<10 vs >=10gm/dl)
Conclusion The major factors associated with LBW in term babies are: History of previous premature delivery Delivery by a caesarean section Maternal age less than 22yrs
Discussion The independent risk factors of giving birth to low birth weight babies in Nepal are: Babies born of pregnant mothers of less than 22 yearsage History of previous premature delivery Delivery by a caesarean section The limitations of study are: sample population may not be the representative of typical community where the LBW is biggest It precludes the home delivered LBW infants Preterm babies and those with congenital anomalies were not considered
Future prospective A large number of infants’ death can be averted by addressing LBW and associated preventable factors. The study will provide further impetus in the attainment of MDG 4(Millennium Development Goal) goal.
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