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Background: Low birth weight is not only an indicator of neonatal mortality and morbidity but also a
morbidity risk in later life. Antenatal care is one of the evidence based interventions to decrease the
probability of adverse birth outcomes such as low birth weight and preterm births. The effectiveness of
antenatal care, however, relies on the quality of care and specific contents provided during each antenatal
care visits. But, little information is available whether antenatal care contents and perceived quality are
linked with weight at birth. Therefore, this study is aimed to assess the link between contents and
perceived quality of antenatal care with low birth weight among term neonates in selected health facilities
of Bahir Dar, North west Ethiopia.
Methods: Facility based unmatched case control study was conducted among mother-newborn pairs in
Bahir Dar special zone selected public health facilities. One referral hospital and four public health
centers were selected for this study. The health centers were selected by random sampling technique
whereas the referral hospital was selected without undergoing further sampling procedures (as it is the
only public hospital in the study area). The sample size was calculated by using EPI info version 7.0 by
considering ratio of control to case 2:1, power of 80%, confidence level of 95%, precision level of 5%,
odd ratio of 2.014 and percentage of control exposed 21.39. Cases were selected consecutively where as
two controls were assigned for each cases. Data was entered by using Epidata version 3.1 and then
exported to statistical package for social science version 21 for analysis. Bi variant analysis was done to
compare birth weight by each explanatory variable using binomial logistic regression. The adjusted odd
ratio was used to determine strength of the association and the corresponding confidence interval was
used to decide whether there was a statistical significant between the explanatory and outcome variables.
Result: Among the contents of antenatal care, dietary advice AOR 2.29(CI 1.03-5.11) and iron intake of
≥30 days AOR 2.93(CI 1.34-6.42) were significantly associated with low birth weight at term. However,
no significant association was observed between antenatal care level of satisfaction and low birth weight
at term. Additionally, wealth, household food insecurity, number of ANC<4 and poor nutritional status of
the mothers were significantly associated with low birth weight at term.
Conclusion and recommendation: In this study setup, the risk of LBW at term was significantly
associated with lack of antenatal care contents such as dietary advice and iron intake. It was also
associated with other modifiable risk factors such as household food insecurity, wealth and nutritional
status. Therefore, public health interventions targeting on antenatal dietary advice and iron intake
preferably ≥ 30 days by giving special emphasis for poor and food in secured women during pregnancy is
recommended to reduce LBW at term in this study setup. |
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