Multiple births and low birth weight: Evidence from South Korea

Author(s):  
Hyunkuk Cho ◽  
Yong Woo Lee
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Duah Dwomoh

Abstract Background Ghana did not meet the Millennium Development Goal 4 of reducing child mortality by two-thirds and may not meet SDG (2030). There is a need to direct scarce resources to mitigate the impact of the most important risk factors influencing high neonatal deaths. This study applied both spatial and non-spatial regression models to explore the differential impact of environmental, maternal, and child associated risk factors on neonatal deaths in Ghana. Methods The study relied on data from the Ghana Demographic and Health Surveys (GDHS) and the Ghana Maternal Health Survey (GMHS) conducted between 1998 and 2017 among 49,908 women of reproductive age and 31,367 children under five (GDHS-1998 = 3298, GDHS-2003 = 3844, GDHS-2008 = 2992, GDHS-2014 = 5884, GMHS-2017 = 15,349). Spatial Autoregressive Models that account for spatial autocorrelation in the data at the cluster-level and non-spatial statistical models with appropriate sampling weight adjustment were used to study factors associated with neonatal deaths, and a p-value less than 0.05 was considered statistically significant. Results Population density, multiple births, smaller household sizes, high parity, and low birth weight significantly increased the risk of neonatal deaths over the years. Among mothers who had multiple births, the risk of having neonatal deaths was approximately four times as high as the risk of neonatal deaths among mothers who had only single birth [aRR = 3.42, 95% CI: 1.63–7.17, p < 0.05]. Neonates who were perceived by their mothers to be small were at a higher risk of neonatal death compared to very large neonates [aRR = 2.08, 95% CI: 1.19–3.63, p < 0.05]. A unit increase in the number of children born to a woman of reproductive age was associated with a 49% increased risk in neonatal deaths [aRR = 1.49, 95% CI: 1.30–1.69, p < 0.05]. Conclusion Neonatal mortality in Ghana remains relatively high, and the factors that predisposed children to neonatal death were birth size that were perceived to be small, low birth weight, higher parity, and multiple births. Improving pregnant women’s nutritional patterns and providing special support to women who have multiple deliveries will reduce neonatal mortality in Ghana.


1999 ◽  
Vol 149 (12) ◽  
pp. 1128-1133 ◽  
Author(s):  
A. K. Daltveit ◽  
S. E. Vollset ◽  
R. Skjaerven ◽  
L. M. Irgens

2005 ◽  
Vol 58 (2) ◽  
pp. 380-380
Author(s):  
M Goldani ◽  
C Homrich ◽  
A Silva ◽  
H Bettiol ◽  
T Nava ◽  
...  

Author(s):  
Betty R. Vohr

Prematurity continues to be a major public health problem and, despite advances in antenatal care, prematurity rates continue to rise in the United States. Preterm and low-birth-weight (LBW) rates increased in 2006 to 12.8% and 8.3%, respectively. The very low birth weight (VLBW) (<1500 g) rate rose to 1.46% (62,283 of 4,265,996 births in 2006). In addition, the birth rate for women aged 40–44 years rose 3% to 9.4 per 1,000 between 2005 and 2006 (Martin et al. 2008). A component of the increase in the preterm birth rate remains attributed to older maternal childbearing, multiple births, and increasing rates of assisted reproductive technology (Heck et al. 1997). The increase in the number of multiple births is a concern because of the associated increased risk of death, preterm birth, low birth weight, and long-term adverse neurodevelopmental outcomes. Major therapeutic advances in perinatal and neonatal care in the past 20 years, including surfactant therapy, antenatal steroids for both pulmonary maturation and central nervous system protection, improved ventilation techniques, and parenteral nutritional support have resulted in a significant improvement in survival of extremely low-birth-weight infants (ELBW) (<1000 g) (National Institutes of Health [NIH] 1995; El-Metwally, Vohr, and Tucker 2000; Fanaroff, Hack, and Walsh 2003; Fanaroff et al. 2007; Hintz et al. 2005a; Hintz et al. 2005b). These infants have increased complex neonatal medical morbidities affecting all organ systems including lungs, gastrointestinal tract, kidneys, and brain, and increased growth, neurological, developmental, and behavioral morbidities both in the neonatal intensive care unit (NICU) and after discharge (Blakely et al. 2005; Ehrenkranz, 2000; Ehrenkranz et al. 2005; Laptook et al. 2005; Shankaran et al. 2004; Schmidt et al. 2003; Vohr et al. 2003; Vohr et al. 2004;Vohr et al. 2005; Walsh et al. 2005). Predicting the survival and neurodevelopmental outcomes of preterm infants becomes a challenge since outcomes are dependent on a combination of biologic factors including gender, gestational age, birth weight, singleton versus multiple, neonatal morbidities, neonatal interventions, and post-discharge environment.


2005 ◽  
Vol 32 (2) ◽  
pp. 87-93 ◽  
Author(s):  
Beatrice Latal Hajnal ◽  
Charlotte Braun-Fahrländer ◽  
Kurt von Siebenthal ◽  
Hans U. Bucher ◽  
Remo H. Largo

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e046322
Author(s):  
Rornald Muhumuza Kananura

ObjectivesTo assess low birth weight’s (LBW) mediation role on the factors associated with newborn mortality (NM), including stillbirth and the role of institutional delivery in the association between LBW and NM.Design and participantsI used the 2011–2015 event histories health demographic data collected by Iganga-Mayuge Health Demographic and Surveillance Site (HDSS). The dataset consisted of 10 758 registered women whose birth occurred at least 22 weeks of the gestation period and records of newborns’ living status 28 days after delivery.SettingThe Iganga-Mayuge HDSS is in Eastern Uganda, which routinely collects health and demographic data from a registered population of at least 100 000 people.Outcome measureThe study’s key outcomes or endogenous factors were perinatal mortality (PM), late NM and LBW (mediating factor).ResultsThe factors that were directly associated with PM were LBW (OR=2.55, 95% CI 1.15 to 5.67)), maternal age of 30+ years (OR=1.68, 95% CI 1.21 to 2.33), rural residence (OR=1.38, 95% CI 1.02 to 1.85), mothers with previous experience of NM (OR=3.95, 95% CI 2.86 to 5.46) and mothers with no education level (OR=1.63, 95% CI 1.21 to 2.18). Multiple births and mother’s prior experience of NM were positively associated with NM at a later age. Institutional delivery had a modest inverse role in the association of LBW with PM. LBW mediated the association of PM with residence status, mothers’ previous NM experience, multiple births, adolescent mothers and mothers’ marital status. Of the total effect attributable to each of these factors, LBW mediated +25%, +22%, +100%, 25% and −38% of rural resident mothers, mothers with previous experience of newborn or pregnancy loss, multiple births, adolescent mothers and mothers with partners, respectively.ConclusionLBW mediated multiple factors in the NM pathways, and the effect of institutional delivery in reducing mortality among LBW newborns was insignificant. The findings demonstrate the need for a holistic life course approach that gears the health systems to tackle NM.


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