Abstract
ASSESSMENT OF DELIVERY OUTCOMES AND FACTORS ASSOCIATED WITH LOW BIRTH WEIGHT FOLLOWING THE INTRODUCTION OF SP-IPTP AS PART OF FOCUSED ANTENATAL CARE IN THE HOHOE MUNICIPALITY, GHANA

Margaret Kweku, Michael Ofori, Wisdom Takramah, Wisdom Kudzo Axame, Phyllis Atta Parbey, Richard Owusu, Elvis Tarkang* and Martin Adjuik

ABSTRACT

Background: Intermittent Preventive Treatment with Sulphadoxine-Pyrimethamine (SP-IPTp) is a key component of malaria control in pregnancy. This study assessed delivery outcomes and factors associated with low birth weight (LBW) following the introduction SP-IPTp. Methods: A cross-sectional study carried out from March 2015 to February 2017 involving paucigravid women who delivered at the Hohoe Municipal Hospital. A semi-structured questionnaire was used to collect data on socio-demographic characteristics, obstetrics and medical history. Information on medical conditions and delivery outcomes were extracted from the antenatal care (ANC) book. Chi-square test and logistic regression were used to determine the association between dependent and independent variables. Results: Of the 1208 women, 90(7.5%) had babies with LBW, with 12.1% among primigravidae and 6.2% among multigravidae (χ2=10.53, p=0.001). The prevalence of LBW babies was also higher among women who took < 2 doses of SP-IPTp than those who took ≥ 2 doses (11.5% vs. 5.6%) (χ2=13.26, p<0.001). Prevalence of neonatal or stillbirths was 63(5.2%) and this was significantly associated with LBW (χ2 =4.50, p=0.034). Women aged 30-39 years, those with parity 4-6 children, those who visited ANC 5-6 times and those who slept inside LLIN were 77%, 83%, 65% and 51% less likely to have babies with LBW (AOR=0.33, p=0.028), (AOR=0.17, p=0.033), (AOR=0.35, p=0.050) and (AOR=0.49, p=0.021) respectively. Women with hypertension were 3.74 times more likely to have LBW babies (AOR=3.74, p<0.001). Conclusion: Prevalence of LBW babies was relatively low as compared to other parts of Ghana. This is probably due to increased number of ANC visits, intake of high doses of SP-IPTp and high LLIN utilisation. Primigravidity, parity and hypertension are risk factors for LBW; and LBW is a risk factor for neonatal death or stillbirth. Implementation of control measures for malaria in pregnancy has reduced the prevalence of LBW babies in the Hohoe Municipality.

Keywords: Low birth weight, Focused ANC, Neonatal/stillbirth, SP-IPTp, LLIN, Paucigravid women, Hohoe Municipality, Ghana.


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