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Determinants of low birth weight in the context of maternal nutrition education in urban informal settlements, Kenya

Published online by Cambridge University Press:  08 October 2018

C. K. Nyamasege*
Affiliation:
Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
E. W. Kimani-Murage
Affiliation:
African Population and Health Research Centre, Nairobi, Kenya Wellcome Trust, London, United Kingdom International Health Institute, Brown University, Providence, RI, USA College of Medical, Veterinary and Life Sciences, Wolfson Medical School Building, University of Glasgow, Glasgow, UK
M. Wanjohi
Affiliation:
African Population and Health Research Centre, Nairobi, Kenya
D. W. M. Kaindi
Affiliation:
Department of Food Science, Nutrition and Technology, University of Nairobi, Nairobi, Kenya
E. Ma
Affiliation:
Global Medical Science Center, Fukushima Medical University, Fukushima, Japan
M. Fukushige
Affiliation:
Department of Clinical Trials and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
Y. Wagatsuma
Affiliation:
Department of Clinical Trials and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
*
*Address for correspondence: C. K. Nyamasege, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan. E-mail nkemunto2030@gmail.com

Abstract

Inadequate knowledge in maternal nutrition is one of the determinants of low birth weight. However, little evidence is available on whether maternal nutrition counselling alone can influence birth weight among women from low socioeconomic households. This study assessed the effect of prenatal maternal nutritional counselling on birth weight and examined the related risk factors. A cluster randomized controlled trial was conducted to assess the effectiveness of home-based maternal nutritional counselling on nutritional outcomes, morbidity, breastfeeding, and infant feeding practices by the African Population and Health Research Center in two urban informal settlements of Nairobi. The intervention group received monthly antenatal and nutritional counselling from trained community health volunteers; meanwhile, the control group received routine antenatal care. A total of 1001 participants were included for analysis. Logistic regression was applied to determine associations between low birth weight and maternal characteristics. A higher prevalence of low birth weight was observed in the control group (6.7%) than in the intervention group (2.5%; P<0.001). Logistic regression identified significant associations between birth weight and intervention group (adjusted odds ratio (AOR)=0.26; 95% confidence interval (CI), 0.10–0.64); maternal height <154.5 cm (AOR=3.33; 95% CI, 1.01–10.96); last antenatal care visits at 1st or 2nd trimesters (AOR=9.48; 95% CI, 3.72–24.15); pre-term delivery (AOR=3.93; 95% CI, 1.93–7.98); maternal mid-upper arm circumference <23 cm (AOR=2.57; 95% CI, 1.15–5.78); and cesarean delivery (AOR=2.27; 95% CI, 1.04–4.94). Nutrition counselling during pregnancy reduced low birth weight and preterm births, which was determined by women of short stature, early stoppage of antenatal visit, and cesarean delivery.

Type
Original Article
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2018. 

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