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European Journal of Applied Sciences – Vol. 12, No. 5

Publication Date: October 25, 2024

DOI:10.14738/aivp.125.17535.

Kabanga, A. K. & Islam, M. S. (2024). Low Birth Weight Associated with Maternal Age, Number of Delivery and Birth Spacing: A

Study in the Uvira Town in Democratic Republic of Congo. European Journal of Applied Sciences, Vol - 12(5). 28-42.

Services for Science and Education – United Kingdom

Low Birth Weight Associated with Maternal Age, Number of

Delivery and Birth Spacing: A Study in the Uvira Town in

Democratic Republic of Congo

Alexandre Kabanga wa Kabanga

Public health, Atlantic International University,

Pioneer Plaza, 900 Fort Street Mall 905, Honolulu, Hawaii 96813, USA

Mohammad Shahidul Islam

School of Science and Engineering, Atlantic International University,

Pioneer Plaza, 900 Fort Street Mall 905, Honolulu, Hawaii 96813, USA

ABSTRACT

The Uvira health zone has never benefited from a study on low birth weight, while

the neonatal mortality rate remains high. Low birth weight is an important public

health indicator because of the strong association between birth weight and infant

morbidity and mortality. This is a cross-sectional, retrospective study conducted

over a ten-month period, from June 2021 to March 2022. In order to achieve a

representative study of the city of Uvira, we identified 6 maternity hospitals

willing to supply data from their facilities during the study. These spread over the

3 communes of the city of Uvira with 2 most frequented maternity hospitals per

commune. We selected births from the delivery registers of six health facilities in

the city between June 2021 and March 2022 (n=802). We estimated the frequency

of newborns with a birth weight of less than 2500 gram, explained the trends and

also checked whether early maternal age, increased number of birth and reduced

birth spacing interval increased the risk of low birth weight. We describe for the

first-time data on low birth weight in the city of Uvira. A total of 21.1% of 802

births were associated with low birth weight. A strong correlation between low

birth weight and early maternal age (r=0.02, CI=95%, P-value=0.00000), high

number of delivery (r=0.003, CI=95%, P-value=0.000001) and reduced birth

spacing interval (r=0.02, CI=95%, P-value=0.000809) were noted. It is important

to conduct further studies to establish the cause-effect relationship for other

determinants with a view to specific interventions to reduce perinatal morbidity

and mortality.

Keywords: survey, low birth weight, maternal age, parity and intergenesic space.

List of Symbols: SIDS: Sudden Infant Death Syndrome, UNICEF: United Nations

Children's Fund, LBW: Low Birth Weight, CEPAC: communauté des églises de pentecote

en afriquecentrale Community of Pentecostal Churches in Central Africa, CPN:

Consultation Prénatale, CDC: Centers for Disease Control and Prevention control, r:

Correlation coefficient, P: P-value, WHO: World Health Organization, HGR: Hôpital

Général de Référence (General Reference Hospital), DHS: Demographic and Health

Survey.

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Kabanga, A. K. & Islam, M. S. (2024). Low Birth Weight Associated with Maternal Age, Number of Delivery and Birth Spacing: A Study in the Uvira

Town in Democratic Republic of Congo. European Journal of Applied Sciences, Vol - 12(5). 28-42.

URL: http://dx.doi.org/10.14738/aivp.125.17535

INTRODUCTION

Low birth weight is described by the World Health Organization as an infant birth weight of

2499 gram or less, regardless of gestational age. Birth weight is considered one of the most

important health indicators in both industrialized and developing countries. It is a major

determinant of perinatal morbidity and mortality, and represents a real public health problem

in developing countries. It is also one of the main factors in the normal growth and

development, and even survival, of newborns and infants. Low-birth weight children are more

vulnerable to the impact of environmental and social conditions (Valero et al. 2004, Jarvelin et

al. 1997, Singh et al. 2009). These children run a higher risk of developing sudden infant death

syndrome (SIDS), diabetes, hypertension, heart disease, asthma, hearing problems and

blindness, ... (THE PULMONARY ASSOCIATION, 2012)

Until recently, policymakers and healthcare professionals in developing countries have

neglected newborn care, despite the fact that 70% of infant deaths occur within the first

month of life. The principles of essential newborn care are simple, and include "early

treatment of low-birth-weight infants". Putting this principle into practice does not require

expensive high-technical equipment (Costello, et al., 2000).

According to UNICEF estimates, around 15.5% of all births worldwide, or more than 20

million children, are born with LBW (Wardlaw et al. 2004). The prevalence of LBW varies

between developed (5-7%) and developing countries (19%). In sub-Saharan Africa, the LBW

rate was around 15.0% (Valero De B J et al. 2004). In the Democratic Republic of Congo, a

study carried out in the Katanga province at the Bumi health center recorded a low birth

weight frequency of 14.3%. LBW is a relatively frequent complication of pregnancy in African

women, with incidence rates ranging from 8.3% to 18.1% (Tel-T et al. 1995).

The determinants of LBW are: advanced maternal age, number of deliveries including the too

early delivery, reduced birth spacing, chronic maternal illness, nutritional status, lifestyle such

as smoking, drug use and physical activity, race and ethnicity. Addressing the factors

associated with low birth weight could reduce the risk of infant morbidity and mortality.

Locally, the town of Uvira in the Uvira health zone has never benefited from a study on low

birth weight, while the neonatal mortality rate remains high. The prevalence and

determinants of low birth weight have not yet been clearly established. That’s way the

present study was carried out, with a view to estimate the frequency of LBW, explaining its

trends, and ascertaining whether maternal age, number of delivery and birth spacing would

be associated with low birth weight.

PROBLEM DESCRIPTIONS

In the researth area, there are no statistics on low birth weight in the area and we note that

efforts have been made to significantly reduce maternal mortality rates, while neonatal and

perinatal mortality rates are increasing. This is the first observational study of the population

in the town of Uvira in the Uvira health zone, and the only one in the province of South Kivu

that describe the situation of low birth weight and establish the causal relationship between

low birth weight and maternal age, number of delivery and birth spacing. This study focuses

on low birth weight as a major factor in neonatal morbidity and mortality and above all as one

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European Journal of Applied Sciences (EJAS) Vol. 12, Issue 5, October-2024

of the main factors in the normal growth and development, and even survival, of newborns

and infants.

OBJECTIVE OF RESEARCH

1. Produce the first statistics on this subject in the town of Uvira.

2. Establish causality between LBW and maternal age, high number of births and reduced

birth spacing.

3. Challenge the health authorities to look for additional specific determinants in the

town.

4. The information generated by this study will enable advocacy aimed at improving

maternal health during pregnancy in this area.

MATERIALS AND METHODS

This study was conducted in the town of Uvira in the Uvira health zone over the period from

06/2021 to 03/2022. Five health facilities in the town of Uvira, including the “Kabimba health

center”, the “Saint Luc medical center on Uvira”, the “Saint Paul health center”, the “Uvira

general referral hospital” and the “8th Cepac hospital”, were identified for data collection for

this study. These health facilities were targeted on the basis of their rate of attendance by

pregnant women for antenatal consultations and by the maternity unit for deliveries during

the study period.

Figure 1: Distribution of records consulted by health facilities providing study data, from

06/2021 to 03/2022 in the town of Uvira.

Study Population

This study targets women who have given birth at the maternity hospital and their new borns,

and who have attended prenatal consultation sessions. Newborns aged between 37- and 42-

weeks’ amenorrhea, born vaginally, alive, with an Apgar score at 5 minutes greater than 7,

born in a monofetal pregnancy, were included in the study.

Study Data Collection

Data were collected by consulting delivery registers and reading women's antenatal

consultation diaries at the time of recruitment. The delivery register collected information on

each birth and on each newborn (mother's age, number of births, date of last menstrual