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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