Study of the relationship of low birthweight with race and socioeconomic status at the Maternity Hospital, Kuala Lumpur, Malaysia: A case-control study.

Abstract

Low birthweight of newborns is a major determinant of perinatal survival as well as postnatal morbidity. It represents major public health problem and is of great economic concern in developing countries. This study investigated the impact of four groups of risk factors: genetic and constitutional factors, namely infant sex, ethnic origin, maternal height and maternal pre-pregnancy weight; demographic/psychosocial and nutritional factors related to the mother, namely maternal age prior to pregnancy, maternal education, occupation, total family income, total gestational weight gain, use of iron and/ or vitamin supplements and haemoglobin level; obstetric factors such as parity, interpregnancy interval, gestational age of previous birth, prior spontaneous abortion, prior stillbirth, prior child death and period of gestation at delivery; and antenatal care (i.e number of antenatal care visits). To identify and quantify risk factors for low birthweight I conducted a hospital-based case-control study at the Kuala Lumpur Maternity Hospital, Malaysia. The case-control study of 295 low birthweights and 590 controls showed that Indian ethnic origin, previous premature birth, low maternal pre-pregnancy weight (46-50 kg), brief use of iron and/or vitamin supplements (2-4 weeks) and prematurity were significant independent risk factors for low birthweight. The results of this study showed that low maternal pre-pregnancy weight, premature birth, poor quality of antenatal care are important and potentially modifiable risk factors. Hence the results suggest that nutritional and health intervention programmes (i.e improvement in nutritional status and antenatal care) can reduce the incidence of low birthweight.