Prevalence and Correlates of Low Birth Weight and Preterm Birth among Kenyan Women

Abstract

Background: Preterm birth is a major cause of infant morbidity and mortality, particularly in sub-Saharan Africa. We determined the prevalence and risk factors of preterm birth (PTB) and low birth weight (LBW) among mother-infant pairs attending 6-week immunization visits in Kenya. Methods: This analysis used data from a nationally representative cross-sectional survey of mother-infant pairs attending week 6 infant immunization visits conducted June-December 2013 at 120 maternal child health (MCH) clinics across Kenya. Facilities were selected using probability proportionate to size sampling. Singleton infants with the MCH booklet-verified infant birth weight were included in the analysis. Logistic regression models were used to determine potential correlates of PTB and LBW. All analyses were weighted to ensure representativeness and to account for the complex sampling design. Results: Overall, 656 mother-infant pairs out of 691 were included in this analysis (94.9% of all mother-infant pairs attending 6 week visits), of whom 55 (8.4%) were HIV-positive. The mean maternal age was 25 years (95% CI: 24.8-25.8) and mothers had a mean of 10 years (95% CI: 9.7-10.4) of education; 71.4% of women had annual household income ≤10,000 Ksh (US$ 97.85). The reported prevalence of PTB was 20.8% (14.8-28.5) and LBW was 3.7% (2.6-5.4). Prevalence of PTB and LBW were significantly higher among HIV-positive than HIV-negative mothers (LBW 9.8% vs. 3.2%, PTB 32.1%, p=0.005 vs. 19.8%, p=0.02 respectively). In multivariate analyses, maternal HIV infection was significantly associated with both PTB (aOR=2.7, 95% CI: 1.1-6.3, P=0.03) and LBW (aOR=1.9, 95% CI: 1.1-3.4, P=0.02) while household income ≤10,000 was a significant correlate of PTB (aOR=2.7, 95% CI: 1.4-5.0, P=0.002), and maternal weight was a significant correlate of LBW (aOR=0.9, 95% CI=0.9-0.9, P=0.03). Conclusion: Maternal sociodemographic, nutritional and HIV status were associated with the adverse birth outcomes. HIV prevention and management strategies and maternal nutritional supplementation in the perinatal period may be important interventions to reduce PTB and LBW.