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Summary
Due to its impact on infant morbidity and mortality, and its effects on adult’s health, low birth weight (LBW) is a major issue in the public health sector. Burkina Faso, a Sahelian country land-locked in the heart of West Africa is listed among the heavily indebted poor countries, with a high prevalence of Low Birth Weight, caused in most cases by intra uterine growth retardation. The context of the current study, conducted in urban area, is characterised by a poor socio-economic situation resulting in weak health indicators and difficult access to the basic social services.
Objectives, assumptions
The study is based o the assumptions that socio-economic factors have an influence on the occurrence of Low Birth Weight and that Low Birth Weight has a negative impact on growth and survival during the first year of the infant.
The study has the following objectives:
• To assess the importance of low birth weight a term;
• To analyse the determinant factors of low birth weight;
• To suggest a classification for the identification of pregnant women at risk of giving birth to low birth weight infants ;
• To identify factors which have an impact on the growth of low birth weight children ;
• To look at the impact of body weight deficiency at birth on infant morbidity and mortality ;
• To give recommendations on the prevention and treatment of low birth weight children from underprivileged background with the aim to orientate strategies for infant mortality reduction.
Methodology
Three types of studies were conducted:
• A retrospective cohort study of 435 children aiming at exploring risk factors, growth, nutritional status, and mortality of low birth weight infants in the long run.
• A cross-sectional study of 1013 live full-term births, which led to determining the frequency of low birth weight and at analysing associated factors which are linked to low birth weight.
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• A prospective cohort study during which the 1013 children taken into consideration for the cross-sectional study were followed up so as to analyse their growth and survival all along the first 12 months of their life.
Main results
• Low birth weight represents 15.8% of full-term births.
• Female babies are predominant among low birth weight babies.
• Socio-demographic factors linked to low birth weight are mainly maternal socio- demographic characteristics: young mother (below 20 years old), low educational level, poor nutritional status and limited geographical access to health infrastructures.
• Obstetrical factors linked to low birth weight are the following: primiparity, occurrence of vomiting during pregnancy, field work and a heavier workload during pregnancy.
• The suggested classification for the identification of women at risk proves to have an acceptable power of discrimination and shows good stability and limited margin of error for prediction.
• Regardless of weight categories at birth, all children remain below medians of international reference curves for all nutritional indicators between 0 and 12 months.
• In spite of more important but not significant weight gains, LBW children prove not to be able to catch up on height and weight.
• LBW is linked to a significantly higher risk in growth retardation and weight deficiency during the newborn’s first year of life.
• LBW and non-complete antenatal visits are linked to a death risk multiplied by two.
• The nutritional status at the age of 3 months and 6 months old plays a more important role in the survival in LBW children than in children born with normal weight.
Conclusions
Solutions to LBW imply a package of interventions which should integrate strategies before, during and after pregnancy, together with treatment programmes targeting LBW children after their birth. In priority, these are:
• Information and awareness given to population for a better follow-up of pregnancies and complete cycles antenatal visits ;
• New practices and habits to be taken on favouring a balanced diet of pregnant women ;
• Advocacy actions aiming at reducing the workload of pregnant women ;
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• The use of operational methods to identify women at risk ;
• Improving the quality of monitoring of pregnancy;
• Redefined content and procedures of monitoring programs and promoting young children growth, with particular focus on LBW children ;
• The fight against some social practices such as early marriages and pregnancies of teenagers and women below 20 years;
• The promotion of school education for young girls and literacy for mothers ;
• Improving the nutritional status of the population;
• The realisation of studies to assess the impact of some determinant factors and interventions on the occurrence of low birth weight and on the future of children born with weight deficiency: role of malaria, nutritional interventions targeting LBW children, nutritional intakes during pregnancy.
Key words
Low birth weight ; risk factors ; risk score; growth ; infant mortality ; developing country ; Burkina.
