Maternal and obstetric risk factors for low birth weight and preterm birth in rural Gambia: a hospital-based study of 1579 deliveries
Abdou Jammeh, Johanne Sundby, Siri Vangen
DOI: 10.4236/ojog.2011.13017   PDF    HTML     7,469 Downloads   15,742 Views   Citations


Introduction: Low birth weight and prematurity are risk factors for perinatal morbidity and mortality, which is high in Sub Saharan African countries. We determined the frequency of and maternal and obstetric risk factors for low birth weight and preterm birth among hospital births in rural Gambia. Method: We performed a hospital-based retrospective analysis of deliveries from July to December 2008 in two rural hospitals. Maternity records were reviewed and abstracted of the mother’s demographic and reproductive characteristics, obstetric complications and foetal outcome. The maternity records contain important information maternal health and complications during pregnancy and intrapartum period. The records also contain information about the newborn’s vital status and birth weight. To determine the association between low birth weight (LBW), preterm birth (PTB) and maternal demographic characteristics and obstetric complications we calculated odds using logistic regression. Main outcome measure(s): Low birth weight (<2500 grams) and preterm birth (<37 weeks). Results: Our final sample included 1244 singleton live births with complete information about all variables. The rate of LBW and PTB were 10.5% and 10.9% respectively. Ninety-four percent of LBW infants were estimated to be preterm births. The mean birth weight was 3013 g (541 g standard deviation-SD), while the mean gestational age was 37 weeks. The pattern of risk factors was similar for LBW and PTB and both were strongly associated with antepartum haemorrhage and hypertensive pregnancy disorders. Additionally, primi parity was a risk factor for both PTB and LBW. Conclusion: The percentage of low birth weight and preterm birth in rural hospitals in The Gambia is high. The most significant risk factors were those that may be detected during the antepartum period. Thus, vigilant monitoring during pregnancy, early detection and management of obstetric complications coupled with provision of timely obstetric care interventions are crucial for reducing

Share and Cite:

Jammeh, A. , Sundby, J. and Vangen, S. (2011) Maternal and obstetric risk factors for low birth weight and preterm birth in rural Gambia: a hospital-based study of 1579 deliveries. Open Journal of Obstetrics and Gynecology, 1, 94-103. doi: 10.4236/ojog.2011.13017.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] McCormick, M.C. (1985) The contribution of lowbirth weight to infant mortality and childhood morbidity: Review. New England Journal of Medicine, 312, 82-90. doi:10.1056/NEJM198501103120204
[2] Conde-Agudelo, A., Belizan, J.M. and Diaz-Rossello, J.L. (2000) Epidemiology of fetal death in Latin America. Acta Obstetrics and Gynecology Scand, 79, 371-378.
[3] Badshah, S., Mason, L., Mckelvie, K., Payne, R. and Lisboa, P.J.G. (2008) Risk factors for low birth weight in the publich hospitals at Peshawar, NWFP-Pakistan. BMC Public Health, 8.
[4] WHO, UNICEF (2004) Low birth weight, country, regional and global estimates. WHO, Dept. of Reproductive Health Research, ISBN: 92-806-3832-7, New York, 1-32.
[5] UNICEF. (2006) The State of the World’s Children 2007. The United Nations Children’s Fund, UNICEF, New York, 2006.
[6] The Gambia Bureau of Statistics. (2007) The Gambia multiple Cluster Indicator Survey report 2005/2006 Banjul, UNICEF, World Bank.
[7] Kramer, M.S. (1987) Determinants of low birth weight: Methodological assessment and meta-analysis. Bull World Health Organ, 65, 663-737.
[8] Steketee, R.W., Wirima, J.J., Slutsker, L., Heymann, D.L. and Breman, J.G. (1996) Problems of malaria and malaria control in pregnancy in sub-Saharan Africa. American Journal Tropical Medicine and Hygiene, 55, 2-7.
[9] McGregor, I.A. (1984) Epidemiology, malaria and pregnancy. American Journal Tropical Medicine and Hygiene, 33, 517-525.
[10] Muylder, D.X. (1989) Perinatal mortality audit in Zimbabwean district. Paediatric and Perinatal Epidemiology, 3, 284-293. doi:10.1111/j.1365-3016.1989.tb00380.x
[11] de Onis, M., Blossner, M. and Villar, J. (1982) Level and patterns of intrauterine growth retardation in developing countries. European Journal of Clinical Nutrition, 52 (supl 1), S5-S15.
[12] Feresu, S.A., Harlow, S.D., Welch, K. and Gillespie, B.W. (2004) Incidence of and socio-demographic risk factors for stillbirth, preterm birth and low birth weight among Zimbabwean women. Paediatr Perinat Epidemiol, 18, 154-163. doi:10.1111/j.1365-3016.2003.00539.x
[13] WHO. (1997) Coverage of Maternity Care: A listing of available information. WHO/RHT/MSM/96.28; Maternal and Newborn Health/Safe Motherhood, WHO. Bull World Health Organ, Geneva.
[14] WHO. (2004) International statistical classification of diseases and related health problems, 10th revision, 2nd Edition. Switzerland. Bull World Health Organ, Geneva.
[15] Gambia Government (2005). The standard drug treatment manual, Department of State for Health & Social Welfare, Banjul.
[16] Rayco-Solon, P., Fulford, A.J., Prentice and A.M. (2005) Differential effects of seasonality on preterm birth intrauterine growth restrictio in rural Africans. American Journal of Clinical Nutrition, 81, 134-139.
[17] Kunzel, W., Herrero, J., Onwuhafua, P., Staub, T. and Hornung, C. (1996) Maternal and perinatal health in Mali, Togo and Nigeria. European Journal of Obstetrics and Gynecology Reproductive Biology, 69, 11-17. doi:10.1016/0301-2115(95)02528-6
[18] Ferraz, E.M., Gray, R.H. and Cunha, T.M. (1990) Determinants of preterm delivery and intrauterine growth retardation in northeast Brazil. International Journal of Epidemiology, 19, 101-108. doi:10.1093/ije/19.1.101
[19] Mavalankar, D.V., Gray, R.H. and Trivedi, C.R. (1992) Risk factors for preterm and term lowborth weight in Ahmeddaba, India. International Journal of Epidemiology, 21, 263-272. doi:10.1093/ije/21.2.263
[20] Andersson, R. and Bergstrom, S. (1995) Use of fundal height as a proxy for length of gestational age in rural Africa. The American Journal of Tropical Medicine Hygiene, 98, 169-172.
[21] Engmann, C., Matendo, R., Kinoshita, R., Ditekemena, J., Moore, J. and Goldenberg, R.L., et al. (2009) Stillbirth and early neonatal mortality in rural Central Africa. International Journal of Gynaecology and Obstetrics, 105, 112-117. doi:10.1016/j.ijgo.2008.12.012
[22] Siza, J.E. (2008) Risk factors associated with low birth weight of neonates among pregnant women attending a referral hospital in Northern Tanzania. Tanzania Journal of Health Research, 10, 1-8.
[23] Sue, R. and Karen, T. (2000). Tipping the scales: Weighing in on solutions to the low birth weight problem in Colorado, Colorado Department of Public Health and Environment, 1-31.
[24] Chumnijarakij, T., Nuchaprayoon, T., Chitinand, S., Onthuam, Y. and Quamkul, N., et al. (2010) Maternal risk factors for low birth weight newborn in Thailand. Journal of Medicine Association of Thailand, 75, 445-452.
[25] Awoleke, J.O. (2011) Maternal risk factors for low birth weight babies in Lagos, Archives of Gynecology and Obstetrics, 6. doi:10.1007/s00404-011-1885-y
[26] Nisell, H., Palm, K. and Wolff, K. (2000) Prediction of maternal and fetal complications in preeclampsia. Acta Obstetrics and Gynecology Scand, 79, 19-23. doi:10.1080/j.1600-0412.2000.079001019.x
[27] Grujic, I. and Milasinovic, L. (2006) Hypertension, preeclampsia and eclampsia-monitoring and outcome of pregnancy. Medicinski Pregled, 59, 556-559. doi:10.2298/MPNS0612556G
[28] Duley, L. (2003) Pre.eclampsia and the hypertensive disorders of pregnancy. British Medicine Bulletin, 67, 161- 176. doi:10.1093/bmb/ldg005
[29] National High Blood Pressure Education Programme Working Group, (2000) Report of the national high blood pressure education programme working group on high blood pressure in pregnancy. American Journal of Obstetrics and Gynecology, 183, S1-S22.
[30] Roudbari, M., Yaghmaer, M. and Soheili, M. (2007) Prevalence and risk factors for low birth weight infants in Zahedan, Islamic Republic of Iran. Eastern Mediterranean Region Health Journal, 13, 838-845.
[31] Yücesoy, G., Ozkan, S., Bordur, H., Tan, T., Caliskan, E., Vural, B. and Corakci, A. (2005) Maternal and perinatal outcome in pregnancies complicated with hypertensive disorder of pregnancy: A seven year experience of a tertiary centre. Archives of Gynecology and Obstetrics, 273, 43-49. doi:10.1007/s00404-005-0741-3
[32] Kato, N. and Matsuda, T. (2006) Estimation of optimal birth weights and gestational age for twins births in Japan. BMC Public Health, 6.
[33] Osungbade, K.O. and Ige, K.O. (2011) Public health perspectives of preeclampsia in developing countries: Implication for health systems strengthening. Journal of Pregnancy. doi:10:1155/2011/181095
[34] WHO, UNICEF (2003) Antenatal care in developing countries: Promises, achievements and missed opportunities an analysis of trends, levels and differentials. 1990-2001. WHO Geneva. Bulletin of World Health Organization.
[35] Kaunitz, A.M., Spence, C., Daneilson, T.S., Rochat, W.A. and Grimes, D.A. (1984) Perinatal and maternal mortality in a religious group avoiding obstetric care. American Journal of Obstetrics and Gynecology, 150, 826-831.
[36] Dowswell, T., Carroli, D., Duley, L. and Gates, S., et al. (2010) Alternative versus standard package of antenatal care for low-risk pregnancy (review). The Cochrane Database of Systematic Review, 10. doi:10.1002/14651858.CD00934.pub2
[37] Reedy, N.J. (2007) Born too soon. The continuing challenges of preterm labour and birth in the United States. Journal of Midwifery & Women’s Health, 52, 281-290. doi:10.1016/j.jmwh.2007.02.022
[38] Beck, S., Wojdyla, D., Say, L., Betran, A.P., Merialdi, M. and Requejo, J.H., et al. (2010) The worldwide incidence of preterm birth: A systemic review of maternal mortality and morbidity. Bulletin of World Health Organization, 88, 31-38. doi:10.2471/BLT.08.062554

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.