Observation of Birth Weight of Babies in relation on maternal age, parity and gestational age in Tertiary Level Hospital

Background: Birth weight of an infant is the most important determi nant of its chances of survival, healthy growth, and develop ment. It depends on many maternal factors. Maternal age, parity and gestational age have been shown to increase the risk of adverse neonatal outcome, such as intrauterine growth retardation, prematurity, mortality and low birth weight. Objective: This study was planned to observe the incidence of low birth weight baby and to correlate the maternal age, parity and gestational age on birth weight of babies. Methodology: It was a retrospective study. Data were collected from medical records. Total 2850 live births new born baby were enrolled in this study during the period January 2013 to December 2018 in Ibn Sina medical college and hospital, Dhaka, Bangladesh with inclusion criteria. The weights of the newborns were measured without clothes on a digital weighing scale soon after the birth. Parameters such as birth weight, gender of baby, maternal age, parity and gestational age of the mother were noted. Data were analyzed statistically. Results: 52.99% baby was male and 47.01% were female. Low birth weight baby were 33.3% in the age group of less than 18 years of aged mother. With increasing the age of mother, birth weight of babies increase. Primipara mother delivered 15.52% low birth weight baby and 84.48% normal birth weight baby. With increasing parity birth weight of baby increased. The birth weight of <2.5 kg was 19.27% and 80.73% baby’s birth weight >2.5 kg in mother more than 37 weeks of gestation. Baby born by 35-37 weeks of gestation had 27.69% low birth weight and 72.31% were normal birth weight. Incidence of low birth weight was 79.3% and normal birth weight 20.7% found by 32-34 weeks of gestation.


Introduction:
Birth weight of an infant is the most important determi nant of its chances of survival, healthy growth, and develop ment. It depends on many maternal factors. Good maternal health and nutrition are important contributors to child survival 1 . A healthy mother delivers a healthy baby and a malnourished mother contributes to low birth weight baby. Parity and gestational age have been shown to increase the risk of adverse neonatal outcome, such as intrauterine growth retardation, prematurity and mortality. Several studies have hypothesized that young mothers, maternal-foetal competition for nutrition and or mothers incomplete physical growth might contribute an adverse neonatal outcome 2 .Birth weight is a critical determinant for neonatal morbidity and also for the growth and development of the infant in the early neonatal period. Birth weight depends on both maternal and foetal genetic constitution as well as other variable such as socioeconomic status, nutritional supplements, bad obstetric history, maternal weight and height and maternal illness. Low birth weight is a significant contributor's factor for increased risk of infant mortality and morbidity 3 and has a health consequence extending into adulthood 4 . Low birth weight is defined as birth weight has less than 2500 gm at birth 5, 6 . In Bangladesh, both growth rate and low birth weight rate are quite high 7 . Neonatal survival depends on both gestational maturity and birth weight and are not significantly better in babies who are low birth weight for gestational age 8 . Increased perinatal and infant mortality are major health problem in a developing country. Perinatal mortality is known to be particularly high in infant with low birth weight. Different workers throughout the world have been working in this field and have determined risk factors present in their local areas. Due to wide variation, factors operating in one region may not be applicable to other parts of the world or nation. Study of birth weight has remained as an important field of research for effective maternal and child health care programmes. This study was planned to observe the incidence of low birth weight baby among institutional deliveries in Ibn Sina Medical College and to correlate the maternal age, parity and gestational age on birth weight of babies.

Materials and Methods
It was a retrospective study. Data were collected from medical records. Total 2850 live births new born baby were enrolled in this study during the period of January 2013 to December 2018 in Ibn Sina medical college and hospital, Dhaka, Bangladesh. Three inclusion criteria were used in this study. (a) Singleton live born baby by LUSC (b) Baby did not suffer from any congenital malformation (c) Gestational age of the mother is 32 to 41 weeks. The weights of the newborns were measured without clothes on a digital weighing scale soon after the birth. Parameters such as birth weight, gender of baby, maternal age, parity and gestational age of the mother were noted. Gestational age in weeks was assessed by either ultrasound examination or according to mothers last menstrual period or both. Data were analyzed statistically.
Ethical clearance: This study was approved by ethic Committee of Ibn Sina Medical College Hospital.     13 showed in his study that incidence of low birth weight irrespective of sex were 20%.

Result:
In this study maternal age with birth weight of babies showed low birth weight baby <2.5kg were 33.3% in age group of mother <18 years and normal birth weight >2.5kg were 66.67%.Incidence of low birth weight babies decreases in the age group of mother 18-34 years. The study also showed that normal birth weight baby >2.5kg were more observed in the age group of 18-30 years. K.Selina and R Mahbub et al 14 found in their study that low birth weight baby belongs to mother age group of <19 years and >30 years. Narwede et al 9 found in his study that with increase age of mother >20 years and <35 years incidence of normal birth weight is more.The study also similar to the result done by Asthekar VS etal 12 .The study also similar to KS Negi partigum, Tabeharen etal 15 ,where maternal age <20 years has higher incidence of low birth weight baby. Mother who deliver normal birth weight baby >2.5kg majority belongs to the age group of 20-29 years.
In this study primipara mother delivered 15.52% baby <2.5kg and 84.48% >2.5kg. The incidence of low birth weight (<2.5 kg) were gradually decreased in 2 nd , 3 rd , 4 th ,5 th and 6 th parity of mother  25 reported that incidence of low birth weight was lower than normal birth weight in full term baby and the incidence of low birth weight was higher than normal birth weight in pre term baby. Both the study is nearly similar to our study.

Conclusion:
The study concluded that as the age of mother increases birth weight of baby increases, as the parity increases birth weight of the baby increases. The study concluded that problem of low birth weight is multi dimensional hence we need integrated and comprehensive approach to improve the overall health of women. To reduce the incidence of low birth weight following steps can be taken a) Health education to adolescent regarding the nutrition and marriage) Health education to married women regarding nutrition and age of first pregnancy) Heath education to pregnant mother regarding the nutrition) Regular antenatal care, birth spacing and family planning.

Conflict of interest: None declared
Authors' contribution: