Maternal and obstetric risk factors for low birth weight and preterm birth in rural Gambia: a hospital-based study of 1579 deliveries

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