Antenatal care attendance and risk of low birthweight in Burkina Faso: a cross-sectional study

Mamadou Bountogo, Ali Sié, Alphonse Zakané, Guillaume Compaoré, Thierry Ouédraogo, Elodie Lebas, Jessica Brogdon, Fanice Nyatigo, Benjamin F Arnold, Thomas M Lietman, Catherine E Oldenburg, Mamadou Bountogo, Ali Sié, Alphonse Zakané, Guillaume Compaoré, Thierry Ouédraogo, Elodie Lebas, Jessica Brogdon, Fanice Nyatigo, Benjamin F Arnold, Thomas M Lietman, Catherine E Oldenburg

Abstract

Background: Low birthweight is a major contributor to infant mortality. We evaluated the association between antenatal care (ANC) attendance and low birthweight among newborns in 5 regions of Burkina Faso.

Methods: We utilized data from the baseline assessment of a randomized controlled trial evaluating azithromycin distribution during the neonatal period for prevention of infant mortality. Neonates were eligible for the trial if the weighed at least 2500 g at enrollment and were 8-27 days of age. Data on ANC attendance and birthweight was extracted from each child's carnet de santé, a government-issued health card on which pregnancy and birth-related data are recorded. We used linear and logistic regression models adjusting for potentially confounding variables to evaluate the relationship between ANC attendance (as total number of visits and ≥ 4 antenatal care visits) and birthweight (continuously and categorized into < 2500 g versus ≥2500 g).

Results: Data from 21,223 births were included in the analysis. The median number of ANC visits was 4 (interquartile range 3 to 5) and 69% of mothers attended at least 4 visits. Mean birthweight was 2998 g (standard deviation 423) and 8.1% of infants were low birthweight (< 2500 g). Birthweight was 63 g (95% CI 46 to 81 g, P < 0.001) higher in newborns born to mothers who had attended ≥4 ANC visits versus < 4 visits. The odds of low birthweight among infants born to mothers with ≥4 ANC visits was 0.71 (95% CI 0.63 to 0.79, P < 0.001) times the odds of low birthweight among infants born to mothers who attended < 4 ANC visits.

Conclusions: We observed a statistically significant association between ANC attendance and birthweight, although absolute differences were small. Improving access to ANC for all women may help improve birth outcomes.

Trial registration: The parent trial is registered at clinicaltrials.gov: NCT03682653 ; first registered 24 September 2018.

Keywords: Antenatal care; Burkina Faso; Low birthweight; Neonates.

Conflict of interest statement

None to report.

© 2021. The Author(s).

References

    1. World Health Organization. Global nutrition targets 2025: low birth weight policy brief (WHO/NMH/NHD/14.5). Geneva: WHO; 2014.
    1. Zoleko-Manego R, Mischlinger J, Dejon-Agobe JC, et al. Birth weight, growth, nutritional status and mortality of infants from Lamberene and Fougamou in Gabon in their first year of life. PLoS One. 2021;16(2):e0246694. doi: 10.1371/journal.pone.0246694.
    1. Hilaire M, Andrianou XD, Lenglet A, et al. Growth and neurodevelopment in low birth weight versus normal birth weight infants from birth to 24 months , born in an obstetric emergency hospital in Haiti , a prospective cohort study. BMC Pediatr. 2021;21:143. doi: 10.1186/s12887-021-02605-3.
    1. Leary MO, Edmond K, Floyd S, Newton S, Thomas SL. A cohort study of low birth weight and health outcomes in the first year of life, Ghana. Bull World Health Organ. 2017;95:574–583. doi: 10.2471/BLT.16.180273.
    1. Godah MW, Beydoun Z, Abdul RA, Safieddine B, Khamis AM. Maternal education and low birth weight in low- and middle- income countries: systematic review and Meta-analysis. Matern Child Health J. 2021. 10.1007/s10995-021-03133-3.
    1. Owolabi OO, Wong KLM, Dennis ML, et al. Comparing the use and content of antenatal care in adolescent and older first-time mothers in 13 countries of West Africa : a cross-sectional analysis of demographic and health surveys. Lancet Child Adolesc Heal. 2017;1(3):203–212. doi: 10.1016/S2352-4642(17)30025-1.
    1. Cates JE, Unger HW, Briand V, et al. Malaria, malnutrition, and birthweight: a meta-analysis using individual participant data. PLoS Med. 2017;14(8):e1002373. doi: 10.1371/journal.pmed.1002373.
    1. Schallig HDFH, Scott S, Traore-coulibaly M, et al. Evaluation of malaria screening during pregnancy with rapid diagnostic tests performed by community health Workers in Burkina Faso. Am J Trop Med Hyg. 2017;97(4):1190–1197. doi: 10.4269/ajtmh.17-0138.
    1. Grietens KP, Gies S, Coulibaly SO, et al. Bottlenecks for high coverage of intermittent preventive treatment in Pregnancy : the case of adolescent pregnancies in rural Burkina Faso. PLoS One. 2010;5(8):e12013. doi: 10.1371/journal.pone.0012013.
    1. im Kampe EO, Muller O, Sie A, Becher H. Seasonal and temporal trends in all-cause and malaria mortality in rural Burkina Faso, 1998–2007. Malar J. 2015;14:300.
    1. Sie A, Bountogo M, Nebie E, et al. Neonatal azithromycin administration to prevent infant mortality: study protocol for a randomised controlled trial. BMJ Open. 2019;9(9):e031162. doi: 10.1136/bmjopen-2019-031162.
    1. Eberly MD, Eide MB, Thompson JL, Nylund CM. Azithromycin in early infancy and pyloric stenosis. Pediatrics. 2015;135(3):483–488. doi: 10.1542/peds.2014-2026.
    1. Hernán MA, Hernández-Diaz S, Werler MM, Mitchell AA. Causal knowledge as a prerequisite for confounding evaluation: an application to birth defects epidemiology. Am J Epidemiol. 2002;155(2):176–184. doi: 10.1093/aje/155.2.176.
    1. VanderWeele TJ. Principles of confounder selection. Eur J Epidemiol. 2019;34(3):211–219. doi: 10.1007/s10654-019-00494-6.
    1. Pusdekar YV, Patel AB, Kurhe KG, et al. Rates and risk factors for preterm birth and low birthweight in the global network sites in six low - and low middle - income countries. Reprod Health. 2020;17(3):1–17. doi: 10.1186/s12978-020-01029-z.
    1. Bater J, Lauer JM, Ghosh S, et al. Predictors of low birth weight and preterm birth in rural Uganda : findings from a birth cohort study. PLoS One. 2020;42:1–16. doi: 10.1371/journal.pone.0235626.
    1. Oldenburg CE, Sié A, Ouattara M, et al. Distance to primary care facilities and healthcare utilization for preschool children in rural northwestern Burkina Faso : results from a surveillance cohort. BMC Health Serv Res. 2021;21:212. doi: 10.1186/s12913-021-06226-5.
    1. Kouanda S, Bado A, Bertrand I, Yameogo GS, Coulibaly A, Haddad S. Home births in the context of free health care: the case of Kaya health district in Burkina Faso. Int J Gynecol Obstet. 2016;135:S39–S44. doi: 10.1016/j.ijgo.2016.08.009.
    1. Leone T, Cetorelli V, Neal S, Matthews Z. Financial accessibility and user fee reforms for maternal healthcare in fi ve sub-Saharan countries: a quasi-experimental analysis. BMJ Open. 2016;6:e009692. doi: 10.1136/bmjopen-2015-009692.
    1. Coulibaly A, Baguiya A, Millogo T, Bertrand I, Koueta F, Kouanda S. Predictors of mortality of low birth weight newborns during the neonatal period: a cohort study in two health districts of Burkina Faso. Obstet Gynecol. 2016;135:S89–S92.

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