Birth weight, growth, nutritional status and mortality of infants from Lambaréné and Fougamou in Gabon in their first year of life

Rella Zoleko-Manego, Johannes Mischlinger, Jean Claude Dejon-Agobé, Arti Basra, J Rodolphe Mackanga, Daisy Akerey Diop, Ayola Akim Adegnika, Selidji T Agnandji, Bertrand Lell, Peter G Kremsner, Pierre Blaise Matsiegui, Raquel González, Clara Menendez, Michael Ramharter, Ghyslain Mombo-Ngoma, Rella Zoleko-Manego, Johannes Mischlinger, Jean Claude Dejon-Agobé, Arti Basra, J Rodolphe Mackanga, Daisy Akerey Diop, Ayola Akim Adegnika, Selidji T Agnandji, Bertrand Lell, Peter G Kremsner, Pierre Blaise Matsiegui, Raquel González, Clara Menendez, Michael Ramharter, Ghyslain Mombo-Ngoma

Abstract

Background: Malnutrition and low birth weight (LBW) are two common causes of morbidity and mortality among children in sub-Saharan Africa. Both malnutrition and LBW affect early childhood development with long term consequences that may vary in their degree depending on the geographical setting. This study evaluates growth, nutritional status and mortality of infants from Lambaréné and Fougamou in Gabon from a birth cohort of a malaria in pregnancy clinical trial (NCT00811421).

Method: A prospective longitudinal birth cohort conducted between 2009 and 2012, included infants that were followed up from birth until their first-year anniversary. The exposure of interest was low birth weight and the outcomes explored were growth represented by weight gain, the nutritional status including stunting, wasting and underweight, and the mortality. Scheduled follow-up visits were at one, nine and 12 months of age. Logistic regression was used to assess the association between low birth weight and growth and nutritional outcomes, and cox regression was used for mortality.

Result: A total of 907 live-born infants were included in the analysis. The prevalence of LBW was 13% (115). At one month of life, out of 743 infants 10% and 4% presented with stunting and underweight, respectively, while these proportions increased at 12 months of life to 17% and 21%, respectively, out of 530 infants. The proportion of infants with wasting remained constant at 7% throughout the follow-up period. Stunting and underweight were associated with LBW, adjusted odds ratio (aOR): 2.6, 95% confidence interval (95%CI): 1.4-4.9 and aOR: 4.5, 95%CI: 2.5-8.1, respectively. Preterm birth was associated with stunting, aOR: 2.7, 95%CI: 1.2-6.3 and underweight, aOR: 5.4, 95%CI: 1.7-16.1 at one month of life. Infants with LBW were at higher hazard of death during the first year of life, adjusted hazard ratio 4.6, 95%CI: 1.2-17.0.

Conclusion: Low birthweight infants in Gabon are at higher risks of growth and nutritional deficits and mortality during the first year of life. Tailored interventions aiming at preventing adverse pregnancy outcomes including LBW, early detection and appropriate management of growth, and nutritional deficits in infants are necessary in Gabon.

Conflict of interest statement

I have read the journal’s policy and the authors of this manuscript have the following competing interests: CM is a member of the Editorial Board of PLOS Medicine. The authors have declared that no other competing interests exist. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1. Flow of children in the…
Fig 1. Flow of children in the study from birth until 12 months of age.
Fig 2. Mean (SE) changes in weight…
Fig 2. Mean (SE) changes in weight at birth, 1, 9 and 12 months by birth weight.
Abbreviations: M1: month one; M9: month nine; M12: month twelve, LBW: Low Birth Weight; NBW: Normal Birth Weight.
Fig 3. Mean (SE) height-for-age Z-score evolution…
Fig 3. Mean (SE) height-for-age Z-score evolution from 1 to 12 months by birth weight.
Abbreviations: M1: month one, M9: month nine; M12: month twelve; LBW: low birth weight; NBW: normal birth weight.
Fig 4. Comparison of survival stratified by…
Fig 4. Comparison of survival stratified by birth weight.

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