MATERNAL CHARACTERISTICS INFLUENCING BIRTH WEIGHT AND EARLY CHILDHOOD GROWTH IN THE TAMALE METROPOLIS

Abstract

Birth weight is used as a measure of maternal health and nutritional status as well as infant growth and survival. Low birth weight and early childhood malnutrition have both been associated with increased mortality and morbidity in children. Despite interventions like the ANC and growth monitoring and promotion by the Ghana Health Service to ensure adequate birth weight and early childhood growth, the prevalence of low birth weight and poor early childhood growth in the Northern Region of Ghana are still very high and unacceptable. The main aim of this study therefore was to identify maternal factors that influence birth weight and early childhood growth in the Tamale metropolis. A retrospective cohort study design was used in the study in which the exposed group was mothers with height <160 cm while the non-exposed group consisted of mothers with height ≥ 160 cm. A systematic random sampling technique was used to select mother-child pairs attending CWC at the Tamale Central and Tamale Teaching hospitals. The study population included mothers with children 12-23 months who were singleton and born to term. In all, four hundred and fourteen (414) mother-child pairs were sampled and included in the study. Hierarchical multiple regression analyses were used to determine the independent predictors of child birth weight, height-for-age Z-scores and growth rate after controlling for confounders. The prevalence of low birth weight and macrosomia among children in the Tamale metropolis were relatively high at 21% and 7.7% respectively while the prevalence of stunting, wasting and underweight were 16.7%, 15.7% and 17.9% respectively. The results also showed significant positive correlations between maternal weight and birth weight (r = 0.37, p < 0.001), maternal height and birth weight (r = 0.27, p < 0.001), maternal body mass index and birth weight (r = 0.32, p < 0.001). After controlling for potential confounding factors, maternal height and gestational weight gain accounted for 13.8 % of the variance in birth weight. Maternal height had a significant positive association with mean heightfor- age Z-score (HAZ) but no effect on growth rate/month. Children of taller (≥160 cm) had 0.18 higher HAZ than those of shorter mothers (<160 cm) (p <0.0001). Children who initiated breastfeeding within 1 hour of birth had mean HAZ which was 0.15 standard units significantly higher than their counterparts who did not [beta = 0.15 (95% CI: 0.17, 0.57)]. The strongest predictor of HAZ was minimum DDS (> 4) with a standardized beta (β) weight of 0.43, p < 0.001. The set of variables accounted for 44.8 % of the variance in mean HAZ (Adjusted R Square = 0.448). Birth order, minimum DDS, age of mother, number of pregnancies, number of under-five children were the most consistent predictors of growth rate of children aged 12-24 months with meeting the minimum dietary diversity of 4 being the highest contributor, F (9, 351) = 32.95, p < 0.001. A number of maternal factors were found to influence the birth weight and growth in the second year of life of children in the Tamale metropolis. Policy makers must therefore take into consideration the influence of these factors in designing and/or modifying health interventions aimed at reducing LBW and poor early childhood growth for maximum impact.