The Effect of Maternal Under Nutrition on Adverse Birth Outcomes among
Women Who Attend Antenatal Care in Gedeo Zone Public Hospitals, Southern
Ethiopia, Prospective Follow-Up Study
Abstract
Objective: The aim of this study was to assess the effect of
maternal undernutrition on adverse birth outcomes in Gedeo zone public
hospitals. Design: A prospective cohort study was employed
Setting: Gedeo zone public hospitals Population:
Antenatal care women Method: A modified Poisson regression
model with robust standard errors was used to determine relative risk
and the statistical association was declared at the p-value ≤0.05.
Main outcome measures: Risk of obstetrics and birth outcomes
from undernutrition during pregnancy. Result: The incidence of
the adverse obstetrics outcomes among women with undernourishment were
hypertensive disorder during pregnancy 22.78%, antepartum haemorrhage
6.33%, obstructed labor 4.64%, premature rupture of the membrane
8.0%, preterm labor 19.83%, instrumental vaginal delivery 5.49%,
operative delivery 18.14%, postpartum haemorrhage 18.14%, and sepsis
or chorioaminitis 11.9%. Similarly the incidence of stillbirth
34(4.71%), intrauterine growth restriction (IUGR) 72(10%), small for
gestational age (SGA) 70(9.7%), low birth weight (<2500g) and
preterm birth 91(12.62%) and 118 (16.36%), low first minute Apgar
score (<7) 230(32.0%) and low fifth minute Apgar score was
and 130 (18.0%), birth asphyxia 136 (18.86%), neonatal intensive care
unit (NICU) 108 (15.0%), neonatal death of 26.3/1000 live birth. The
risk of hypertensive disorder during pregnancy (HDDP) was (aRR)=4.07,
95%CI: 2.53-6.55), antepartum haemorrhage (APH) (aRR=5.0,
95%CI:2.08-12.72), preterm labor (aRR=1.8, 95%CI: 1.23-2.62),
operative delivery (aRR=1.24,95%CI;0.87-1.78), postpartum haemorrhage
(aRR=3.02, 95%CI: 1.91-4.79), and sepsis/chrioaminitis (aRR=3.55,
95%CI: 1.83- 6.89) times higher compared to women without
undernourishment. The risk of intrauterine growth restriction (IUGR)
aRR=4.05 times (95%CI; 2.87-8.47), small for gestational age (SGA)
aRR=2.49 times (95%CI; 1.55-4.0), birth asphyxia aRR=2.72 times
(95%CI; 2.0-3.0), and admission to neonatal intensive care unit (NICU)
aRR=4.29times (95%CI; 2.94-6.24) higher for undernourished women than
normally nourished women. Conclusion: According to this study,
the overall incidence of adverse birth outcomes was high. The fetus born
from an undernourished woman has a higher risk for stillbirth 1.92
times, intrauterine growth restriction 4.05 times, small for gestational
age 2.49 times, birth asphyxia 2.72 times, admission to NICU 4.29 times,
and early neonatal death 3.79 times.