ABSTRACT OF MASTER’S DISSERTATION
No.1
CourseMPH

NameSilas Adjei-Gyamfi

ThesisMaternal risk factors for low birthweight and macrosomia:

title

A cross-sectional study in Northern Region, Ghana

Background:
Abnormal birthweights are critical public health challenges accountable for most noncommunicable diseases and perinatal mortalities. Globally, there are myriad of mixed evidence onmaternal factors responsible for abnormal birthweights. This study serves as one of key pieces ofevidence in view of the increasing prevalence of these abnormal birthweights particularly in someparts of semi-rural Ghana.

Objective:
The study aimed to identify maternal risk factors for abnormal birthweights in Savelugu
municipality, Northern region, Ghana. The specific objectives were to:1) estimate the prevalence of low birthweight and macrosomia in the municipality.
2) identify maternal risk factors for low birthweight.
3) identify maternal risk factors for macrosomia.

Methods:
A retrospective cross-sectional study was conducted, using public health facilities as data collection
points in Savelugu municipality from February 1 to March 31, 2022. Single-stage sampling withprobability proportional to size technique was employed, to select 356 mothers having a neonate
born during the last four weeks, as study participants. Anthropometric, antenatal, and obstetricdata were collected from maternal and child health record books. Sociodemographic,socioeconomic, and knowledge-related data were collected through structured interviews withconsented mothers. Using STATA (version 17.0), Chi-square/Fisher’s exact and Wilcoxon rank-sum
tests were used for bivariate analyses after descriptive statistics at 95% significance level. Dummyvariables were created for the variables with more than two categories. Logistic regression was thenemployed to identify maternal risk factors for abnormal birthweights after addressing
multicollinearity.

ABSTRACT OF MASTER’S DISSERTATION
No.2
CourseMPH

NameSilas Adjei-Gyamfi

Results:
Of the 356 participant mothers, 308 (86.5%) were 20−35 years of age. Most neonates (n =250; 70.2%) were older than one-week of age. Approximately, 51.0% (n = 181) mothers wereself-employed, and one-third had no formal education (n = 121; 34.0%). Mean birthweight of
the neonates was 2880g (sd = 620g). Surprisingly, majority of male neonates (n = 70; 63.6%)
had abnormal birthweights. The prevalence rates of low birthweight and macrosomia were22.2% (95%CI: 17.9%−26.9%) and 8.7% (95%CI: 4.9%−12.1%) respectively. Maternal anaemia
in first trimester (aOR:4.041; 95%CI: 1.741−9.381) and third trimester (aOR:25.71; 95%CI:8.245−80.18) of gestation were strong predictors for low birthweight. Mothers having
neonates whose birth length was greater than 47.5cm (aOR:0.280; 95%CI: 0.117−0.670);
mothers who attended eight antenatal care visits or more (aOR:0.264; 95%CI: 0.112−0.622);
and mothers belonging to minority ethnic groups in the study area (aOR:0.089; 95%CI:0.009−0.859) had reduced odds for low birthweight. Alternatively, mothers with advanced
gestational age (≥ 42 weeks) had 9.713 times higher risk of giving birth to macrosomic
neonates (95%CI: 2.127−44.34). Mothers also had lesser chance (aOR:0.201; 95%CI:0.060−0.668) to deliver macrosomic neonates through the vagina.

Conclusion:
The prevalence rates of low birthweight and macrosomia were relatively high. Anaemia in thefirst and third trimesters, and advanced gestational age were strong determinants of lowbirthweight and macrosomia respectively. Childbirth length, frequency of antenatal carevisits, and being minority ethnic groups were protective factors against low birthweight. Also,
vaginal delivery was protective against macrosomia. Hence, nutrition counseling, community
health education, and promotion of lifestyle improvement coupled with strengthening ofhealth service delivery are recommended interventions. (499 words)