Affiliation:
1. Nepal Development Society
2. Independent Public Health Consultant
Abstract
Abstract
Background
The prevalence of low birth weight (LBW) has remained high in the South Asian region with a significant impact on newborn survival. While antenatal care (ANC) and iron-folic acid supplementation independently have been considered effective interventions to improve maternal and newborn outcomes, the evidence on the combined effect of these two services with LBW is lacking. This study aimed to examine the synergistic impact of ANC and iron-folic acid supplementation on LBW in the South Asian region using pooled data from six countries.
Methods
Nationally representative surveys from Nepal, India, Bangladesh, Pakistan, Maldives, and Afghanistan were included in the study. Birth weight and the prevalence of LBW for singleton last-born children were reported using descriptive statistics. The association between LBW and ANC visits and the two-way interaction between iron-folic acid consumption and ANC were examined using multiple logistic regression.
Results
Mean birth weight in the region was 2841.8 grams with a LBW prevalence of 17.1%. Country-specific prevalence ranged from 11.4% in Nepal to 22.4% in Pakistan. Not attending ANC visits (adjusted odds ratio (AOR): 1.24; 95% confidence interval (CI): 1.16, 1.34) and not consuming iron-folic acid (AOR: 1.14; 95% CI: 1.08, 1.21) were significantly and positively associated with a higher likelihood of LBW. Furthermore, jointly, having < 4 ANC visits and < 180 days of iron-folic acid supplementation was associated with a higher likelihood (AOR: 1.29; 95% CI: 1.22, 1.36) of having LBW infants compared to those who had had ≥ 4 ANC visits and ≥ 180 days of iron-folic acid after controlling for key confounding factors.
Conclusions
The current study provides important evidence on the synergy between ANC visits and iron-folic acid supplementation during pregnancy to capitalize on the existing national maternal health programs in the South Asian region, including low-and middle-income countries for positive foetal outcomes.
Publisher
Research Square Platform LLC
Reference34 articles.
1. Effects and safety of preventive oral iron or iron + folic acid supplementation for women during pregnancy;Peña-Rosas JP;Cochrane Database of Systematic Reviews
2. Interventions to improve birth outcomes of pregnant women living in low- and middle-income countries: a systematic review and network meta-analysis [version 2; peer review: 1 approved, 2 approved with reservations];Park J;Gates Open Research,2020
3. Effects of nutrition interventions during pregnancy on low birth weight: an overview of systematic reviews;Katharina da Silva L;BMJ Global Health,2017
4. WHO. Global nutrition targets 2025: low birth weight policy brief. World Health Organization; 2014.
5. Global nutrition targets. 2025. Low birth weight policy brief. Geneva; 2023.