Antenatal Care Services and Incidence of Low Birth Weight: A Comparison of Demographic and Health Surveys in 4 ASEAN Countries

Abstract

Objectives: This study aimed to assess the effect of complete coverage and content of available antenatal care (ANC) on the incidence of low birth weight (LBW) in 4 countries belonging to the Association of Southeast Asian Nations (ASEAN).Methods: Measures of complete coverage and content of ANC services included the frequency of ANC visits and the seven service components (blood pressure measurement, iron supplementation, tetanus toxoid immunization, explanations of pregnancy complications, urine sample test, blood sample test, and weight measurement). The complete coverage and content of ANC services were assessed as high if more than 4 ANC visits and all seven components were delivered. Multivariable logistic regression with complex survey designs was conducted using Demographic Health Survey data from the 4 ASEAN countries in question from 2014 to 2017.Results: The proportion of LBW infants was higher in the Philippines (13.8%) than in Indonesia (6.7%), Cambodia (6.7%), or Myanmar (7.5%). Poor ANC services were associated with a 1.30 times higher incidence of LBW than a high level of complete coverage and content of ANC services (adjusted odds ratio [aOR], 1.30; 95% confidence interval [CI], 1.11 to 1.52). In addition, the risk of LBW was higher in the Philippines than in other countries (aOR, 2.25; 95% CI, 2.01 to 2.51) after adjusting for mothers’ demographic/socioeconomic factors, health behaviors, and other factors.Conclusions: In sum, complete coverage and content of ANC services were significantly associated with the incidence of LBW in Indonesia, Cambodia, and Myanmar. The Philippines did not show statistically significant results for this relationship, but had a higher risk of LBW with poor ANC.

Effect of the Enhancing Nutrition and Antenatal Infection Treatment (ENAT) intervention on birth weight in Ethiopia: A cluster randomized controlled trial

“…Hence, direct comparison of our results with other studies is not warranted. However, many have studied the relationship between birthweight and the quality of ANC services and suggested a lower risk of LBW associated with high-quality ANC services [30][31][32][33][34][35][36][37][38]. Most of these studies, however, lack rigor due to their cross-sectional nature, and few relied on data from case-control designs.…”

Compliance with the World Health Organization’s 2016 prenatal care contact recommendation reduces the incidence rate of adverse birth outcomes among pregnant women in northern Ghana

“…According to the study, at least one ANC visit is associated with a 3.8% point reduction in the probability of giving birth to a LBW baby, and having at least four ANC visits with at least one of them being with a skilled provider reduced the probability by an additional 2.8% [ 11 ]. From their analysis of demographic and health data from four (ASEAN) countries, Arsyi and colleagues reported that more pregnant women in Indonesia, Cambodia, and Myanmar who made fewer ANC contacts and did not receive the full components of prenatal care interventions before delivery had LBW babies compared to their counterparts [ 37 ]. A study in a teaching hospital in southern Ghana found that an increase in the number of ANC contacts reduced the odds of PTB [ 21 ].…”

Synergistic associations of antenatal care visits and iron-folic acid supplementation with low birth weight: a pooled analysis of national surveys from six south Asian countries

“…The causes and associated factors were reviewed comprehensively at a global level by Kramer in the 1980s [ 11 ]. Several studies since then have highlighted the role of improved maternal health, nutrition, socioeconomic status, education, smoking, and alcohol consumption on LBW [ 12 , 13 ]. While addressing socioeconomic inequality and promoting the principles of justice within the healthcare system is a long-term solution to combat LBW [ 1 ], it is equally important to implement effective short-and mid-term strategies to bring about immediate improvements through the utilization of existing evidence-based routine services offered through most of the national health systems.…”

“…However, a recent review [ 15 ] reported that there was no significant improvement. Most of the original studies are country-specific or conducted in regions other than South Asia [ 12 , 20 ]. A recent study from South Asia [ 21 ] has examined the quantity and quality of ANC in the region and its association with LBW prevalence.…”