Biopsychosocial and Economic Determinants of Low Birth Weight in Jambi, South Sumatera: Path Analysis

Abstract

Background: Low birthweight (LBW) is one of the main risk factors of neonatal mortality and morbidity. As such, it is an important public health issue particularly in developing countries. Worldwide, LBW shares around 15-20% of birth outcome. In Indonesia, LBW shares about 10.2% of birth outcome. In theory, the risk factors of LBW include not only biological aspect but also psychosocial and economic aspects. This study sought to estimate the biopsychosocial and economic determinants of LBW in Jambi, South Sumatera, using path analysis approach. Subjects and Method:This was an analytic observational study with case control design. The study was carried out at 20 community health centers in Jambi, South Sumatera, from December 2017 to January 2018. A total sample of 200 newborn infants consisting of 50 LBW and 150 normal birthweight newborn infants were selected for this study by fixed disease sampling. The dependent variable was birthweight. The independent variables were maternal age, maternal mid-upper arm circumference (MUAC), gestational age, infant sex, maternal gestational stress, maternal education, family income at gestational period, and sanitation. Data on birthweight and MUAC were taken from obstetric record. The other data were collected by questionnaire. The data were analyzed by path analysis. Results: The risk of LBW was increased by female sex (b= 0.99; 95% CI= -0.12 to 2.12; p= 0.081), and high maternal stress (b= 2.35; 95% CI= 0.70 to 4.01; p= 0.005). The risk of LBW decreased with gestational age ≥37 weeks (b= -5.06; 95% CI= -6.49 to -3.62; p= 0.000), and good sanitation (b= -1.04; 95% CI= -2.13 to 0.05; p= 0.062). Gestational age increased with nutritional status (b= 1.91; 95% CI= 0.94 to 2.89; p<0.001), and family income (b= 1.50; 95% CI= 0.66 to 2.32; p=

Determinants of Low Birth Weight in Indonesia

“…The proportion of LBW decreased along with the increasing level of household wealth of respondents. This finding is in line with other studies that the incidence of LBW is inversely related to wealth quintiles (Trisnawati, Salimo and Murti, 2018;Bekalo et al, 2021). In addition, it is stated that economically well-off families will go to better quality health facilities and be exposed to as much information as possible regarding adequate health during pregnancy, because rich women are easier to educate.…”

“…the lower the mother's education level leads to a greater chance of giving birth to LBW babies. This finding corroborates other studies investigating factors associated with LBW, highlighting the importance of socioeconomic conditions, especially with regard to the education level of mothers or their families (Trisnawati, Salimo and Murti, 2018;Falcão et al, 2020;Mulu et al, 2020;Bekalo et al, 2021). Maternal education level is associated with better knowledge of nutrition and generally understanding and adhering to health professional recommendations during pregnancy (Falcão et al, 2020).…”

Multilevel Analysis on the Contextual Effect of Village and Sociodemographic Factors on Neonatal Death in Karanganyar, Central Java

“…Family income is linked to the family's ability to meet basic needs and obtain health care. High family income would reduce the risk of LBW because the mother would have low stress compared to low/lower family income (Trisnawati et al, 2018). This study is in line with the results of other studies that the father's education level had a negative correlation with neonatal mortality.…”

Determinants of low birth weight and its relationship with stunted toddler status in Magelang Regency, Indonesia

“…The tendency of mothers giving birth to LBW babies prematurely (< 9 months) is 11.722 times higher than women giving birth at full term (≥ 9 months). Preterm birth is the dominant cause of the incidence of LBW [21][22][23]. According to Manuaba, when gestational age is less than 9 months, the formation of the fat storage system is disrupted, which causes risk to LBW babies [12].…”