Survival of low birthweight neonates in Uganda: analysis of progress between 1995 and 2011

Abstract

BackgroundAlthough low birthweight (LBW) babies represent only 15.5% of global births, it is the leading underlying cause of deaths among newborns in countries where neonatal mortality rates are high. In Uganda, like many other sub-Saharan African countries, the progress of reducing neonatal mortality has been slow and the contribution of low birthweight to neonatal deaths over time is unclear. The aim of this study is to investigate the association between low birthweight and neonatal mortality and to determine the trends of neonatal deaths attributable to low birthweight in Uganda between 1995 and 2011.MethodsCross-sectional survey datasets from Uganda Demographic and Health Surveys between 1995 and 2011 were analyzed using binary logistic regression with 95% confidence interval (CI) and Kaplan-Meier survival analysis to examine associations and trends of neonatal mortalities with respect to LBW. A total of 5973 singleton last-born live births with measured birthweights were included in the study.ResultsThe odds of mortality among low birthweight neonates relative to normal birthweight babies were; in 1995, 6.2 (95% CI 2.3 −17.0), in 2000–2001, 5.3 (95% CI 1.7 −16.1), in 2006, 4.3 (95% CI 1.3 − 14.2) and in 2011, 3.8 (95% CI 1.3 − 11.2). The proportion of neonatal deaths attributable to LBW in the entire population declined by more than half, from 33.6% in 1995 to 15.3% in 2011. Neonatal mortality among LBW newborns also declined from 83.8% to 73.7% during the same period.ConclusionLow birthweight contributes to a substantial proportion of neonatal deaths in Uganda. Although significant progress has been made to reduce newborn deaths, about three-quarters of all LBW neonates died in the neonatal period by 2011. This implies that the health system has been inadequate in its efforts to save LBW babies. A holistic strategy of community level interventions such as improved nutrition for pregnant mothers, prevention of teenage pregnancies, use of mosquito nets during pregnancy, antenatal care for all, adequate skilled care during birth to prevent birth asphyxia among LBW babies, and enhanced quality of postnatal care among others could effectively reduce the mortality numbers.

The effect of age at first marriage on the incidence of labor complications and babies with low birth weight in Indonesia

“…In addition, babies with low birth weight (LBW) are highly susceptible to neonatal mortality [8]. Indonesia's 2016 neonatal mortality rate (NMR) was worse than other countries in the Association of Southeast Asian Nations with higher gross domestic products (GDP) per capita, including Singapore, Thailand, Brunei Darussalam, and Malaysia.…”

<p>Preterm Neonatal Mortality and Its Determinants at a Tertiary Hospital in Western Uganda: A Prospective Cohort Study</p>

“…4 Whereas significant progress has been made to lower under-five mortality, the decline of neonatal mortality has been slow, especially in many low-income countries where only 30% of babies born at 28 to 32 weeks survive and almost all (>90%) those born at <28 weeks die in the first few days of life. 3,5,6 Unfortunately, health-care providers and families in many countries still perceive the death of any premature baby as inevitable. 6 Preterm babies account for 0.7% of all hospital admissions in Uganda, and yet are responsible for 11.1% of under-five deaths, and 5% of deaths among children of all ages.…”

Comparative analysis of perinatal outcomes and birth defects amongst adolescent and older Ugandan mothers: evidence from a hospital-based surveillance database

“…Our study finds that adolescent mothers were more likely to deliver LBW babies, and is consistent with results from the Uganda Demographic Health Survey (UDHS) 2011 [ 33 ], and several other studies in sub-Saharan Africa [ 14 , 34 – 36 ]. That UDHS also identified infants born with LBW to be at increased risk of neonatal death [ 37 ], highlighting the risks associated with LBW in this population. The LBW observed among infants born to adolescent mothers could have been due to factors such as inadequate maternal nutrition, or the related but distinct issue of inadequate weight gain during pregnancy [ 26 ], which were not assessed in our study.…”