Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
권호 표지
DOI QR코드

DOI QR Code

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

  • Received : 2022.07.20
  • Accepted : 2022.09.30
  • Published : 2022.11.30
Download PDF
⟨ Previous Next ⟩

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.

Keywords

Acknowledgement

The authors would like to thank all parties who have contributed to this research, including the Demographic Health Survey as the owner of the data. The publication is sponsored by the Directorate of Research and Community Service Universitas Indonesia.

References

  1. World Health Organization. Global nutrition targets 2025: low birth weight policy brief; 2014 [cited 2020 Nov 12]. Available from: https://www.who.int/publications/i/item/WHO-NMHNHD-14.5.
  2. United Nations Children's Fund (UNICEF). Low birthweight; 2019 [cited 2020 Nov 12]. Available from: https://data.unicef.org/topic/nutrition/low-birthweight/.
  3. United Nations Children's Fund (UNICEF), World Health Organization (WHO). UNICEF-WHO low birthweight estimates: levels and trends 2000-2015: new global, regional and national estimates of low birthweight; 2019 [cited 2021 Nov 12]. Available from: https://www.unicef.org/reports/UNICEF-WHO-lowbirthweight-estimates-2019.
  4. World Health Organization. Preterm and low birth weight infants; 2018 [cited 2020 Nov 12]. Available from: https://www.who.int/teams/maternal-newborn-child-adolescent-healthand-ageing/newborn-health/preterm-and-low-birth-weight.
  5. National Population and Family Planning Board (BKKBN), Statistics Indonesia (BPS), Ministry of Health (Kemenkes), ICF. Indonesia Demographic and Health Survey 2017; 2018 [cited 2020 Nov 12]. Available from: https://dhsprogram.com/pubs/pdf/FR342/FR342.pdf.
  6. National Institute of Statistics, Directorate General for Health, ICF International. Cambodia Demographic and Health Survey 2014; 2015 [cited 2020 Nov 12]. Available from: https://dhsprogram.com/pubs/pdf/fr312/fr312.pdf.
  7. Philippine Statistics Authority, ICF. Philippines National Demographic and Health Survey 2017; 2018 [cited 2020 Nov 12]. Available from: https://psa.gov.ph/sites/default/files/PHILIPPINE%20NATIONAL%20DEMOGRAPHIC%20AND%20HEALTH-%20SURVEY%202017_new.pdf.
  8. Ministry of Health and Sports, ICF. Myanmar Demographic and Health Survey 2015-16; 2017 [cited 2020 Nov 12]. Available from: https://dhsprogram.com/pubs/pdf/FR324/FR324.pdf.
  9. United Nations Children's Fund (UNICEF). Maternal and newborn health disparities country profiles [cited 2022 Nov 14]. Available from: https://data.unicef.org/resources/maternalnewborn-health-disparities-country-profiles/.
  10. Zhou H, Wang A, Huang X, Guo S, Yang Y, Martin K, et al. Quality antenatal care protects against low birth weight in 42 poor counties of Western China. PLoS One 2019;14(1):e0210393.
  11. Paul P, Zaveri A, Chouhan P. Assessing the impact of antenatal care utilization on low birthweight in India: analysis of the 2015-2016 National Family Health Survey. Child Youth Serv Rev 2019;106:104459.
  12. da Fonseca CR, Strufaldi MW, de Carvalho LR, Puccini RF. Adequacy of antenatal care and its relationship with low birth weight in Botucatu, Sao Paulo, Brazil: a case-control study. BMC Pregnancy Childbirth 2014;14:255.
  13. World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience; 2016 [cited 2020 Nov 12]. Available from: https://www.who.int/publications/i/item/9789241549912.
  14. Lincetto O, Mothebesoane-Anoh S, Gomez P, Munjanja S. Antenatal care. In: Lawn J, Kerber K, editors. Opportunities for Africa's newborns: practical data, policy and programmatic support for newborn care in Africa. Geneva: World Health Organization; 2019, p. 51-62.
  15. Bountogo M, Sie A, Zakane A, Compaore G, Ouedraogo T, Lebas E, et al. Antenatal care attendance and risk of low birthweight in Burkina Faso: a cross-sectional study. BMC Pregnancy Childbirth 2021;21(1):825.
  16. Indonesian Ministry of Health. Regulation of the Republic of Indonesia Health Minister Number 97 in 2014; 2015 [cited 2020 Nov 12]. Available from: https://sikompak.bappenas.go.id/pembelajaran/view/52/id/other_doc/Permenkes%20No%2097%20tahun%202014%20tentang%20P4K/download.pdf (Indonesian).
  17. Oulay L, Laohasiriwong W, Phajan T, Assana S, Suwannaphant K. Effect of antenatal care on low birth weight prevention in Lao PDR: a case control study [version 1; peer review: 1 approved with reservations, 1 not approved]. F1000Research 2018;7:1138.
  18. Kananura RM, Wamala R, Ekirapa-Kiracho E, Tetui M, Kiwanuka SN, Waiswa P, et al. A structural equation analysis on the relationship between maternal health services utilization and newborn health outcomes: a cross-sectional study in Eastern Uganda. BMC Pregnancy Childbirth 2017;17(1):98.
  19. United States Agency for International Development (USAID). Guide to DHS statistics; 2018 [cited 2020 Nov 12]. Available from: https://dhsprogram.com/publications/publicationdhsg1-dhs-questionnaires-and-manuals.cfm.
  20. Hastono SP. Health data analysis. Depok: Rajawali Pers; 2016 (Indonesian).
  21. Servan-Mori E, Sosa-Rubi SG, Najera-Leon E, Darney BG. Timeliness, frequency and content of antenatal care: which is most important to reducing indigenous disparities in birth weight in Mexico? Health Policy Plan 2016;31(4):444-453. https://doi.org/10.1093/heapol/czv082
  22. Tafere TE, Afework MF, Yalew AW. Providers adherence to essential contents of antenatal care services increases birth weight in Bahir Dar City Administration, north West Ethiopia: a prospective follow up study. Reprod Health 2018;15(1):163. https://doi.org/10.1186/s12978-018-0496-5
  23. Assefa N, Berhane Y, Worku A. Wealth status, mid upper arm circumference (MUAC) and antenatal care (ANC) are determinants for low birth weight in Kersa, Ethiopia. PLoS One 2012;7(6):e39957.
  24. Bhaskar RK, Deo KK, Neupane U, Chaudhary Bhaskar S, Yadav BK, Pokharel HP, et al. A case control study on risk factors associated with low birth weight babies in eastern Nepal. Int J Pediatr 2015;2015:807373.
  25. Benova L, Tuncalp O, Moran AC, Campbell OM. Not just a number: examining coverage and content of antenatal care in low-income and middle-income countries. BMJ Glob Health 2018;3(2):e000779.
  26. Khanal V, Zhao Y, Sauer K. Role of antenatal care and iron supplementation during pregnancy in preventing low birth weight in Nepal: comparison of national surveys 2006 and 2011. Arch Public Health 2014;72(1):4.