Indian Journal of Neonatal Medicine and Research (Jan 2014)
Magnifying Glass on Why Newborns Die : Low Birth Weight and Maternal Factors
Abstract
Background: Low birth weight babies weighing less than 2000gms weight are immunologically deficient. In addition, they are at risk of birth asphyxia, hypothermia, respiratory distress, hyperbilirubinemia, hypoglycaemia, coagulopathy, sepsis and neonatal death. The apt way to reduce mortality is to identify the prepregnant and antenatal factors which ascertain the uterine milieu and nutrient bioavailability to the fetus in utero. Aim:. This study was designed to reduce the mortality in low birth weight babies. We studied the various maternal and placental factors which affect the fetus in utero. Intrapartum events like presentation, premature rupture of membranes and cord accidents were also recorded. Materials and methods: This prospective study was carried out on 100 low birth weight babies out of 1800 deliveries in the Department of Paediatrics at Saveetha Medical College and hospital, Chennai, India between 1 October 2012 and 30 September 2013. Maternal factors like age, parity, prepregnancy body mass index, haemoglobin levels, preeclampsia, placental abnormalities, presentation, premature rupture of membranes and mode of delivery were studied. Cases of still birth, chronic maternal illness and gestational diabetes mellitus were excluded. Result: Seven newborns out of hundred died despite the level 2 neonatal intensive care. We found that maternal age (30), weight <45kg, preeclampsia, anaemia, placental abnormalities and breech presentation were the maternal factors significantly associated with increased mortality in low birth weight babies. However in 28.6% of low birth neonate mortality no maternal cause could be identified. A literature search revealed that these could be inherent foetal genetic and/or chromosomal anomalies. Conclusion: Maternal age, Prepregnancy Body mass index, preeclampsia, maternal anaemia, breech presentation and placental abnormities are significant maternal factors resulting in mortality in low birth weight babies. Only in one third cases no maternal cause can be identified. Timely correction of maternal body mass index and anaemia can reduce the death rates of our low weight newborns.
Keywords
