Publication:

Maternal determinants for 4 Ds in children registered under Rashtriya Bal Swasthya Karyakram program at an urban health centre of Ahmedabad

Background Maternal determinants influence the outcome of pregnancy and child’s health in early years.  Rashtriya Bal Swasthya Karyakram (RBSK) deals with the 4 D (birth defects, chronic diseases, deficiency disorders and developmental delays) among children (from birth till 18th years). Objectives were to determine and document the association between maternal determinants especially antenatal care (ANC) and 4 Ds and suggest preventive measures.

Methods Out of 302 children with 4 D’s registered during April 2018-March 2020, 102 children were selected using probability proportionate to sample size (PPS) sampling for each category of 4D. Information of socio demographic details and maternal determinants was gathered on a semi structured questionnaire by interviewing mothers/caretaker.

Results Relevant information could be gathered from 96 caregivers/parents. Mean maternal age was 26.4±4.1 years. Congenital defects were significantly associated with higher maternal age (p<0.0001). Out of 102 cases under study, minimum recommended 4 ANC visits were not taken by 17 (17.7%) mothers. Also, 13 (13.5%) did not take IFA supplementation. Poor health status during pregnancy, was significantly associated for deficiency disorders of child in later life (p<0.04).

Conclusions Maternal age at pregnancy, health status of mother, ANC care (number of ANC visits, IFA supplementation), health seeking behaviour, birth weight and birth order of child were major determinants of 4Ds.