Publication:

Determinants of birth weight abnormalities at a university hospital in Mahajanga, Madagascar: a prospective case-control study

Background Birth weight abnormalities, including low birth weight and macrosomia, represent a major public health problem due to their neonatal and long-term consequences. Identifying the associated factors helps guide prevention strategies adapted to the local context of the neonatology department of the University Hospital Center of Mahajanga, Madagascar.

Methods This was a prospective descriptive and analytical case-control study conducted from 19 March to 19 September 2024, in the neonatology department of the University Hospital Center of Mahajanga, Madagascar. Seventy-four newborns presenting with birth weight abnormalities were compared with 222 controls with normal birth weight. Sociodemographic, obstetric, and maternal factors were analyzed.

Results The hospital incidence of birth weight abnormalities was 9%. The identified risk factors were gestational hypertension (OR=9.84; 95% CI: 4.21–21.02), fewer than four antenatal care visits (OR=4.73; 95% CI: 2.01–10.12) and single marital status (OR=2.79; 95% CI: 0.98–7.99). Conversely, maternal age between 18 and 35 years (OR=0.42; 95% CI: 0.21–0.84), iron and folic acid supplementation (OR=0.34; 95% CI: 0.16–0.72), normal maternal body mass index (OR=0.51; 95% CI: 0.27–0.95) and secondary or higher education level also reduced the risk (OR=0.31; 95% CI: 0.15–0.66) had a protective effect.

Conclusion Birth weight abnormalities at the University Hospital of Mahajanga are mainly influenced by modifiable maternal determinants. Strengthening antenatal care and early management of hypertensive disorders could significantly reduce their frequency.