1. Timalsina U, Sharma S, Giri S, Basyal B, Bhandari S, Neupane M
Risk factors of Intrauterine growth retardation: A study in a tertiary hospital of Nepal
Timalsina U, Sharma S, Giri S, Basyal B, Bhandari S, Neupane M
Utsav Timalsina,
4th year Medical Student,
Institute of Medicine,
Kathmandu, Nepal

3. Introduction
Birth weight is an important determinant of an infant’s survival and future development.
Low Birth Weight (LBW), defined as a weight of less than 2500g at birth regardless of gestational age.
Globally, LBW contributes to 40-60% of newborn mortality.
In Nepal, there is high prevalence ( %) of LBW.

4. Research question
What are the major factors associated with low birth weight term babies?

5. Conceptual framework Low Birth Weight Maternal related factors
Anemia in pregnancy
Maternal weight gain during gestation
Hard physical work
BMI (Height and Weight)
Hypertension
Smoking and alcoholism
Mother related factors
Age of mother at child birth
Smoking and alcoholism
Education of mother
Mother’s occupation
Earning status
Gravida
Parity
Birth spacing
History of abortion
ANC status
Socio-economic
Family type
Family size
Economic status
Caste group
Residence
Food security
Sex determination
Sex of the child

6. Case-control study in Tribhuvan University Hospital, Nepal.
Materials and Methods
Case-control study in Tribhuvan University Hospital, Nepal.
Cases
All singleton newborns with birth weight <2500gm
156
Controls
Singleton newborns with normal birth weight
312
Preterm babies, new born with congenital diseases and twin delivery were excluded.
Powered to detect an odds ratio of 1.8 at two sided significance level of 0.05 and 80%power.

7. Materials and Methods
Mothers were interviewed by medical students with pretested structured questionnaires in Nepali.
Informed consent was taken and medical records were observed.
Questionnaire were drafted reviewing related articles and standards.
Non-stretchable measuring tape and weighing scale were used.
Analyses were done using SPSS (version 14) using appropriate tests.

8. Result
Characteristics of the mothers with LBW

9. Result History of previous premature delivery 8.59 (1.57-46.91)
Factors
OR (95% CI)
P value
History of previous premature delivery
8.59 ( )
p=0.013
Maternal age less than 22yrs
2.95 ( )
p=0.000
Delivery by a caesarean section
11.14 ( )
Disadvantaged ethnic group
0.41 ( )
p=0.01
Height of mother
1.19 ( )
p=.069
Very hard physical work
1.53 ( )
p=.082
Not eating meat, beans, green vegetables regularly
1.08 ( )
p=.752

10. Result
These factors were not associated with the delivery of LBW babies:
History of previous abortions; place of residence rural or urban
Education level and occupation of mother or father
Cooking food during pregnanacy and type of food consumed during prgnancy
Family type and number of family members
Number of antenatal check-ups and maternal hemoglobin level (<10 vs >=10gm/dl)

11. The major factors associated with LBW in term babies are:
Conclusion
The major factors associated with LBW in term babies are:
History of previous premature delivery
Delivery by a caesarean section
Maternal age less than 22yrs

12. Discussion
The independent risk factors of giving birth to low birth weight babies in Nepal are:
Babies born of pregnant mothers of less than 22 years age
History of previous premature delivery
Delivery by a caesarean section
The limitations of study are:
sample population may not be the representative of typical community where the LBW is biggest
It precludes the home delivered LBW infants
Preterm babies and those with congenital anomalies were not considered

13. Future prospective
A large number of infants’ death can be averted by addressing LBW and associated preventable factors.
The study will provide further impetus in the attainment of MDG 4(Millennium Development Goal) goal.

14. Thank you very much…
Namaste !!!