الملخص الإنجليزي
Background:
Low birth weight (LBW) has been linked to several short and long-term adverse health problems such as cognitive and behavioral developmental delays, neurological problems, and incidence of chronic health problems such as hypertension, coronary heart disease, diabetes, and stroke. In Oman, the incidence of LBW is on the rise. It increased from 4.2% in 1980 to 12.0% in 2021. According to the latest statistics from Oman Ministry of Health, LBW is the first leading cause of inpatient morbidity among newborns who are less than 7 days of age. Previous studies on the determinants of LBW have focused mainly on Western countries, limiting the generalizability of the findings of these studies to Arab countries, where the burden of LBW is highest due to cultural, economic, and healthcare differences. Variations in dietary habits, genetic factors, and environmental conditions also play significant roles.
Purpose:
To examine the determinants of low birth weight among newborns of Arab women in Oman.
Methods:
A retrospective matched (1:1) case-control study design was conducted to answer the study aim. Four hundred and fourteen (414) participants were included in the study, assuming power of 80%, with alpha level 0.05, two-tailed, and a small effect size of 0.1. The setting for this study was the delivery units of five major tertiary hospitals in Oman, namely Royal Hospital, Khoula Hospital, Sultan Qaboos University Hospital, Nizwa Hospital, and Suhar Hospital. The measurement tool included a standardized report form developed by the study's principal investigator based on an extensive literature review on the determinants of low birth weight. The analytical tools included Chi-square test and fitting binary logistic regression for the outcome LBW (case vs. control) and determinants of LBW.
Results:
The logistic regression results showed that Nagelkerker R Square was 0.271, suggesting that 27.1% of the variance in low birth weight was explained by the variables included in the model, and the model was statistically significant (χ²(27) = 92.737, p < 0.001). Total weight gain (β = -0.004, p < 0.05), baby gender (β = 0.685, p < 0.05), presence of IUGR (β = 1.82, p < 0.05), and hemoglobin level at delivery (β = -0.010, p < 0.05) were significant determinants of low birth weight. The sensitivity of the model to correctly predict LBW cases was 67.0%, and the specificity was 71.8%. Overall, the model correctly classified 69.4% of the cases.
Conclusion:
This study is aligned with Oman’s Health Research Priorities in 2014. Generally, the findings from this study are expected to inform the policymakers in Oman Ministry of Health about the determinants of LBW and subsequently adopt culturally sensitive strategies and health policies to curb the incidence of LBW in Oman. This is an essential future strategy to be taken into consideration, given the fact that Oman is undergoing an epidemiological transition and facing a mounting morbidity burden.
Implications for Practice and Policy:
The implications for practice and policy in addressing LBW highlight the necessity for targeted interventions. In clinical practice, healthcare providers should emphasize maternal nutrition education, early identification, and management of medical conditions, along with interventions addressing lifestyle factors. From a policy standpoint, there is a need for accessible and quality prenatal care initiatives, particularly focusing on high-risk populations. Public health campaigns should raise awareness about the impact of maternal lifestyle choices. Collaborative efforts between healthcare providers, policymakers, and communities are essential to comprehensively address LBW determinants and improve maternal and neonatal outcomes.
