Abstract
BACKGROUND: Birthweight has an impact on newborn's future health outcomes. Maternal factors, including age, delivery mode, HIV status, gestational age, parity and obstetric complications (preeclampsia or eclampsia [PE], antepartum hemorrhage [APH] and sepsis), however, have been shown as risk factors of low birthweight (LBW) elsewhere. For data-guided interventions, we aimed to identify predictors of LBW and compare newborn birthweights between different groups of maternal factors at Rev. John Chilembwe Hospital in Phalombe district, Malawi. METHODS: Using a retrospective record review study design, we extracted data from maternity registers of 1244 women and their newborns from October, 2022 to March, 2023. Data were skewed. Median test was used to compare median birthweights. Chi-square or Fisher's exact tests were used to compare proportions of LBW among different groups of maternal factors. Multivariable logistic regression with stepwise, forward likelihood method was performed to identify predictors of LBW. RESULTS: Median birthweight was 2900.00g (interquartile range [IQR]: 2600.00g to 3200.00g). Prevalence of LBW was 16.7% (n = 208). Proportions of LBW infants were higher in women with PE, APH, including women with sepsis than controls (10 [47.6%] of 21 vs 7 [58.3%] of 12 vs 191 [15.8%] of 1211, p < .001). Lower in term and postterm than preterm (46 [5.5%] of 835 vs 2 [3.7%] of 54 vs 160 [45.1%] of 355, p < .001). The odds of LBW infants were higher in preterm than term (AOR = 13.76, 95%CI: 9.54 to 19.84, p < .001), women with PE (AOR = 3.88, 95%CI: 1.35 to 11.18, p = .012), APH, including women with sepsis (AOR = 6.25, 95%CI: 1.50 to 26.11, p = .012) than controls. CONCLUSION: Prevalence of LBW was high. Its predictors were prematurity, PE, APH and sepsis. Interventions aimed to prevent these risk factors should be prioritized to improve birthweight outcomes.