Study of the Relationship Between Maternal and Neonatal Anthropometric Parameters Among Hausas in Kano, Nigeria
Chapter One
Aim
The study aims to determine the relationship between maternal and neonatal anthropometric parameters among Hausas in Kano
Objectives
The objectives of this work are:
- To form linear regression equations that can be used for birth weight estimation in neonates from maternal variables of the Hausa ethnic group in
- To determine the relationship between maternal parity and neonatal anthropometric parameters among Hausas insane
- To form linear regression equations that can be used for birth length estimation in neonates from maternal variables of the Hausa ethnic group in Kano
- Provide reference data on neonatal and maternal anthropometric parameters among Hausas in Kano
CHAPTER TWO
LITERATURE REVIEW
Maternal Age and Birth Weight
It was reported that the mother`s age served as an indirect factor affecting birth weight (Hoffman et al., 2007). Earlier studies showed that the normal age range of a mother to be given normal birth weight was 21-30 years, also the mean birth weight is normal in both male and female newborns since the normal range of birth weight was 2500gm to 3500gm (WHO, 1992). It was also reported that maternal age and other anthropometric parameters such as height, weight, body mass index (BMI), weight gain during pregnancy, nutritional status, socioeconomic status, and parity are some of the well-established determinants of the birth weight of the neonate (Shamsun et al., 2007). Generally speaking aged women may have an increased risk for abnormal labour, although the mother’s age by itself may be one of the factors which can have effect on the doctor’s decision, patient’s request or obstetric troubles (Bell et al., 2001). According to Wildschut (1999) maternal age, social class and ethnicity are interrelating socio-demographic factors that influence maternal health and childbearing. Reports on complications of pregnancy in young girls are contradictory and difficult to interpret because of confounding effects of adverse social circumstances and poor attendance for antenatal care. This phenomenon is of concern because teenage mothers are reported to be disadvantaged financially, educationally and cognitively (Hanna, 2001). It is interesting that the characteristics of babies’ fathers whose mothers are adolescent are also unique. These men have a lower level of education, a greater age discrepancy between themselves and the mothers, a greater unemployment rate, less financial independence, less supportive attitude toward pregnancy, poorer attendance at childbirth, less provision of postpartum care for mothers and infants (Wang and Chou, 2001). The incidence of LBW was high among mothers of age 20 years or less.
Similar observations were also reported (Negi et al., 2006). It is now universally acknowledged that maternal age is an important factor influencing the incidence of LBW. Moreover, the rate of LBW decreases significantly with the increasing age of mother after 18 years of age. Earlier studies have also reported that the young (<20 years) mothers had higher incidence of LBW than older (<30 years) mothers (Begum et al., 1995 and Oni, 1986).
Maternal weight and birth weight
Birth weight is now widely used as an indicator of health status of individuals and populations as it has strong associations with both childhood and adult health. It is associated with childhood growth, cognitive deficit and disability (Fairley, 2000). Birth weight plays an important role in infant mortality and morbidity, development, and future health of the child (WHO, 1995). It is also documented that the most important determinant of children’s chance of survival, healthy growth and development in future (Ghaiet al., 2004). In recent years infant birth weight has been increasing in many countries, representing an obstetric hazard and a potential public health problem since high birth weight involves a risk of obesity later in life (Forsum, 2006). Maternal anthropometric parameters such as weight, height, body mass index (BMI), weight gain during pregnancy, nutritional status, socioeconomic status, are some of the well- established determinants of the birth weight of the neonate (Shamsun et al., 2007).
Parity and birth weight
It has been reported that primipara has higher relative risk of delivering low birth weight (LBW) babies in developing countries (Lawoyin, 2007; Bisai et al., 2006; Hirve et al., 1994). In another study Elshibly and Schmalisch (2008) shows that primiparity is associated with an increased relative risk for LBW and that was distinctly higher when compared to the relative risk for LBW of other maternal characteristics. Several studies relating the effect of mother’s age and parity on birth weight indicate that parity is the most important factor of the two (Millis and Seng, 1954).
Maternal height and birth size
Maternal height is one of the most important parameter which influences the birth weight with cut-off point of 156 cm which agrees well with investigators in Bangladesh (Baqui et al., 1994). Several studies from developing countries observed the relationship between mother’s height and infant birth size, most importantly; this study provides strong evidence that maternal height had the strongest significant impact on new-born size (Deshmukh et al., 1998; Gopalan, 1991). Likewise the study conducted by Pachauri et al. (1971) showed that, the taller the mothers the heavier the babies and similarly, Bhatia et al. (1985) noticed birth weight increased as maternal height increased.It is well established that socio-economic status and ethnicity influences height as stunting is a consequence of long-term poor nutritional intake and is the best indicator of decreased growth in children over an extended period. Stunting has been associated with poorer cognition and school achievement in later childhood (Chang et al., 2002). Stunting has also been linked to the perpetuation of the cycle of under nutrition by causing low birth weight among offspring of the stunted mother (Kramer et al., 1990). A study from other developing countries reported high incidence of low birth weight of infants in mothers with height less than145cm than the mothers with greater than 145cm (Kamaladoss et al., 1992).
CHAPTER THREE
MATERIALS AND METHODS
Equipment
Measuring tape (to nearest 0.1cm), questionnaire, Stadiometer (Holtain Ltd., Crymych, Dyfed, UK) to the nearest 0.1 cm, and weight was measured using digital standing scales (Model DS-410, Seiko, Tokyo, Japan), to the nearest 0.1 kg, Vanier caliper (Starrett, 123 Series, U.S.A.).
Location of the study
The study was conducted in the Murtala Muhammad Specialist Hospital Kano, Kano State, Nigeria, for period of two month.
Study population and sample size
Sample was randomly collected from Murtala Muhammad Specialist Hospital, Kano, Department of Obstetrics and Gynaecology.
The sample size was 384 subjects comprising both mothers and neonates calculated using a formula below;
CHAPTER FOUR
RESULTS
Table 4.1 shows the mean ± standard deviation (S.D) for the measured neonatal parameters among the Hausa neonates in Kano. The subjects had mean birth weight (BW) of 3.37kg ± 0.51. Mean birth length (BL) among the Hausa neonates was found to be 49.17 cm ± 2.06. The mean value for head circumference (HC) was 35.39 cm ±
1.80. For chest circumference (CC), the mean value was found to be 34.28cm ± 2.40while the mid upper arm circumference had mean value of 11.02 ± 0.80. The hand length had mean value of 6.55 ± 0.65 while hand breadth had mean value of 3.86 ± 0.39. The foot length had mean value of 7.96 ± 0.74. Foot breadth had mean value of 3.82 ± 0.42.
CHAPTER FIVE
DISCUSSION
Determination of maternal anthropometry is a potential tool in the evaluation and prediction of birth weight and other neonatal parameters (Benjumea, 2007). In the course of establishing the relationship, the present study observed a significant relationship between these parameters. The result revealed a statistically significant relationship between maternal weight and neonatal birth weight which is in agreement to what reported by Mohanty et al. (2006). It was also reported that birth weight and maternal weight have significant correlation value after controlling other anthropometric variables (Bhatia and Tyagi, 1984). Recent study confirms the relationship between maternal weight and other neonatal parameters by extension, as it was observed that there is strong correlation between birth weight, mid upper arm circumference, chest circumference and head circumference of the neonates (Mohsen et al., 2011). According to Mandeep et al. (2013) birth weight has shown to have correlation with the chest circumference, mid-calf circumference, birth length and mid upper arm circumference and head circumference. Also reported, there is correlation between head circumference, thigh circumference and birth weight (Ezeaka et al., 2003; Kadam et al., 2005).
CHAPTER SIX
CONCLUSIONS AND RECOMMENDATIONS
The present study is a preliminary one in anthropological studies of relationship between maternal and neonatal anthropometric parameters among Hausas of Kano State origin- Nigeria. The study highlighted the relationship between maternal parameters (age, weight, height, body mass index and mid upper arm circumference) and neonatal parameters (birth weight, birth length, head circumference, chest circumference, and mid upper circumference), and are found to be correlated. When dealing with both sexes maternal weight and age shows highest correlation coefficient with birth weight and thigh circumference of r=0.487 and
0.341 respectively. In male neonates it was observed that maternal age correlates with birth weight and thigh circumference (r=0.460 and 0.453 respectively), maternal weight with birth weight and thigh circumference (r=0.308 and 0.494 respectively) while for female neonates Some of the maternal variables that show strong correlations are; maternal body mass index (BMI) with birth weight and thigh circumference(r=0.192 and 0.509 respectively).
Despite some limitations, the present study establishes the association between maternal anthropometry and with those of new-born babies among Hausas of Kano State origin, Maternal parameters can be used for estimation of birth weight and birth length in neonates. Also, the study has been successful in forming equations for the calculation of birth weight and birth length in neonates of Hausa ethnic group, with the maternal age having the highest correlation value of 0.341 in estimating birth weight while maternal hand breadth (MHB)had highest correlation value of 0.210in estimating birth length. Therefore, maternal age equation will give a better estimate of birth weight and maternal hand breadth equation will give better estimate of birth length in this age group. It should be noted that these equations cannot be used for other Nigerian ethnic groups, as anthropometry is population and sex specific.
In conclusion, Null hypothesis (H˳) is rejected, while Alternate hypothesis (H¡) is accepted, that is:
- Maternal age shown to have higher correlation value with the birth weight of neonates among Hausas in Kano (r=0.341,p<0.0001)
- Maternal anthropometric parameters can be used to estimate birth weight (BW=2.672+0.03*MA) of Hausa neonates inKano
- Maternal anthropometric parameters can be used to estimate birth length (BL=43.707+0.641*MHB) of Hausa neonates inKano
- The neonatal variable changes across different categories of parity among Hausa neonate (stable in the 3rdand 4thparities, decreases in the 1st and 2nd parities)
RECOMMENDATIONS
- Maternal age equation can be used to estimate the birth weight of a neonates (BW=2.672+0.03*MA)
- Maternal hand breadth equation can be used to estimate birth length (BL=43.707+0.641*MHB)
- The concerned authorities should formulate appropriate health awareness to encourage pregnant women to have good nutritional status and to have ante natal
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