Socio-economic and medical determinants of low birth weight in Iran: 20 years after establishment of a primary healthcare network.
OBJECTIVE
Establishment of a primary healthcare network in Iran has provided free and universal access to primary health care. Although the health status of Iranians has improved since this network was established, the low-birthweight rate has not decreased. The objective of the present study was to describe socio-economic and medical factors related to low birth weight in the context of free and universal access to primary health care.


METHODS
Descriptive, hospital-based prospective study.


METHODS
Data about socio-economic, reproductive and prenatal condition of 4510 live singleton births from June to October 2004 were gathered using a standard questionnaire by interview and record review. The effect of these conditions on birth weight was investigated using a logistic regression model.


RESULTS
Of 4510 newborns, 305 (6.8%) were low birth weight. Among these low-birthweight newborns, there were 159 preterm and 146 term newborns. Mothers with a primary and secondary education [odds ratio (OR) 6.83, 95% confidence interval (CI) 2.35-7.34 and OR 4.81, 95%CI 1.95-6.37, respectively], who lived with farmer and unskilled worker husbands (OR 2.52, 95%CI 1.12-4.66 and OR 2.91, 95%CI 1.35-2.52, respectively), with a birth interval of 1 year or less (OR 3.54, 95%CI 1.80-5.95) and height less than 155cm (OR 1.82, 95%CI 1.12-3.31) were more likely to have low-birthweight infants.


CONCLUSIONS
In the context of free and universal access to health care, it is recommended that policy makers should place more emphasis on education as it imparts knowledge and thus influences dietary habits and birth-spacing behaviour. This will lead to a better nutritional status, particularly in dealing with pregnancy, resulting in lower rates of low birth weight.
Department of Public Health, School of Health and Paramedical, Zanjan University of Medical Sciences, Zanjan, Iran. jafary@razi.tums.ac.ir
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Jafari
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Eftekhar
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Pourreza
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Mousavi
D000328:Adult; D000886:Anthropometry; D001721:Birth Intervals; D016001:Confidence Intervals; D005260:Female; D005865:Gestational Age; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007492:Iran / Q000453:epidemiology; D016015:Logistic Models; D008423:Maternal Age; D008875:Middle Aged; D016017:Odds Ratio; D010298:Parity; D011247:Pregnancy; D011295:Prenatal Care; D011320:Primary Health Care / Q000458:organization & administration*; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult