Effects of maternal pregnancy intention, depressive symptoms and social support on risk of low birth weight: a prospective study from southwestern Ethiopia.
BACKGROUND
Low birth weight (LBW) is the principal risk factor for neonatal and infant mortality in developing countries. This study examines the effects of unwanted pregnancy, prenatal depression and social support on the risk of low birth weight in rural southwestern Ethiopia. We hypothesized that unwanted pregnancy and prenatal depression increase the risk of low birth weight, while social support mediates this association.


METHODS
Data for the study comes from a prospective study in which women were followed from pregnancy through to delivery. Six hundred twenty two women were followed and 537 birth weights were measured within 72 hours. Multivariable log binomial regression was used to model the risk of low birth weight.


RESULTS
The mean birth weight was 2989 grams (SD ± 504 grams), and the incidence of LBW was 17.88%. The mean birth weight of babies after unwanted pregnancy was 114 g lower compared to births from intended pregnancy. Similarly, mean birth weight for babies among women with symptoms of antenatal depression was 116 grams lower. Results of unadjusted log-binomial regression showed that unwanted pregnancy, prenatal depression and social support were associated with LBW. The relationship between antenatal depressive symptoms and LBW was mediated by the presence of social support, while the association between LBW and unwanted pregnancy remained after multivariable adjustment.


CONCLUSIONS
The incidence of low birth weight is high in the study area. Poverty, nonuse of antenatal care, low social support and unwanted pregnancy contribute to this high incidence of low birth weight. Hence, identifying women's pregnancy intention during antenatal care visits, and providing appropriate counseling and social support will help improve birth outcomes.
Department of Population & Family Health, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia.
Yohannes Dibaba
YD
Wado
School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Mesganaw Fantahun
MF
Afework
Johns Hopkins Bloomberg School of Public Health, John Hopkins University, Baltimore, Maryland, United States of America.
Michelle J
MJ
Hindin
D003863:Depression / Q000150:complications* / Q000453:epidemiology; D005002:Ethiopia; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D033182:Intention; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000523:psychology*; D011275:Pregnancy, Unwanted; D011446:Prospective Studies; D012307:Risk Factors; D012944:Social Support