title: Predictors and outcomes of low birth weight in Lusaka, Zambia.
abstract: OBJECTIVE
  To determine factors associated with low birth weight (LBW) in an urban Zambian cohort and investigate risk of adverse outcomes for LBW neonates.
  
  
  METHODS
  The present retrospective cohort analysis used data recorded between February 2006 and December 2012 for singletons and first-born twins delivered in the public health system of Lusaka, Zambia. Routine clinical data and generalized estimating equations were used to examine covariates associated with LBW (<2500 g) and describe outcomes of LBW.
  
  
  RESULTS
  In total, 200 557 neonates were included, 21 125 (10.5%) of whom were LBW. Placental abruption, delivery before 37 weeks, and twin pregnancy were associated with LBW in multivariable analysis (P<0.01 for all). Compared with neonates weighing more than 2500 g, LBW neonates were at higher risk of stillbirth (adjusted odds ratio [AOR] 8.6, 95% confidence interval [CI] 6.5-11.5), low Apgar score (AOR 5.7, 95% CI 4.6-7.2), admission to the neonatal intensive care unit (AOR 5.4, 95% CI 3.5-8.3), and very early neonatal death (AOR 6.2, 95% CI 3.7-10.3).
  
  
  CONCLUSIONS
  LBW neonates are at increased risk of adverse outcomes, including stillbirth and neonatal death, independent of pregnancy duration at delivery and multiple pregnancy. These findings underscore the need for early, comprehensive, and high-quality prenatal care.
authors.affiliation: Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia. Electronic address: carla_chibwesha@med.unc.edu.
authors.forename: Carla J
authors.initials: CJ
authors.lastname: Chibwesha
authors.affiliation: Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.
authors.forename: Arianna
authors.initials: A
authors.lastname: Zanolini
authors.affiliation: Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Marcela
authors.initials: M
authors.lastname: Smid
authors.affiliation: Department of Obstetrics and Gynaecology, University of Zambia School of Medicine, Lusaka, Zambia.
authors.forename: Bellington
authors.initials: B
authors.lastname: Vwalika
authors.affiliation: Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.
authors.forename: Margaret
authors.initials: M
authors.lastname: Phiri Kasaro
authors.affiliation: Centre for Infectious Disease Research in Zambia, Lusaka, Zambia; Department of Obstetrics and Gynaecology, University of Zambia School of Medicine, Lusaka, Zambia.
authors.forename: Mulindi
authors.initials: M
authors.lastname: Mwanahamuntu
authors.affiliation: Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Jeffrey S A
authors.initials: JS
authors.lastname: Stringer
authors.affiliation: Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Stringer
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care; D012189:Retrospective Studies; D012307:Risk Factors; D050497:Stillbirth / Q000453:epidemiology*; D055815:Young Adult; D015024:Zambia / Q000453:epidemiology
keywords: Low birth weight; Neonatal death; Obstetrics; Perinatal outcomes; Stillbirth; Sub-Saharan Africa