Maternal hematological status and risk of low birth weight and preterm delivery in Nepal

Background Our aim was to investigate associations between maternal charact eristics, with emphasis on hematological status, and risk of low birth weig ht and preterm delivery among pregnant Nepali women. Methods. In a case-control study, 1400 pregnant women attending Patan Hospi tal, Kathmandu, Nepal for antenatal care and delivery in the period 1994 to 1996 were included. Women with twin pregnancies (n=15) and those deliverin g infants with congenital malformations (n= 13) were excluded from the stud y. Maternal characteristics including hematocrit values were recorded at th e first antenatal visit. Main outcome measures included birth weight, gesta tion at delivery, Apgar score, mode of delivery, and perinatal death. Linea r and logistic regression models were used to analyze data. Results. Severe anemia (hematocrit less than or equal to 24%) was associate d with a significantly increased risk of low birth weight (< 2500 g) and pr eterm delivery (< 37 weeks gestation). High hematocrit values (greater than or equal to 40%) did not increase the risk of low birth weight or preterm delivery. The risk of low Apgar score or operative deliveries was significa ntly increased in women with severe anemia in the first trimester. Teenager s, women with short height or low body mass index, and those belonging to t he ethnic group Brahmins, had significantly higher risks of delivering low birth weight infants. Conclusions. Severe maternal anemia, particularly in the first trimester, w as significantly associated with adverse pregnancy outcome. Low maternal ag e, height or body mass index also increased the risk of low birth weight. I mprovements in the nutritional status of young Nepali women could contribut e to improved health among their infants.