Half of the babies born at the Brazzaville University Hospital weigh less than 2,5 kilograms. Malaria, hypertension, poverty and the age of the mother, among others, explain this problem.
A survey carried out between 1er January and June 30, 2020 at the University Hospital Center (CHU) of Brazzaville in Congo, reveals that of all the births registered in this hospital, 45,6% are low birth weight births, that is to say with a weight of less than 2500 grams according to WHO criteria.
According to the results which were published in June 2022 in the journal American Journal of Pediatrics, several factors explain this high rate of low birth weight at the Brazzaville University Hospital.
These are socio-demographic factors such as the mother's age, level of education, marital status, place of residence (city where campaign); socio-economic factors (mother's income level), as well as monitoring the pregnancy (diet and prenatal visits) and even the conditions of delivery.
The study also indicates that the malaria and high blood pressure are also responsible for 64% of cases of births of babies below 2500g.
“It should be noted that the presence of malaria and especially arterial hypertension in the mother aggravates the state of health of the fetus and most often lead to a low birth weight, because the exchanges between the mother and the placenta are disturbed", explains to SciDev.Net Gauthier Buembo, doctor and teacher-researcher at Marien Ngouabi University in Brazzaville, main author of this study.
The health director of thechild at the Ministry of Health and Population in Congo, Josiane Sabaye, agrees.
She recalls that "when the blood pressure is not stabilized in time, the child is born with a low weight, because he has not received the nutritional exchanges that are necessary through the placenta", she maintains.
She also deplores the nutritional status of pregnant women, which “leaves something to be desired”. Because they often have a deficiency in iron folic acid, she says.
Factors
According to the observation made by the researchers, the youngest mothers, aged between 14 and 35, are those who give birth to the most babies below 2500g, i.e. 86% of births against 14% of births below 2500g for mothers aged 35-43.
On this subject, the study does not provide an explanation and still leaves the field open to scientific debate.
Marital status (69% of mothers of low birth weight babies are single), level of education (50,56% of mothers have secondary education) and income level (71,5% of mothers have low incomes ) are also factors closely linked to low birth weight at the Brazzaville University Hospital.
In view of this study, the composite portrait of the mother of a low-weight baby would be a mother between 20 and 35 years old, thin (with a body load index below 18,5), single, of a secondary school, with "low financial means".
Prenatal checks
To reverse the trend in Congo, the study recommends a real sensitization for the change of behavior of women in particular and of the community in general.
The researchers also advocate theeducation sexual and family planning (with contraception, spacing and birth control).
At the same time, health personnel should place emphasis on the quality of prenatal check-ups, the identification of risks and the treatment of ailments associated with pregnancy.
“The State should also step up the fight against poverty by increasing aid intended for the poorest,” adds Gauthier Buembo.
At the Ministry of Health, Josiane Sabaye emphasizes that efforts are being made to improve the health of mothers and children.
“Training is supported and funded by partners (WHO, UNICEF, UNFPA, editor’s note) to improve prenatal health (…) for quality follow-up,” she says, adding that WHO now recommends eight contacts prenatal before delivery.
To deal with this phenomenon, she maintains that the Ministry of Health has started "improving care at birth with the kangaroo method (which consists of putting the infant skin to skin with his parent, editor's note) which we will soon popularize in health centers to take good care of these children”.
For Cyriaque Djiodo, a pediatrician in Pointe-Noire, the authorities should take this study into account. “It would be profitable to generalize it. It could be a multicenter study. This would select representative health centers throughout the country. Thus, we will have a mapping of factors and determinants (newborn babies with low weight, editor's note)”, he concludes.
This article was published on the French version of SciDev.net and is reproduced with their permission.