MALARIA IN PREGNANCY: GESTATIONAL AGE AT FIRST ANTENATAL CARE REGISTRATION AND ITS ASSOCIATION WITH NEONATAL BIRTH WEIGHT
Abstract
Malaria during pregnancy is associated with adverse maternal, fetal and neonatal outcomes, including maternal anaemia, prematurity and low birth weight. Antenatal care (ANC) provides an important platform for malaria prevention, screening, treatment and broader maternal and fetal assessment. The World Health Organization recommends that the first ANC contact occur within the first 12 weeks of gestation. This study examined whether gestational age at first ANC registration was associated with neonatal birth weight in records from a retrospective malaria-in-pregnancy study. A retrospective observational analysis was performed on 452 identifiable records. Records with available ANC gestational age and birth weight were included in the principal analysis (n=434). ANC registration was categorized as early (<12 weeks) or late (≥12 weeks). Low birth weight (LBW) was defined as <2.5 kg. Continuous birth weight was compared using Welch's independent-samples t-test, and the association between ANC timing and LBW was assessed using a continuity-corrected Pearson chi-square test. Binary logistic regression estimated adjusted odds ratios (aORs) for LBW. Analyses were performed in IBM SPSS Statistics version 24. The findings indicated that early ANC registration occurred in 350/434 records (80.6%), while 84/434 (19.4%) registered at ≥12 weeks. Mean birth weight was 2.420 ± 0.252 kg in the early group and 2.394 ± 0.251 kg in the late group. The mean difference was 0.026 kg (95% CI −0.034 to 0.087), Welch's t(126.22)=0.859, p=.392. LBW occurred in 294/434 records (67.7%). ANC timing was not significantly associated with LBW, continuity-corrected χ²(1)=0.874, p=.350. In the adjusted logistic model, ANC gestational age was not associated with LBW (aOR=0.979, 95% CI 0.877–1.093, Wald χ²=0.148, p=.700). The overall model was not significant, likelihood-ratio χ²(4)=0.896, p=.925. Within the analyzed records, gestational age at first ANC registration was not significantly associated with neonatal birth weight or LBW. The high observed proportion of LBW requires cautious interpretation and verification of the birth-weight source, units and study-population characteristics.
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