Maternal determinants for 4 Ds in children registered under Rashtriya Bal Swasthya Karyakram program at an urban health centre of Ahmedabad
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20230236Keywords:
ANC care, Child health, 4 D’s, Maternal determinants, Outcome of pregnancy, RBSKAbstract
Background: Maternal determinants influence the outcome of pregnancy and child’s health in early years. Rashtriya Bal Swasthya Karyakram (RBSK) deals with the 4 D (birth defects, chronic diseases, deficiency disorders and developmental delays) among children (from birth till 18th years). Objectives were to determine and document the association between maternal determinants especially antenatal care (ANC) and 4 Ds and suggest preventive measures.
Methods: Out of 302 children with 4 D’s registered during April 2018-March 2020, 102 children were selected using probability proportionate to sample size (PPS) sampling for each category of 4D. Information of socio demographic details and maternal determinants was gathered on a semi structured questionnaire by interviewing mothers/caretaker.
Results: Relevant information could be gathered from 96 caregivers/parents. Mean maternal age was 26.4±4.1 years. Congenital defects were significantly associated with higher maternal age (p<0.0001). Out of 102 cases under study, minimum recommended 4 ANC visits were not taken by 17 (17.7%) mothers. Also, 13 (13.5%) did not take IFA supplementation. Poor health status during pregnancy, was significantly associated for deficiency disorders of child in later life (p<0.04).
Conclusions: Maternal age at pregnancy, health status of mother, ANC care (number of ANC visits, IFA supplementation), health seeking behaviour, birth weight and birth order of child were major determinants of 4Ds.
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References
Procter SB, Campbell CG. Position of the Academy of Nutrition and Dietetics: nutrition and lifestyle for a healthy pregnancy outcome. J Acad Nutr Diet. 2014;114(7):1099-1032.
Mate A, Reyes-Goya C, Santana-Garrido Á, Vázquez CM. Lifestyle, Maternal Nutrition and Healthy Pregnancy. Curr Vasc Pharmacol. 2021;19(2):132-40.
Ramakrishnan U, Grant F, Goldenberg T, Zongrone A, Martorell R. Effect of women's nutrition before and during early pregnancy on maternal and infant outcomes: a systematic review. Paediatr Perinat Epidemiol. 2012;26(1):285-301.
Suárez-Idueta L, Bedford H, Ohuma EO, Cortina-Borja M. Maternal risk factors for small-for-gestational-age newborns in Mexico: analysis of a nationwide representative cohort. Front Public Health. 2021;9.
Khalil A, Syngelaki A, Maiz N, Zinevich Y, Nicolaides KH. Maternal age and adverse pregnancy outcome: a cohort study. Ultrasound Obstet Gynecol. 2013;42(6):634-43.
Wu Y, Chen Y, Shen M, Guo Y, Wen SW, Lanes A, et al. Adverse maternal and neonatal outcomes among singleton pregnancies in women of very advanced maternal age: a retrospective cohort study. BMC Pregnancy Childbirth. 2019;19(1):3.
Harris BS, Bishop KC, Kemeny HR, Walker JS, Rhee E, Kuller JA. Risk factors for birth defects. Obstet Gynecol Surv. 2017;72(2):123-35.
Rashtriya Bal Swasthya Karyakram (RBSK), operational Guidelines. Ministry of Health and Family Welfare Government of India. Feb 2013. Available at: https://cghealth.nic.in/nhmcg/ Informations/RMNCH/7Rastriya_Bal_Swaasthya_karyakaram.pdf. Accessed on 20 June 2022.
Wong SPW, Twynstra J, Gilliland JA, Cook JL, Seabrook JA. Risk factors and birth outcomes associated with teenage pregnancy: a Canadian sample. J Pediatr Adolesc Gynecol. 2020;33(2):153-9.
Njim T, Tanyitiku BS, Babila CS. Prevalence of adolescent deliveries and its complications in Cameroon: a systematic review and meta-analysis. Arch Public Health 2020;78(24).
U.S. National Library of Medicine Clinicaltrials.gov. Pregnancy and chronic disease: The effect of a midwife- coordinated maternity care intervention. Available at: https://clinicaltrials.gov/ ct2/show/NCT03511508. Accessed on 20 June 2022
National Family Health Survey- 5. State fact sheet Gujarat. Available at: https://www.im4change. org/docs/Gujarat%20NFHS-5%20Factsheet.pdf. Accessed on 20 June 2022.
Bhatt G, Sharma R, Bakshi H, Oza D, Dave R, Pirzada A. A retrospective cohort study on utilization of Rashtriya Bal Swasthya Karyakram (RBSK) services among children screened at an urban health centre (UHC) of Ahmedabad Municipal Corporation (AMC). Healthline. 2022;13(3):228-32.
