Table 2.
Prevalence and risk factors for preterm birth, small for gestational age and low birthweight among women enrolled in SHINE trial (2012–17)a
| Preterm |
Small for gestational age |
Low birthweight |
|||||||
|---|---|---|---|---|---|---|---|---|---|
| 18.2% (95% CI 16.9, 19.5) |
16.1 % (95% CI 15.0, 17.3) |
9.8% (95% CI 9.0, 10.7) |
|||||||
| [666/3667] |
[591/3667] |
[422/4304] |
|||||||
| Unadj. RR (95% CI) |
Adj. RR (95% CI) |
Unadj. RR (95% CI) |
Adj. RR (95% CI) |
Unadj. RR (95% CI) |
Adj. RR (95% CI) |
||||
| n = 3409 | n = 3030 | n = 3409 | n = 2892 | n = 3987 | n = 3303 | ||||
| Maternal factors | |||||||||
| Age, y | |||||||||
| <20 | 1.17 (0.98, 1.40) | 1.01 (0.81, 1.26) | 1.39 (1.17, 1.65) | 1.44 (1.16, 1.79) | 1.46 (1.17, 1.82) | 1.41 (1.07, 1.85) | |||
| 20–35 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |||
| >35 | 1.36 (1.10, 1.68) | 1.46 (1.14, 1.87) | 0.89 (0.67, 1.17) | 0.95 (0.70, 1.30) | 1.30 (0.97, 1.74) | 1.34 (0.95, 1.90) | |||
| Married | 0.48 (0.37, 0.61) | 0.51 (0.37, 0.70) | 0.93 (0.63, 1.39) | Not retained | 0.59 (0.41, 0.85) | Not retained | |||
| Education, y | 0.94 (0.91, 0.98) | 0.97 (0.93, 1.02) | 1.01 (0.97, 1.06) | 1.01 (0.96, 1.07) | 0.96 (0.91, 1.01) | 0.97 (0.92, 1.04) | |||
| Maternal height | 0.99 (0.99, 1.00) | 0.99 (0.98, 1.00) | 0.99 (0.98, 0.99) | 0.99 (0.98, 1.00) | 0.98 (0.98, 0.99) | 0.98 (0.98, 0.99) | |||
| Maternal MUAC, cm | |||||||||
| <23 (thin) | 1.17 (0.94, 1.46) | 1.12 (0.86, 1.47) | 1.49 (1.20, 1.84) | 1.38 (1.05, 1.82) | 1.81 (1.42, 2.32) | 1.98 (1.47, 2.67) | |||
| 23 <27 (normal) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |||
| 27 <31(overweight) | 0.70 (0.58, 0.84) | 0.66 (0.53, 0.82) | 0.81 (0.67, 0.98) | 0.83 (0.66, 1.04) | 0.69 (0.53, 0.89) | 0.62 (0.45, 0.84) | |||
| ≥31 (obese) | 0.62 (0.43, 0.87) | 0.65 (0.44, 0.95) | 0.54 (0.36, 0.81) | 0.68 (0.44, 1.05) | 0.71 (0.46, 1.09) | 0.71 (0.41, 1.22) | |||
| HIV-infected | 1.08 (0.89, 1.31) | 0.93 (0.73, 1.18) | 1.25 (1.03, 1.52) | 1.31 (1.02, 1.67) | 1.46 (1.16, 1.83) | 1.32 (0.98, 1.77) | |||
| Anaemic | 1.40 (1.18, 1.67) | 1.26 (1.01, 1.56) | 1.09 (0.89, 1.32) | 0.95 (0.75, 1.22) | 1.30 (1.03 1.65) | 1.07 (0.80, 1.43) | |||
| Hypertensive | 0.95 (0.58, 1.57) | 1.06 (0.61, 1.84) | 1.14 (0.70, 1.84) | 1.02 (0.56, 1.86) | 1.17 (0.65, 2.11) | 1.24 (0.63, 2.44) | |||
| Maternal capabilitiesb | |||||||||
| Depression | 1.28 (0.97, 1.69) | Not retained | 0.94 (0.67, 1.33) | Not retained | 0.76 (0.48, 1.20) | 0.72 (0.41, 1.26) | |||
| Low PHS | 0.89 (0.76, 1.04) | Not retained | 0.97 (0.82, 1.13) | Not retained | 0.89 (0.73, 1.08) | 0.96 (0.76, 1.21) | |||
| Low DMA | 1.02 (0.87, 1.18) | Not retained | 1.02 (0.87, 1.20) | Not retained | 1.00 (0.82, 1.23) | Not retained | |||
| Low MSE | 0.98 (0.84, 1.14) | Not retained | 1.140.9 (0.98, 1.34) | Not retained | 1.04 (0.86, 1.26) | Not retained | |||
| Low GNA | 1.18 (1.02, 1.38) | Not retained | 1.12 (0.95, 1.32) | Not retained | 1.09 (0.89, 1.34) | Not retained | |||
| Low PSS | 0.93 (0.80, 1.08) | 0.87 (0.73, 1.04) | 1.07 (0.92, 1.25) | Not retained | 1.06 (0.88, 1.29) | 0.91 (0.72, 1.15) | |||
| Low PTS | 1.00 (0.86, 1.16) | Not retained | 1.09 (0.94, 1.27) | Not retained | 1.16 (0.96, 1.41) | Not retained | |||
| Household factors | |||||||||
| Wealth scorec | 1.01 (0.97, 1.06) | Not retained | 0.97 (0.93, 1.01) | Not retained | 0.98 (0.93, 1.03) | Not retained | |||
| Food insecurityd | 1.07 (0.89, 1.29) | Not retained | 1.03 (0.84, 1.25) | Not retained | 1.15 (0.91, 1.45) | Not Retained | |||
| No improved latrine | 1.11 (0.95, 1.31) | Not retained | 0.91 (0.77, 1.07) | Not retained | 0.88 (0.72, 1.07) | 0.89 (0.70, 1.13) | |||
| Feces in yard | 1.17 (1.01, 1.37) | 1.18 (0.99, 1.41) | 0.92 (0.78, 1.09) | Not retained | 1.09 (0.89, 1.34) | Not retained | |||
| Improved drinking water | 0.90 (0.77, 1.05) | Not retained | 0.93 (0.79, 1.09) | Not retained | 0.78 (0.64, 0.94) | 0.84 (0.67, 1.06) | |||
| Antenatal/delivery factors | |||||||||
| Booked ANC | 0.47 (0.19, 1.17) | 0.46 (0.15, 1.46) | 0.63 (0.19, 2.05) | 0.54 (0.14, 2.12) | 0.62 (0.17, 2.26) | 0.48 (0.12, 1.95) | |||
| Non-inst delivery | Not applicable | Not applicable | 1.12 (0.84, 1.50) | 1.25 (0.91, 1.73) | 1.77 (1.33, 2.36) | 1.98 (1.43, 2.75) | |||
| Twin/triplet | 3.24 (2.66, 3.94) | 3.06 (2.26, 4.14) | 2.87 (2.27, 3.62) | 3.25 (2.32, 4.55) | 7.00 (5.84, 8.39) | 8.09 (5.98, 10.96) | |||
| Hungry season deliveryc | 1.02 (0.88, 1.18) | 1.04 (0.88, 1.23) | 1.07 (0.92, 1.25) | 1.09 (0.91, 1.30) | 1.20 (0.99, 1.45) | 1.15 (0.92, 1.45) | |||
| Female infant | 0.84 (0.72, 0.97) | 0.83 (0.70, 0.99) | 1.07 (0.92, 1.25) | 1.16 (0.97, 1.39) | 1.18 (0.98, 1.43) | 1.30 (1.04, 1.64) | |||
| n = 3409 | n = 3409 | n = 3983 | |||||||
| Study arme | |||||||||
| SOC | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| IYCF | 0.84 (0.66, 1.07) | 0.84 (0.65, 1.09) | 1.09 (0.88, 1.35) | 1.15 (0.90, 1.46) | 1.00 (0.75, 1.33) | 1.01 (0.75, 1.37) | |||
| WASH | 0.99 (0.79, 1.24) | 0.97 (0.76, 1.23) | 1.14 (0.93, 1.40) | 1.10 (0.86, 1.39) | 1.12 (0.85, 1.47) | 0.98 (0.72, 1.31) | |||
| WASH+IYCF | 0.98 (0.79, 1.23) | 0.99 (0.78, 1.26) | 1.02 (0.83, 1.26) | 1.08 (0.85, 1.36) | 0.99 (0.75, 1.31) | 0.91 (0.67, 1.22) | |||
RR, risk ratio; LB, live births; Small for gestational age, <10th centile weight for gestational age using Intergrowth Fetal Growth Standards; low birthweight, <2500 g at birth; anaemic, haemoglobin concentration during pregnancy <12 µg/dl; HTN, hypertensive during pregnancy defined as systolic blood pressure >140 mm Hg and/or diastolic blood pressure >90 mm Hg; MUAC, mid-upper arm circumference; ANC, antenatal care. Maternal and household baseline data were collected about 2 weeks after consent was recorded (at roughly 14 weeks’ gestation). This gap created opportunity for loss to follow-up between consent and baseline; thus for all outcomes, the number of mothers included in the risk factor analysis is less than the denominator used to calculate prevalence. Bold indicates factors asssociated at P value <0.05.
For further discussion of all maternal capabilities see reference.20 Low PHS, low perceived health status defined as mother perceives herself to have poor health status; low DMA, low decision-making autonomy defined as mother perceives herself to have little decision-making autonomy; low MSE, low mothering self-efficacy, mother perceives herself not to be efficacious in her mothering skills; low GNA, low gender norm attitudes defined as mother holds inequitable gender norm attitudes; low PSS, low perceived social support defined as mother perceives herself to have little social support; low PTS, low perceived time stress defined as mother perceives herself as unstressed.
Hungry season is period of relative food scarcity defined as October–March.
Preterm birth defined as <37 weeks’ gestation calculated from last menstrual period.
Study arms of SHINE trial. SOC, Standard of Care; IYCF, Infant and Young Child Feeding; WASH, Water And Sanitation, Hygiene; WASH+IYCF, WASH and IYCF interventions delivery concurrently.