الفهرس 
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Abstract
Low Birth Weight continues to remain a multifaceted socio- medical and public health problem worldwide, especially in the developing countries. It indicates socio-economic conditions and indirectly measures the health of the mother and the child. Low Birth Weight is also one of the reliable indicators to measure the success of maternal and child health programs.
Infants with LBW are at a disproportionately higher risk of morbidity, mortality; poor growth, as well as impaired psychomotor and cognitive development. During childhood, LBW is associated with higher probabilities of infection; malnutrition; handicapped conditions; mental deficiencies as well as problems related to behavior and learning. When LBW children become adults, they are more susceptible to type 2 diabetes mellitus; hypertension; stroke; as well as coronary heart disease and related disorders; in addition to other future chronic health problems.
Therefore, the main associated, modifiable risk factors of LBW need to be identified and understood in order to prevent it. Appropriate interventions will also help reduce the incidence of LBW deliveries and improve neonatal survival outcomes.
The aim of this study was to identify the factors associated with delivery of full-term, low birth weight babies among women in Sidi Salem City.
The study comprised a convenient sample of 240 postpartum women, 120 with full-term, normal birth weight babies and 120 with full-term, low birth weight babies. They were selected from the postpartum ward and the Neonatal Intensive Care Unit (NICU) of Sidi Salem hospital affiliated to Ministry of Health in Sidi Salem City, Kafr El-Sheikh Governorate.
One tool was developed and used by the researcher to collect the necessary data and included four parts: Part I: socio-demographic data, Part II: Reproductive history, Part III: Medical/Gynecological and family history and Part IV: Lifestyle and behavior during current pregnancy. In addition, a scoring system was used to assess postpartum women’s lifestyle and behavior during current pregnancy.
A pilot study was carried out on 24 postpartum women; 12 with full-term normal birth weight babies and 12 with full-term low birth weight babies (excluded from the study subjects) to test the feasibility of the study as well as to ascertain the clarity and applicability of the tool, in addition to calculate the time needed to complete it. After pilot study, the tool was revised, reconstructed and made ready for use.
Data were collected over a period of 4 months (starting from the beginning of October 2018 till the end of January 2019), 4 days/week; 2- 3 postpartum women /day. The average time needed to complete the interview schedule ranged between 15-25 minutes.
The collected data were categorized, coded, tabulated and analyzed using Statistical Package for Social Sciences (SPSS) version 23 program.
The main findings of the study were:
Socio - demographic data:
- Occupation displayed that one-fifth (20%) of working full-term LBW group was farmers, compared to none of full-term NBW group.
- Type of family clarified that 60.83% of full-term LBW group had extended family, compared to 51.67% of full-term NBW group.
- Crowding index revealed that 72.5 % of full-term LBW group was living in crowded houses, compared to 66.67% of full-term NBW.
Reproductive history:
- Gravidity elucidated that more than one-half (55.83%) of full-term LBW group had 2-3 pregnancies, compared to less than one-half (48.33%) of full-term NBW group.
- Parity demonstrated that 58.33% of full-term LBW group had 2-3 deliveries, compared to 50% of full-term NBW group.
- Previous pregnancy complications were significantly (P=0.001) reported by 18.39% of full-term LBW group, compared to 2.38% of full-term NBW group. However, bleeding and PIH were the main complications reported by 18.75% of the former group, compared to none of the latter group.
- Sex of living children displayed that 57.50% of full-term LBW group had both male and female children, compared to 46.67% of full-term NBW group.
- Type of previously used contraceptive methods clarified that 25.88% of Full-term LBW group reported use of an IUD, compared to 16.25% of Full-term NBW group.
History of current pregnancy:
- Number of antenatal visits exhibited that 9.16 % of full-term LBW group reported no or less than 4 visits, compared to 4.17% of full-term NBW.
- Pregnancy complications were highly significantly (P=0.000) reported by all (100%) of full-term LBW, compared to 35.83% of full-term NBW group. Meanwhile, PIH was the main complication significantly (P=0.033) reported by 30% of the former group, compared to 6.98% of the latter group.
- Birth order 3-6 was reported by 47.5% of full-term LBW group, compared to 35.83% of full-term NBW.
Gynecological history:
- Previous gynecological diseases were reported by 22.5% of full-term LBW group, compared to 15.83% of full-term NBW group. However, genital tract infection was the main disease reported by 92.59% of the former group, compared to 73.68% of the latter group.
Lifestyle & behavior during current pregnancy:
- Nutritional intake illustrated that 44.17%, 42.5% & 50% of full-term LBW reported occasional intake of fiber-rich foods, one time /week intake of canned fish as well as less than 3 & 3 or more times/week intake of fresh fruits and natural juices respectively, compared to 36.67%, 35% & 39.17% respectively of full-term NBW
- Exposure to passive smoking was reported by 59.17% of full-term LBW group, compared to 49.17% of full-term NBW group.
- Every day & 3 times or more exposure to environmental pollutants was reported by 76.92% of full-term LBW group, compared to 37.5 % of full-term NBW group.
- Drug intake revealed that anti-emetics, anti-coagulants and anti-histamines were taken by 10%, 50% & 20% respectively of full-term LBW group, compared to 0%, 37.5% & 12.5% respectively of full-term NBW group.
- Household activities were carried out by almost all (99.17%) of full-term LBW and NBW groups, where they were performed daily by all (100%) of both groups.
- Sleeping for less than 8 hours was reported by 30.83% of full-term LBW group, compared to 22.5% of full-term NBW group, while sleeping for 8 hours was reported by 77.5% of the latter group, compared to 67.5% of the former group.
Recommendations:
- There is a great necessity for improving the antenatal care, both in coverage and quality of services provided.
- In-service education programs should be offered to maternity nurses about LBW to increase their ability to detect high-risk pregnant women.
- Pregnant women should be encouraged to receive early, regular and high quality ANC to improve pregnancy outcomes and reduce the incidence of LBW.
- More studies are needed to determine the effect of young maternal age, excessive and insufficient physical activity as well as malnutrition and early pregnancy bleeding on birth outcomes, including LBW.