Seasonality of birth outcomes in rural Sarlahi District, Nepal: a population-based prospective cohort

Authors

Michelle M. Hughes, Johns Hopkins University
Joanne Katz, Johns Hopkins UniversityFollow
Luke C. Mullany, Johns Hopkins University
Subarna K. Khatry, Nepal Nutrition Intervention Project–Sarlahi, Kathmandu, NepalFollow
Steven C. LeClerq, Nepal Nutrition Intervention Project–Sarlahi, Kathmandu, Nepal
Gary L. Darmstadt, Bill and Melinda Gates Foundation, Seattle, WA
James M. Tielsch, George Washington UniversityFollow

Document Type

Journal Article

Publication Date

9-6-2014

Journal

BMC Pregnancy and Childbirth

Volume

Volume 14

Inclusive Pages

Article number 310

Abstract

Background

While seasonality of birth outcomes has been documented in a variety of settings, data from rural South Asia are lacking. We report a descriptive study of the seasonality of prematurity, low birth weight, small for gestational age, neonatal deaths, and stillbirths in the plains of Nepal.

Methods

Using data collected prospectively during a randomized controlled trial of neonatal skin and umbilical cord cleansing with chlorhexidine, we analyzed a cohort of 23,662 babies born between September 2002 and January 2006. Project workers collected data on birth outcomes at the infant’s household. Supplemental data from other studies conducted at the same field site are presented to provide context. 95% confidence intervals were constructed around monthly estimates to examine statistical significance of findings.

Results

Month of birth was associated with higher risk for adverse outcomes (neonatal mortality, low birthweight, preterm, and small for gestational age), even when controlling for maternal characteristics. Infants had 87% (95% CI: 27 – 176%) increased risk of neonatal mortality when born in August, the high point, versus March, the low point.

Conclusion

Seasonality of neonatal deaths, stillbirths, birth weight, gestational age, and small for gestational age were found in Nepal. Maternal factors, meteorological conditions, infectious diseases, and nutritional status may be associated with these adverse birth outcomes. Further research is needed to understand the causal mechanisms that explain the seasonality of adverse birth outcomes.

Comments

Reproduced with permission of BioMed Central Pregnancy and Childbirth.

Creative Commons License

This work is licensed under a Creative Commons Attribution 3.0 License.

APA Citation

Hughes, M.M., Katz, J., Mullany, L.C., Khatry, S.K., LeClerq, S.C. et al. (2014). Seasonality of birth outcomes in rural Sarlahi District, Nepal: a population-based prospective cohort. BMC Pregnancy and Childbirth, 14:310.

Peer Reviewed

1

Open Access

1