BMC Pregnancy and Childbirth
Article number 310
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.
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.
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.
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.
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This work is licensed under a Creative Commons Attribution 3.0 License.
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.
STROBE Statement checklist
Stillbirths, Early Neonatal, Perinatal, and Neonatal Mortality Rates and Numbers by Month.docx (218 kB)
Stillbirths, Early Neonatal, Perinatal, and Neonatal Mortality Rates and Numbers by Month
Mean Birthweight by Sex and Month..docx (16 kB)
Mean Birthweight by Sex and Month.
Preterm Category by Month.docx (17 kB)
Preterm Category by Month
Average Gestational Age by Month..docx (15 kB)
Average Gestational Age by Month.
Small for Gestational Age by Month..docx (17 kB)
mall for Gestational Age by Month.
Small for Gestational Age & Preterm by Month..docx (16 kB)
Small for Gestational Age & Preterm by Month.
Percent Small for Gestational Age and Preterm by Month..docx (16 kB)
Percent Small for Gestational Age and Preterm by Month.
Food Insecurity by Month (From NNIPS cohort September 2006 – March 2008)..docx (15 kB)
Food Insecurity by Month (From NNIPS cohort September 2006 – March 2008).
Average Max and Min Temperatures..docx (18 kB)
Average Max and Min Temperatures.
Summary of Monthly Prevalence of Neonatal Outcomes Peaks and Troughs and Risk Factor Peaks..docx (118 kB)
Summary of Monthly Prevalence of Neonatal Outcomes Peaks and Troughs and Risk Factor Peaks.
Logistic Regression for Main Outcomes..docx (380 kB)
Logistic Regression for Main Outcomes.
Comparison of Characteristics between those with birthweights and those with birthweights missing.docx (16 kB)
Comparison of Characteristics between those with birthweights and those with birthweights missing/collected >72 hours.