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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Malaria Infection, Poor Nutrition and Indoor Air Pollution Mediate Socioeconomic Differences in Adverse Pregnancy Outcomes in Cape Coast, Ghana
PLoS ONE, Volume 8, No. 7, Article e69181, Year 2013
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Description
Background:The epidemiological evidence linking socioeconomic deprivation with adverse pregnancy outcomes has been conflicting mainly due to poor measurement of socioeconomic status (SES). Studies have also failed to evaluate the plausible pathways through which socioeconomic disadvantage impacts on pregnancy outcomes. We investigated the importance of maternal SES as determinant of birth weight and gestational duration in an urban area and evaluated main causal pathways for the influence of SES.Methods:A population-based cross-sectional study was conducted among 559 mothers accessing postnatal services at the four main health facilities in Cape Coast, Ghana in 2011. Information on socioeconomic characteristics of the mothers was collected in a structured questionnaire.Results:In multivariate linear regression adjusting for maternal age, parity and gender of newborn, low SES resulted in 292 g (95% CI: 440-145) reduction in birth weight. Important SES-related determinants were neighborhood poverty (221 g; 95% CI: 355-87), low education (187 g; 95% CI: 355-20), studentship during pregnancy (291 g; 95% CI: 506-76) and low income (147 g; 95% CI: 277-17). In causal pathway analysis, malaria infection (6-20%), poor nutrition (2-51%) and indoor air pollution (10-62%) mediated substantial proportions of the observed effects of socioeconomic deprivation on birth weight. Generalized linear models adjusting for confounders indicated a 218% (RR: 3.18; 95% CI: 1.41-7.21) risk increase of LBW and 83% (RR: 1.83; 95% CI: 1.31-2.56) of PTB among low income mothers. Low and middle SES was associated with 357% (RR: 4.57; 95% CI: 1.67-12.49) and 278% (RR: 3.78; 95% CI: 1.39-10.27) increased risk of LBW respectively. Malaria infection, poor nutrition and indoor air pollution respectively mediated 10-21%, 16-44% and 31-52% of the observed effects of socioeconomic disadvantage on LBW risk.Conclusion:We provide evidence of the effects of socioeconomic deprivation, substantially mediated by malaria infection, poor nutrition and indoor air pollution, on pregnancy outcomes in a developing country setting. © 2013 Amegah et al.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC3718681/bin/pone.0069181.s001.docx
https://efashare.b-cdn.net/share/pmc/articles/PMC3718681/bin/pone.0069181.s002.docx
https://efashare.b-cdn.net/share/pmc/articles/PMC3718681/bin/pone.0069181.s003.docx
Authors & Co-Authors
Amegah, A. K.
Finland, Oulu
Faculty of Medicine
Ghana, Cape Coast
University of Cape Coast Ghana
Ghana, Accra
Radel Consulting
Finland, Oulu
Oulun Yliopisto
Damptey, Obed K.
Ghana, Cape Coast
University of Cape Coast Ghana
Sarpong, Gideon A.
Ghana, Cape Coast
University of Cape Coast Ghana
Duah, Emmanuel
Ghana, Cape Coast
University of Cape Coast Ghana
Vervoorn, David J.
Ghana, Cape Coast
University of Cape Coast Ghana
Jaakkola, Jouni J.K.
Finland, Oulu
Faculty of Medicine
Finland, Oulu
Oulun Yliopisto
Finland, Oulu
Oulu University Hospital
Statistics
Citations: 34
Authors: 6
Affiliations: 5
Identifiers
Doi:
10.1371/journal.pone.0069181
e-ISSN:
19326203
Research Areas
Environmental
Food Security
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Study Approach
Quantitative
Study Locations
Ghana