Sammendrag
1. Abstract
Background
The frequency of stillbirth and low birth weight in India is far higher than in Western countries. Lower quality of maternity care and greater morbidity among pregnant women are considered important risk factors for these unwanted outcomes.
Objective
To observe the antenatal care at a public health centre in rural India, and to analyze the outcome of childbirths in this clinic over a 12-year period with respect to birth rate, birth weight, stillbirth and explanatory parameters affecting these.
Setting
A four-week stay at the Methodist Public Health Centre (MPHC), a health clinic in the village Mursan in rural India.
Method
Data on 3882 deliveries at the MPHC in the village Mursan, India, were retrieved from hand written birth registries that spanned 12 years (1995-2004). No registered births were excluded.
Selected variables (birth rate, month and year of birth, maternal age and gravidity, birth weight and stillbirth) were analysed retrospectively. Logistic regression analysis and other statistical methods were used to determine the factors affecting birth weight and rate. We observed and participated in the daily routine at the centre and also visited other health care projects run by MPHC in nearby villages.
Results
3882 births (224 per year) were registered in the period 1994-2005. Year of birth had no influence on birth rate in general (p=0.388), although a significant drop in birth rates occurred in 1998 (p<0.01) and a significant peak in 2000 and 2001 (p<0.01 for both). Birth rates were significantly higher in March, and in the months May to October, compared to january (p<0.01). Each year, the birth rate peaked in August. The average maternal age was 25.1 years, and 34 % were pregnant for the first time. The mean birth weight among live newborns was 2761 g. There was no significant increase in birth weight, except from a peak in 2004 (p<0.01). Birth weight was consistently higher in January, February and March compared to the rest of the year (p<0.01). Overall, 21 % of newborns weighed less than 2500 g at birth, and an estimated 3.2-5.3 % of children were stillborn. However, a decreasing incidence was observed for both stillbirth and low birth weight (p=0.036 and 0.0096, respectively).
Conclusion
Birth weight and still birth rates at MPHC are similar to available numbers for the rest of India, and both are decreasing during the period 1994-2005. The prevalence of low birth weight at MPHC was lower than India as a whole.