Predictors of low birth weight in pregnant women with malaria: a prospective cohort facility-based study in Webuye-Kenya

Malaria is caused by protozoa of the genus Plasmodium and remains a major public health burden in Sub-Saharan Africa. Its prevalence varies between 9 to 18% with harmful consequences to both the mother and her baby, including adverse pregnancy outcomes such low birth weight, high morbidity, and mortality. However, effective antenatal strategies for improving maternal and child health outcomes through the prevention, early detection, and treatment of malaria in pregnancy, are still lacking in resource-constrained settings. Here, we sought to determine the predictors of low birth weight in pregnant women with malaria in a cohort study in Webuye hospital. Prior to the enrollment of 140 participants, permission was sought from relevant institutions and consent from the participants. Malaria test was conducted either with microscopy or rapid test, and then the cohort splits into malaria positive and negative followed up from the first antenatal visit (March 2022) and delivery (December 2022). Before data collection, training, pre-testing and quality control were duly observed. Data were fed into SPSS 27 version, Chi-square and Fischer’s Exact were used for bi-variate analysis at a p-value less or equal 0.05 (95%). Our results revealed that birth cohort with malaria did not result in significant low birth weight with a relative risk of 0.999, confidence level of 0.926-1.077. The prevalence of low birth weight was 4.6% with 6 cases of which 3 (4.5%) in the negative cohort and 3 (4.7%) in the positive cohort. Anemic pregnant women were 41 (31.5%), HIV were 5 (3,8%), pre-eclampsia was 5 (3.8%), gestational diabetes was 2 (1.5%). Confounding factors, such as anemia, HIV, preeclampsia, and gestational diabetes did not influence low birthweight (p-value >0.923). Otherwise, most of the participants were aged 18–25 years, were primigravida, were married, had secondary school level education, earned between 20-30 thousand shillings, were resident in rural areas, and were in their second trimester. Marital status, gestational age and area of residence were associated with malaria with a p-value less than 0.001 and 0.028 respectively. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethics approval was granted by the Ethics Review Committee of Mount Kenya University (MKU/ERC/2100). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors * ANC : Antenatal clinic C/s : caesarian section CIPD : County Integrated Development Plan HIV : Human Immunodeficiency Virus KNBS : Kenya National Bureau of Statistics Ksh : Kenyan Shilling RR : Relative Risk SPSS : Statistical Package for Social Science WHO : World Health Organization