Abstract:
The pathway that links socioeconomic disadvantage to birth outcomes is not known. Data on the link between socioeconomic disadvantages to birth outcomes are important for planning maternal and child care services. Hence, this study aimed to determine the prevalence and examine the pathway between socioeconomic disadvantage and birth outcomes of a maternal exposed to indoor air pollution, food insecurity and substance use during pregnancy among deliveries at Gondar teaching referral and Bahir Dar Felege Hiwot referral hospitals, North West Ethiopia. Institution based cross-sectional study was conducted from May 1, 2015 to May 30, 2015 at Gondar and Bahir Dar referral hospitals. Primary data were collected using a structured questionnaire. Gestational age was determined based on the last menstrual period and birth weight was measured following the standard procedures. After wealth index was calculated using principal component analysis, structural equation modeling was applied to find the mediating factors of socioeconomic disadvantage to birth outcomes. The prevalence of low birth weight was 13.5% and the prevalence of preterm birth was 15.0%. Based on the fit indices, mean and variance adjusted weighted least square estimator is better than maximum likelihood estimator to estimate the model parameters of this study. Socioeconomic disadvantage was directly and negatively associated to gestational age but not directly associated to birth weight. Indoor air pollution, food insecurity and substance use were negatively associated to birth weight, and gestational age was positively associated to birth weight after adjusting sex of the infant. However, indoor air pollution, food insecurity and substance use were not significantly associated to gestational age. The pathway that links socioeconomic disadvantage to birth weight was indoor air pollution, food insecurity and substance use. Indoor air pollution, food insecurity and substance use did not mediate the pathway between socioeconomic disadvantages to gestational age. There is high prevalence of low birth weight and preterm birth in this area. Hence intervention and preventive strategies should focus on indoor air pollution, food insecurity and substance use behavior of mothers during pregnancy
