Trends and Risk Factors for Low-Birth Weight and Preterm Deliveries between 2018–2022 in a PHC Setting of South Africa

Background: Negative birth outcomes such as low birthweight (LBW) and preterm births (PTB) are public health concerns that require an understanding of the magnitude and risk factors for intervention. Objective: The objectives were to characterize the patterns of maternal demographics and antenatal care (ANC) variables that may be connected to PTB and LBW. Materials and Method: A retrospective cohort study focused on all pregnant women who gave livebirths of singleton babies at Kwadebeka Community Health Centre between January 2018 and December 2022. Data was collected from the birth registration. Cases were categorized as either having or not having PTB, LBW, and both PTB and LBW babies. Each dependent variable of interest was subjected to an independent model. Adjusted odds ratios (OR), matching two-sided 95% confidence intervals (CI), and related p-values were used to express the outcomes of regression models. A p-value of less than 0.05 was deemed significant. Results: A total of 4116 women were registered in the birth register, 48 of whom had stillbirths and delivered multiple babies, and they were excluded from the analysis; thus, 4057 women were the study’s sample. Overall, 8.4%, 15.7%, and 5.6% of women had LBW, PTB, and both LBW and PTB, respectively, showing no annual trend. Logistic regression for PTB showed that ANC at KCHC had a higher OR = 1.4 (95% CI:1.1-1.8, p = 0.004), having no ANC OR = 9.3 (95% CI:3.94-22.22, p < 0.001) and number of ANC visits between 1–3 had OR = 3.85 (95% CI:2.42–6.13, p < 0.001) respectively. On the other hand, having no BBA and no LBW had lower ORs of 0.47 (95% CI:0.28-0.79, p = 0.004) and 0.11 (95% CI:0.08-0.16, p < 0.001) respectively. Variables showed lower ORs of 0.38 (95% CI:0.22-0.67, p < 0.001), 0.33 (95% CI:0.13-0.63, p = 0.002), 0.11 (95% CI:0.08-0.16, p < 0.001) and 0.69 (95% CI:0.49-0.97, p = 0.037) for not having BBA, not having syphilis, not having PTB and having ANC at KCHC respectively for LBW babies. On the contrary, having no ANC (0 visits) showed a higher OR of 2.90 (95% CL:1.24-6.78, p = 0.014). Conclusion: PTB and LBW continue to be common problems at some of the PHC facilities, particularly among those women who do not attend ANC, have low numbers of ANC visits, attend late for ANC, have BBAs, and have syphilis infection. Several types of programs, such as specific medical procedures to broad-scale public health interventions such as screening for risk factors, socioeconomic insufficiencies, and educational programmes should be undertaken simultaneously.