Exposure to armed conflict as a factor associated with very low birthweight: case‐control population study

Introduction

Very low birthweight (VLBW) is a multifactorial etiology public health problem that includes poverty and violence aspects. The study aimed to determine the association between armed conflict and VLBW.

Material and Methods

Case-control population study matched by year of delivery conducted in Cauca, Colombia, between 2010 and 2016. Cases of VLBW, with weights between 500-1,499 g and controls weighing between 2,500-3,999 g. Cases and controls were identified through the vital statistics registry, and exposure was determined using a multidimensional index designed by the Colombian State. Multiple gestations were excluded. Conditional logistic regression for matched data was used, adjusting for confounding variables.

Results

Overall, 7,068 matched participants (1,767 cases and 5,301 controls) were included. Cases and controls had similar baseline characteristics. Participants were predominantly women in the second and third decades of life, 46% were exposed to armed conflict, and 25% were of African-Colombian or indigenous ethnicity. Maternal exposure to armed conflict significantly increased the odds of VLBW among women with rural birth (aOR 3.86; 95%CI 2.74-5.45) and inadequate prenatal care (aOR 10.38; 95%CI 8.20-13.12).

Conclusions

Exposure to armed conflict increases the odds of VLBW neonates. This factor needs to be considered in prenatal care.

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