International Journal of Statistics and Applications 2013, 3(3): 50-58
DOI: 10.5923/j.statistics.20130303.03
Poverty Levels and Maternal Nutritional Status as
Determinants of Weight at Birth: An Ordinal Logistic
Regression Approach
Oladipupo B. Ipadeola
1,*
, Samson B. Adebayo
2
, Je nnife r Anyanti
3
, Emmanuel T. Jolayemi
4
1
Malaria Action Program for States, Abuja, Nigeria
2
National Agency for Food, Drug Administration and Control, Abuja, Nigeria
3
Society for Family Health, Research and Evaluation Division, Abuja, Nigeria
4
Department of Statistics, University of Ilorin, Ilorin, Nigeria
Abstract This paper explores the possible influence of household poverty levels and maternal nutritional status on child’s
weight at birth. The 2003 Nigeria Demographic Health Survey (NDHS) measures weight at birth on an ordinal scale.
Therefore, modelling techniques that take cognizance of ordinal responses are suitable for this situation. Ordinal logistic
regression technique was employed for all analyses. Quintiles of wealth index were used as a measure of assets owned by
households while body mass index was used to assess maternal nutritional status. Other demographic characteristics such as
mother’s age at birth of the child, educational attainment, locality (urban/rural) and geo-political zones were controlled for in
the models. The sample size for survey was 5138. Wealth index and maternal nutritional status were positively associated
with child’s weight at birth, while mother’s educational attainment was not statistically significant. Significant and positive
association of wealth index was evident with middle and richest when compared with those in the poorest category of wealth
index. Mothers that were underweight are less likely to give birth to heavier children while those that were overweight or
obese are more likely to give birth to children with heavier weights compared with mothers with normal BMI.
Keywords Proportional Odds Ratio, Nigeria Demographic and Health Survey, Wealth Index, Cut-off Points, Cumulative
Logistic Regression
1. Introduction
Child’s weight at birth has been shown to be associated
with child’s and maternal health; which in turn could be a
determining factor of maternal and child mortality before,
during and after birth. This may also be related to many
factors, both physical and physiological. Among such factors
that have been investigated in the past were maternal and
paternal weights and heights, ethnicity, gestational age, birth
order, maternal education, mother’s age at the birth of child
and race[1][2][3][4]. Other possible determinants of child’s
weight at birth that have been considered in literature were:
paternal education, socio-economic status, prenatal care,
method of delivery (either normal or through caesarean),
child’s sex, maternal smoking status, consumption of alcohol,
and use of psychoactive drugs duringpregnancy[5][6][7][8]
[9]. It was observed that maternal weight had a greater
influence on birth weight, while maternal and paternal height
contributions were similar in nature[2]. Furthermore, weight
* Corresponding author:
ladiipadeola@yahoo.com (Oladipupo B. Ipadeola)
Published online at http://journal.sapub.org/statistics
Copyright © 2013 Scientific & Academic Publishing. All Rights Reserved
and height of father and mother contributed equally to
infant’s weight gain.
Low birth weight (LBW) i.e. birth weight less than 2.5
Kilograms (KG), as a result of preterm birth or intrauterine
growth retardation, is the strongest single factor associated
with peri-natal, neo-natal, post-natal and infant mortality.
Birth weight is related to health outcomes in childhood, such
as neurological deficits and lower cognitive skills[10][11] as
well as in adulthood; such as high blood pressure, diabetes,
coronary heart disease and stroke[12][13][14][15]. LBW
remains a substantial public health concern even in
industrialized countries. It is more common among blacks
than whites[16]. In addition, socio-economic factors have
been suggested in literature[5][17]. Worldwide, it is
estimated that 15.5% of all live birth per year are LBW, and
more than 95% of LBW infants are born in developing
countries[18]
Birth weight is also an important determinant of weight
gain after birth. While low birth weight is associated with
increased risk of morbidity and mortality in newborns and
during infancy, excessive weight is associated with
decreased maternal amino acids[19] Decreased foetal growth
may result from a limitation in the nutrient supply to the
foetus. Research has also linked small size at birth to