Prevalence and risk factors associated with preeclampsia , low 1 birth weight and postpartum hemorrhage in Northern Ghana

Prevalence and risk factors associated with preeclampsia, low 1 birth weight and postpartum hemorrhage in Northern Ghana. 2 Benjamin Ahenkorah, Samuel Asamoah Sakyi, Gideon Helegbe, Eddie-Williams Owiredu, 3 Winfred Ofosu, Edmund Muonir Der, Richard K.O. Ephraim, Benjamin Amoani, Priscilla 4 Arthur-Johnson, Dominic Apio, Susanna Cheetham, Ben Gyan 5 Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah 6 University of Science and Technology, Kumasi, Ghana 7 Department of Medical Laboratory Science, Bolgatanga Technical University, Bolgatanga-Upper 8 East Region, Ghana 9 Department of Biomedical Sciences, University of Cape Coast, Cape Coast, Ghana 10 School of Medicine and Health Science, University for Development Studies, Tamale, Ghana 11 Ghana Health Service, Upper East Region, Ghana 12 Department of Immunology, Noguchi Memorial Institute for Medical Research 13 School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana 14 8 School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana 15


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According to the World Health Organization (WHO), low birth weight (LBW) refers to the weight 55 at birth that is less than 2500g [1]. Birth weight is an essential predictor of infant growth and survival. 56 Infants born with low birth weight (LBW) begin life immediately disadvantaged and face extremely 57 poor survival rates [2,3]. LBW infants suffer severe cognitive and neurological impairment, 58 increased risk of high blood pressure, obstructive lung disease, cholesterol, renal damage, acute 59 diarrhea, impaired immune function and poor cognitive development [4,5]. Globally, about 16% of 60 live births, or 20 million infants per year, are born with LBW, with 90% of these born in developing 61 countries [6]. The prevalence of LBW varies between and within geographical regions. In Northern 62 Ghana, the prevalence of LBW was 13.8% based on data collected between 2009 and 2011 [7]. 63 Current data on LBW is thus needed. The factors associated with LBW is multifactorial, including 64 nutritional factors, younger and advanced maternal age, parity, limited birth spacing, low pre-65 pregnancy BMI and parasitic infections [8,9]. 66 Postpartum hemorrhage (PPH) is blood loss of ≥1000 ml in the immediate post-partum period [10]. 67 Although there have been several advances aimed at its prevention and management in recent years, 68 PPH remains a leading cause of maternal mortality and morbidity globally, affecting approximately 69 2% of all women who give birth [11]. In Ghana, the prevalence of PPH was 4.4% in 2018 [12]. Like 70 LBW, the cause of PPH is multifactorial and has been related with late antenatal care (ANC) 71 registration [13], preexisting maternal anaemia [11], prolonged labor and younger maternal age [12]. 72 Preeclampsia (PE) is the leading cause of maternal morbidity and mortality globally [14]. The 73 prevalence of PE is 2-8% worldwide and up to 10% in developing countries [15]. In Ghana,the 74 prevalence of PE ranged between 6.55 and 7.03% from 2006-2009 [16]. Data from 2014 revealed 75 an increased prevalence of PE (48.8%) and eclampsia (13.5%) among women with hypertensive 76 disorders of pregnancy [17]. Current data on PE, particularly in Northern Ghana    Birth weight in grams (g) was measured within 24 hours after birth and LBW was diagnosed if a 119 neonate has a weight <2500 g [1]. PE was diagnosed based on a systolic blood pressure ≥140 mmHg             Additionally, young women are given out for marriage at a tender age in most parts of Northern 205 Ghana. These factors could account for the higher prevalence of PE in this study.

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The AS haemoglobin genotype was also found to be associated with reduced odds of PE. This  We found a LBW prevalence of 15.7% in this study. This finding is higher compared to a study by

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The prevalence of PPH in this study was 6% which is equal in magnitude to the global incidence of   This research did not receive any specific grant from funding agencies in the public, commercial, or 303 not-for-profit sectors. 305 Not applicable 306 Availability of data and materials 307 The datasets used and analysed during the current study are available from the corresponding 308 author on reasonable request.

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The authors declare that they have no competing interests.

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Ethics approval and consent to participate 314 Ethical approval for this study was obtained from the institutional review board of the Navrongo 315 Health Research Centre of the Ghana Health Service. Written informed consent was obtained from 316 all participants who opted to participate after the aims and objectives of the study had been explained 317 to them. Participation was voluntary, and respondents were assured that the information obtained 318 was strictly for research and academic purposes only and were guaranteed the liberty to opt out from 319 the study at their own convenience.