| Abstract
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The incidence of low birth weight (LBW) and perinatal mortality rate are high in the Sudan and malaria is a major health problem in the country. To identify the major risk factors which contribute to LBW and perinatal mortality, hospital-based case-control and community midwife-based surveillance studies were conducted in Central Sudan. Wad Medani and Sennar hospitals and six community centers which represent the catchment areas of these hospitals were the study sites. In the hospitals, cases were LBW infants and stillbirths while controls were liveborn normal birth weight (BW) infants. LBW cases were divided in the analysis into preterm and term LBW to identify the predictors of each group separately. All cases and two controls per case were included in the study. In the community surveillance, all births comprised the study population; cases were LBW, stillbirths, perinatal deaths, and neonatal deaths while the comparison groups were liveborn normal BW babies or survivors in the neonatal period. Information on possible risk factors was obtained in the hospital by interviewing, anthropometric, and clinical methods. However, malaria was determined by parasitological, histopathological, and immunological examinations is addition to history. The community data were obtained from maternal history and anthropometry. The results showed consistent associations in the hospital and the community studies for both perinatal mortality and LBW. The major predictors of perinatal and neonatal mortalities were biological. They included prepregnancy factors such as priori reproductive wastage, multiparity, and short birth-to-conception interval (<18 months). Pregnancy factors related to perinatal and neonatal death included exposure to agricultural pesticides, LBW, low maternal weight postnatally (<50 Kg), non-use of hematinics during pregnancy, delivery complications, birth defects, male gender, and neonatal tetanus. Of the socioeconomic factors, only lack of modern objects was associated with neonatal mortality. On the other hand, the major determinants of LBW included malaria, maternal weight <50 Kg, birth-to-conception interval <18 months, other illnesses, and female sex. In addition, the risks attributed to non-piped water and unavailability of household facilities were modest. Programs to ensure safe motherhood are recommended.
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