Auspicious beginnings: A high altitude study of antenatal care patterns and birth weight at two hospitals in the Leh District of Ladakh, India
Wahlfeld, Christopher Canterbury
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Background. Birth weight, a proxy for newborn health, is influenced by a confluence of biological, genetic and cultural factors. These factors become increasingly pronounced among populations residing at altitudes above 2500 meters (-8000 feet). Previous research in the Ladakh region of Northern India revealed a high percentage of newborns weighing less than 2500 grams (-5.5 pounds), a marker associated with increased neonatal morbidity and mortality. Purpose. This doctoral research seeks to add to the current knowledge of high altitude reproductive health by examining the current patterns of antenatal care sought by native Ladakhi women and determining if a relationship exists between the frequency of antenatal care and birth outcome, in particular birth weight. Methods. Using a bio-cultural approach, research was conducted at two hospitals in the Leh District of Ladakh, India from late April through early November of 2006. Maternal and neonatal data were collected from a sample of 188 native Ladakhi women as they sought reproductive healthcare. Additional data were obtained from the antenatal charts of native Ladakhi women who delivered at either hospital from November 2005 through October of 2006. These data were combined to create a complete sample of 1073 individuals, spanning twelve consecutive months. Results. The use of hospital based antenatal care continues to increase in the Leh District. Importantly, the percentage of newborns weighing less than 2500 grams was reduced from 27% in 1990 to 13.9% in the 2006 complete sample. Increases in mean birth weight and the mean number of antenatal visits were noted, though the frequency of antenatal care explained less than one percent of the variance in birth weight.