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Impact of Maternal Deworming on Low Birth Weight among Newborns in Nigeria

Abstract

Maternal intestinal worm infections remain an important public health and maternal health concern in Nigeria, particularly in communities where poor sanitation, unsafe water, inadequate hygiene, and limited access to preventive healthcare increase the risk of helminth infections during pregnancy. Maternal helminth infections may contribute to anaemia, nutritional deficiencies, impaired maternal health, and adverse pregnancy outcomes that may increase the risk of low birth weight. Maternal deworming during pregnancy provides an opportunity to reduce the burden of intestinal helminth infections and improve maternal nutritional and health status, potentially contributing to improved birth outcomes. However, inadequate antenatal care attendance, limited access to deworming services, poor adherence to recommended treatment, inadequate awareness, concerns about medication use during pregnancy, and persistent exposure to contaminated environments may reduce the effectiveness of maternal deworming programmes. Against this background, this study investigates the impact of maternal deworming on low birth weight among newborns in Nigeria. The study will be anchored on the Health Belief Model, Social Ecological Model, and Health Systems Framework. The Health Belief Model explains how pregnant women's perceptions of susceptibility to helminth infections, perceived severity, perceived benefits of deworming, perceived barriers, and cues to action may influence participation in maternal deworming programmes. The Social Ecological Model emphasizes the influence of individual, household, community, environmental, healthcare, and policy factors on maternal infection, treatment, nutrition, and birth outcomes. The Health Systems Framework emphasizes antenatal service delivery, health workforce, availability of medicines, health information, financing, governance, and accessibility as essential components of effective maternal preventive healthcare. Collectively, these theoretical perspectives provide a suitable framework for explaining how maternal deworming may influence low birth weight among newborns in Nigeria. The study will adopt a quantitative analytical cohort or retrospective cohort research design. The study population will comprise pregnant women who received antenatal care in selected healthcare facilities in Nigeria and their newborns. A multistage sampling technique will be used to select states, local government areas, healthcare facilities, antenatal clinics, pregnant women, and eligible mother-newborn pairs. Maternal deworming will be assessed using indicators such as receipt of recommended anthelminthic treatment during pregnancy, timing of treatment, number of doses received, treatment adherence, availability of deworming medicines, antenatal care attendance, documentation of treatment, and maternal history of intestinal helminth infection where available. Low birth weight will be assessed using newborn birth weight measured at delivery, with low birth weight defined as a birth weight below 2,500 grams. Additional pregnancy and birth outcomes, including preterm birth and maternal anaemia, may be assessed to provide further context. Data will be collected using structured questionnaires, antenatal care records, maternal treatment registers, prescription or medication records, laboratory records where available, delivery registers, maternal health records, and newborn birth-weight documentation. Descriptive statistics will be used to summarize maternal and newborn characteristics, deworming coverage, treatment patterns, and birth-weight outcomes. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the impact of maternal deworming on low birth weight. Where a cohort design is adopted, the prevalence of low birth weight among newborns of mothers who received appropriate deworming may be compared with that among newborns of mothers who did not receive or inadequately received deworming, while relevant maternal, nutritional, socioeconomic, and pregnancy-related factors are appropriately controlled. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that appropriate maternal deworming has a significant protective impact on low birth weight among newborns in Nigeria. Newborns of mothers who received recommended deworming during pregnancy are expected to have a lower likelihood of low birth weight than newborns of mothers who did not receive appropriate deworming. Reduction in maternal helminth infection may improve maternal nutritional status and reduce infection-related anaemia, thereby supporting healthier fetal growth and pregnancy outcomes. However, the relationship between maternal deworming and birth weight may also be influenced by maternal nutrition, malaria, anaemia, socioeconomic conditions, gestational age, maternal infections, and other determinants of fetal growth. Inadequate access to antenatal services, poor treatment adherence, limited availability of deworming medicines, late initiation of antenatal care, and recurrent exposure to helminth infections may reduce programme effectiveness. The study therefore expects maternal deworming, combined with appropriate antenatal care, nutritional support, sanitation, hygiene, and management of other pregnancy-related conditions, to contribute significantly to reducing the occurrence of low birth weight in Nigeria. The study is expected to contribute to the literature on maternal deworming, intestinal helminth infections, low birth weight, maternal nutrition, antenatal care, pregnancy outcomes, maternal and newborn health, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, healthcare facilities, maternal and child health programmes, obstetricians, midwives, community health workers, development partners, and policymakers regarding strategies for strengthening maternal deworming services. The study will also provide evidence-based recommendations for improving access to antenatal deworming, strengthening maternal health education, ensuring availability of appropriate anthelminthic medicines, improving treatment documentation and adherence, strengthening maternal nutrition services, promoting sanitation and hygiene, and integrating maternal deworming into broader maternal, newborn, and child health programmes across Nigeria.

Keywords: Maternal deworming, low birth weight, intestinal helminth infections, anthelminthic treatment, maternal nutrition, antenatal care, pregnancy outcomes, newborn health, maternal health, Nigeria, public health.