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Predictive accuracy of perceived baby birth size for birth weight: a cross-sectional study from the 2016 Ethiopian Demographic and Health Survey
  1. Dabere Nigatu1,
  2. Demewoz Haile2,
  3. Bereket Gebremichael3,
  4. Yordanos M Tiruneh4,5
  1. 1 Department of Reproductive Health and Population Studies, Bahir Dar University College of Medical and Health Sciences, Bahir Dar, Amhara, Ethiopia
  2. 2 School of Public Health, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia
  3. 3 Department of Nursing and Midwifery, Allied School of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
  4. 4 Department of Community Health, University of Texas Health Science Center at Tyler, Tyler, Texas, USA
  5. 5 Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
  1. Correspondence to Dabere Nigatu; daberen{at}


Objectives The study was designed to evaluate the accuracy of maternally perceived baby birth size assessments as a measure of birth weight and examine factors influencing the accuracy of maternal size assessments.

Study design Cross-sectional study.

Setting The study is based on national data from the 2016 Ethiopian Demographic and Health Survey.

Participants We included 1455 children who had both birth size and birth weight data.

Main outcome measures Predictive accuracy of baby birth size for low birth weight. Level of discordance between maternally perceived birth size and birth weight including factors influencing discordance.

Results Mother-reported baby birth size had low sensitivity (57%) and positive predictive value (41%) to indicate low birth weight but had high specificity (89%) and negative predictive values (94%). The per cent of agreement between birth weight (<2500 g vs ≥2500 g) and maternally perceived birth size (small size vs average or above) was 86% and kappa statistics indicated a moderate level of agreement (kappa=0.41, p<0.001). Maternal age, wealth index quintile, marital status and maternal education were significant predictors of the discordance between birth size and birth weight.

Conclusions Maternal assessment of baby size at birth is an inaccurate proxy indicator of low birth weight in Ethiopia. Therefore, a mother’s recall of birth size should be used as a proxy indicator for low birth weight with caution and should take maternal characteristics into consideration.

  • predictive accuracy
  • perceived baby size
  • birth weight
  • Ethiopia

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  • Contributors DN conceived the study, performed the data analysis, contributed in the interpretation of data and drafting the manuscript and critically reviewed the manuscript. DH conceived the study, contributed in the interpretation of data and critically reviewed the manuscript. BG contributed in the interpretation of data, drafted the manuscript and critically reviewed the manuscript. YMT contributed in the interpretation of data and critically reviewed the manuscript. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer We used the STROBE 2007 (v4) statement—checklist for reporting cross-sectional study.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data may be obtained from a third party and are not publicly available.

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