Low Birth Weight and its Association with Maternal Melasma: A Case-Control Study inthe Primary Care Setting of District Peshawar, Pakistan

Abstract

Melasma is a skin condition that causes patches and spots usually on the face which is darker than
the natural skin. In Khyber Pakhtunkhwa, the prevalence of maternal Melasma is 68.8% while in
Pakistan this prevalence is about 40 to 50%. Most common cause of Melasma is nutritional
deficiency. Low birth weight babies are a significant public health problem in developing countries
like Pakistan. Low birth weight considers below 2.5kg of birthweight. Prevalence of low-birthweight babies in Pakistan is 19% in urban areas while 32% in rural areas. Objective of the study
is to determine the association between low birth weight and pregnancy induced Melasma in
women attending primary health care facility of Peshawar. And to identify the factors associated
with low-birth-weight occurrence in pregnancy induced Melasma in these patients. The study
design is case-control study and the methodology used in this study is that we take two groups’
cases and control. The sample size was calculated using Open Epi Sample Size calculator by
assuming: Low birth weight occurrence in pregnancy-induced Melasma group =40%, Low birth
weight occurrence in normal pregnant women=20 %(unknown) 95% CI Power =80% ratio of cases
to control =1:1. The required sample size will be 344 i.e. 172 cases and 172 controls. Data analysis
is done on computer software, Excel and Spss 2022 version is used in analysis of the collected
data. The results of the study are positive and after the data analysis and interpretation the
association is statistically significant between maternal Melasma and low birth weight babies.
Mean that the data we collected from cases (patient who have low birth weight babies) are suffering
from maternal Melasma in their gestational stage. All of the variables that we take for our data
collection give us complete data about the patient lifestyle, socioeconomic status, maternal
Melasmatic history, history of abortion, anemia, and history of antenatal visits. All these variables
give us the comprehensive information about the patient history which help us find association
between the low birth weight and maternal Melasma. This study shows that female who have
maternal Melasma have an increase chance of low-birth-weight babies as compare to female who don’t have maternal Melasma during their gestational age. And it’s also a cost-effective way to
determine the nutritional status of mother which help to prevent the nutritional deficiency during
that stage so we can prevent the low-birth-weight babies which can decrease the burden of the lowbirth-weight babies as well. The high prevalence of LBW in Pakistan is driven by factors like
maternal malnutrition, early pregnancies, poor healthcare access, and cultural practices, with
significant health consequences. Maternal melasma, often linked to nutritional deficiencies, may  also contribute to LBW, highlighting the need for early interventions. This research could offer
insights to improve maternal health, nutrition, and reduce LBW births in Pakistan.