CHAPTER I

THE PROBLEM AND ITS BACKGROUND

Introduction

Providing decent education is what every parent wants for their children. But unfortunately, poor families cannot provide for the education of their children. Some families can only afford to eat one meal a day and they can’t even send their children to school. Sometimes encouraging their children to work and earn for their living instead of studying so they can have something to eat.

The government on its action proclaims Senate Bill No. 3412 “PANTAWID PAMILYANG PILIPINO PROGRAM ACT OF 2009” which has been a big help to the youth, as the primary beneficiaries for their education and health services.

Pantawid Pamilyang Pilipino Program or 4Ps is a human development program of the national government that invests in the health and education of poor households, particularly of children aged 0-18 years old. Patterned after the conditional cash transfer scheme implemented in other developing countries, the Pantawid Pamilya provides cash grants to beneficiaries provided that they comply with the set of conditions required by the program. 

Pantawid Pamilya has dual objectives:

Social Assistance - to provide cash assistance to the poor to alleviate their immediate need (short term poverty alleviation); and

Social Development - to break the intergenerational poverty cycle through investments in human capital.

Pantawid Pamilya helps to fulfill the country’s commitment to meet the Millennium Development Goals, namely:

1. Eradicate Extreme Poverty and Hunger2. Achieve Universal Primary Education3. Promote Gender Equality4. Reduce Child Mortality5. Improve Maternal Health

To avail of the cash grants beneficiaries should comply with the following conditions: 

1. Pregnant women must avail pre- and post-natal care and be attended during childbirth by a trained health professional;

2. Parents must attend Family Development Sessions (FDS);3. 5 year old children must receive regular preventive health check-ups and vaccines;4. 6-14 years old children must receive deworming pills twice a year.

5. All child beneficiaries (0-18 years old) must enroll in school and maintain a class attendance of at least 85% per month.

Health education is any combination of learning experiences designed to help individuals and communities improve their health, by increasing their knowledge or influencing their attitudes.

4P’s beneficiaries are entitled to have regular check-ups and is required to attend Family Development Sessions, This Family Development Sessions or FDS is in the form of Health education discussing topics which is essential to everyday living, this FDS is conducted by the Department of Social Welfare and Development in collaboration with Nurses deployed by the Department of Health in different municipalities, this nurses are under the Nurse Deployment Project.

Health education in the community is very important and is vital to people of poor community, the DSWD together with the Nurses from DOH discusses topics on how to take care of family members from 0 days old up to 19 years old, pregnant mothers, post-partum mothers, family planning methods, and Pulmonary Tuberculosis Detection and Control.

Background of the Study

Objectives of the Study

The general objective of the study was to find out the impact of maternal anemia on the

health of the newborn mainly the haemoglobin level birth weight of the newborn. Specifically,

To determine the effects of the level of hemoglobin of the mother to the hemoglobin level

of the newborn.

To determine the effects of the level of haemoglobin of the mother to the birth weight of

the newborn.

To determine the effects of the number of pregnancy to the hemoglobin level of the

newborn

To determine the effects of the number of pregnancy to the birth weight of the newborn.

Statement of the Problem

The study aimed to answer the following questions:

1.    What is the profile of the pregnant women?

1.1      Age

2.2      Number of pregnancy

3.3 Hemoglobin level of the mother during pregnancy

2.     What is the profile of the newborn?

2.1     Birth weight

2.2  Hemoglobin level after birth

3. Is there a relationship between maternal hemoglobin and the hemoglobin level of her

newborn?

4. Is there a relationship between maternal hemoglobin and birth weight of her newborn?

5. Is there a relationship between the number of pregnancy and the hemoglobin level of

her newborn?

6. Is there a relationship between the number of pregnancy and birth weight of her

newborn?

Hypothesis

1. There is no significant relationship between the hemoglobin level of the mother and the

birth weight of the baby.

2. There is no significant relationship between the haemoglobin level of the mother and the

hemoglobin of the newborn.

3. There is no significant relationship between the number of pregnancy and the hemoglobin

level of the newborn.

4. There is no significant relationship between the number of pregnancy and the birth

weight of the newborn.

Scope and Delimitation of the Study

This study focused on the maternal health during pregnancy and the neonatal health in

Southern Isabela General Hospital in Santiago City. The relationship of maternal hemoglobin

and the health of the newborn was determined by the laboratory exam results of both mother and

the newborn, and the weight of the newborn in the selected hospital in Santiago City.

Significance of the Study

The result of this study will be a great benefit to the following:

Department of Health. This study can help to reduce and eliminate possible cause of

problems to newbornthrough promoting maternal health.

Physicians. This study may help physician to identify problems and promote maternal

health much easier before it affects the baby.

Nurses. This study may help nurses to provide sufficient knowledge to the pregnant

women in identifying possible interventions to prevent maternal health problems.

Hospitals. This study may help the hospitals to require newly born babies to have

different laboratory test to identify possible problems.

Mother. This study may help to minimize the possibility of acquiring maternal health

problems and to secure good health of the baby.

Father. This study may help the father to gain more information about maternal health

and would be able to help his wife to reduce the risk of having maternal problems.

Significant Others. This study may help the other family members to spread information

about the possible risk of having maternal anemia to reduce its occurrence.

Future Researchers. This will be beneficial to future researchers so that they will be

motivated to pursue more study on the same topic like this research. It can also be supplemental

to them wherein they can get insights about this study.

Definition of Terms

Anemia-A disease where there is a decrease in haemoglobin in the blood to levels below the

normal range of 12 to 16 g/dL.

Birth weight- Number of babies born low birth weight (less than 2500 grams)

Blood Picture- in other words called Complete Blood Count. A diagnostic procedure wherein

the blood is taken from the client’s body is being examined.

Diet- nutrients prescribed, regulated or restricted as to kind amount for therapeutic or other

purposes.

Folic Acid Deficiency Anemia- is an anemia due to Folic Acid deficiency.

Folic Acid- is a Vitamin B needed for RBC formation and DNA synthesis and to prevent neural

tube defects in the developing fetus.

Gravida- is defined as the number of times that a woman has been pregnant.

Health- is the level of functional or metabolic efficiency of a living being.

Hemoglobin- a complex protein iron compound in the blood that caries oxygen to the cells from

the lungs and carbon dioxide away from the cells to the lungs.

Hemolysis- the breakdown of red blood cells and the release of haemoglobin that occur normally

at the end of the life span of a red cell.

Intrinsic factor-a substance secreted by a gastric mucosa that is essential for the absorption of

cyanocobalamin

Nutrition-A well-balanced diet is the most important requirement for healthy living. Good

nutrition helps reduce our risk if getting a large number of diseases, from

diabetes to heart disease.

Parity-is defined as the number of times that she has given birth to a fetus with a gestational age

of 24 weeks or more, regardless of whether the child was born alive or was

stillborn.

Pregnancy- the gestational process, comprising the growth and a development within a woman

of a new individual from conception through the embryonic and fetal

periods to birth.

Pernicious Anemia-anemia due to Vitamin B12 deficiency, Vitamin B12 is particularly helpful

in formation of Red Blood Cells.

Supplementation- The adding nutrients-minerals, vitamins, to a diet.

Vitamin B12 test(cyanocobalamin)-a blood test that measures the level of vitamin B12, which

is necessary for conversion of the inactive form of folate to the active form,

process that is crucial in the formation and function of red blood cells.

CHAPTER II

THEORETICAL FRAMEWORK AND CONCEPTUAL FRAMEWORK

This chapter presents review of studies and pertinent theories about Maternal

Hemoglobin: A Predictor of Neonatal Health that will serve as the primary foundation in

making our research. Related literature, review clarifies and discusses different point of views

from different authors and references. Review of related studyis gathered information which is

related to the topic or from previous topics. Relevant theories are theories gathered that have a

relation to the present study and serve as background on the topic being investigated. Paradigm

of the study is a diagrammatic presentation of the data and its topics for understanding and

comprehension. Hypotheses are tentative prediction in the study. Assumption of the study, are

propositions used in delimiting the area of study. And lastly definition of terms, these are

important terms used in the study that are defined clearly for better understanding.

Related Literature

According to Rouse, Dwight J.; Weiner, Steven J.; Bloom, Steven L.; Varner,

Michael W.; Spong, Catherine Y.; Ramin, Susan M.; Caritis, Steve N.; Peaceman, Alan M.

et al. (2009).Stated that the maternal health refers to the women’s health during pregnancy,

childbirth, and the postpartum period. It encompasses the health care dimensions of family

planning, preconception, prenatal, and postnatal care in order to reduce maternal morbidity and

mortality. Preconception care can include education, health promotion, screening and other

interventions among women of reproductive age to reduce risk factors that might affect future

pregnancies. The goal of prenatal care is to detect any potential complications of pregnancy

early, to prevent them if possible, and to direct the woman to appropriate specialist medical

services. Postnatal care issues include recovery from childbirth, concerns about newborn care,

nutrition, breastfeeding, and family planning. Childbirth is the culmination of a human

pregnancy or gestation period with the expulsion of one or more newborn infants from a

woman's uterus. The process of normal human childbirth is categorized in three stages of labour:

the shortening and dilation of the cervix, descent and birth of the infant, and birth of the placenta.

In many cases, with increasing frequency, childbirth is achieved through caesarean section, the

removal of the neonate through a surgical incision in the abdomen, rather than through vaginal

birth. Medical professional policy makers find that induced births and elective cesarean can be

harmful to the fetus and neonate without benefit to the mother, and have established strict

guidelines for non-medically indicated induced births and elective cesarean before 39 weeks.

According to “Maternal and Child Health Nursing: Care of the Childbearing

&Childrearing Family” by Adele Pillitteri, PhD, RN, PNP, 6th edition (2010), it stated that

during normal pregnancy, birth, the postpartum, and newborn period, the health of the fetus and

the health of the mother are inextricably linked. Generally, a woman who eats well and takes

care of her own health during pregnancy provides a healthy environment for fetal growth and

development. However, she may need instruction on exactly what constitutes a healthy lifestyle

for herself and her baby. The health promotion during pregnancy begins with the aspects of self-

care.

A 2007 edition of the same bookstated that Second-born children usually weigh more

than first-born. Birth weight continues to increase with each succeeding child in family.

Klusmann A, Heinrich B, Stöpler H, Gärtner J, Mayatepek E, Von Kries R. (2005),

stated that balanced nutrition and nutritious diet is an important aspect of a healthy pregnancy.

Eating a healthy diet, balancing carbohydrates, fat, and proteins, and eating a variety of fruits and

vegetables, usually ensures good nutrition. Those whose diets are affected by health issues,

religious requirements, or ethical beliefs may choose to consult a health professional for specific

advice.

According to Crombleholme (2009), restated that during pregnancy a woman must eat

adequately to supply enough nutrients to the fetus, so it can grow, as well as to support her own

nutrition.

Subramanian et al., (2008), stated that adequate protein intake is vital because so much

is needed by a fetus to build a body framework. Adequate protein may also help prevent

complication of pregnancy.

According to Kuha (cradle) A Maternal and Child with Pediatric Nursing Handbook

by Aaron “CY” Tuesca Untalan RN, 1st edition (2005), it stated that woman’s or maternal

health is not only as a mother during her child bearing, but throughout life, from infancy to post

reproductive health with full exercise of her reproductive life. Especially the achievement of

reproductive health among woman is dependent upon their attitudes toward health, their

knowledge and skills which sometimes is also dependent upon their level of education and more

exposure outside her home, acquisition of more knowledge and skill and practice of which shall

develop their behavior towards health.

According to the Article reviewed by Esther Sherry, R.N., B.S. Feb 3, 2011, it stated

that anemia is a condition in which the body lacks enough red blood cells to transport oxygen-

rich blood to body tissues. Iron deficiency is the main cause of iron deficiency anemia. Iron is an

essential mineral that is needed to form hemoglobin, an oxygen carrying protein inside red blood

cells. A decrease in iron amounts in the body may be caused by poor intake of iron-rich foods,

prolonged bleeding or intestinal disorders that prevent iron absorption. Iron deficiency anemia is

the most common form of anemia and it develops over time if the body does not have enough

iron to manufacture red blood cells. Without enough iron, the body uses up all the iron it has

stored in the liver, bone marrow and other organs. Once the stored iron is depleted, the body is

able to make very few red blood cells. The red blood cells the body is able to make are abnormal

and do not have a normal hemoglobin-carrying capacity, as do normal red blood cells.

Shersten Killip, M.D., M.P.H., John M. Benneth, M.D., M.P.H., and Maria D.

Chambers, M.D., University of Kentucky, Lexington, Kentucky Am Fam

Physician. 2007 Mar 1; stated that Iron deficiency anemia (IDA) is the most common

nutritional deficiency. It can cause reduced work capacity in adults and impact motor and mental

development in children and adolescents. There is some evidence that iron deficiency without

anemia affects cognition in adolescent girls and causes fatigue in adult women. IDA may affect

visual and auditory functioning and is weakly associated with poor cognitive development in

children. Iron metabolism is unusual in that it is controlled by absorption rather than excretion.

Iron is only lost through blood loss or loss of cells as they slough. Men and non-menstruating

women lose about 1 mg of iron per day. Menstruating women lose from 0.6 to 2.5 percent more

per day. An average 132-lb (60-kg) woman might lose an extra 10 mg of iron per menstruation

cycle, but the loss could be more than 42 mg per cycle depending on how heavily she

menstruates. A pregnancy takes about 700 mg of iron, and a whole blood donation of 500 cc

contains 250 mg of iron. Iron absorption, which occurs mostly in the jejunum, is only 5 to 10

percent of dietary intake in persons in homeostasis. In states of overload, absorption decreases.

Absorption can increase three- to fivefold in states of depletion. Dietary iron is available in two

forms: heme iron, which is found in meat; and non heme iron, which is found in plant and dairy

foods. Absorption of heme iron is minimally affected by dietary factors, whereas non heme iron

makes up the bulk of consumed iron. The bioavailability of non-heme iron requires acid

digestion and varies by an order of magnitude depending on the concentration of enhancers and

inhibitors found in the diet. Iron deficiency results when iron demand by the body is not met by

iron absorption from the diet. Thus, patients with IDA presenting in primary care may have

inadequate dietary intake, hampered absorption, or physiologic losses in a woman of

reproductive age. It also could be a sign of blood loss, known or occult. IDA is never an end

diagnosis; the work-up is not complete until the reason for IDA is known.

According to Rubin’s Pathology: Clinicopathologic Foundations of Medicine by

Rubin’s, Gorstein, Schwarting and Strayer, 4th edition, 2004 p. 1032,it stated that iron

deficiency interferes with normal heme synthesis and thereby leads to impaired erythropoiesis

and anemia. The rate of iron absorption is regulated by normal losses, but with anemia intestinal

absorption is increased and may ultimately lead to iron overload. Following absorption, about

85% of absorbed iron is transported in the blood by a carrier protein, transferring, and is then

incorporated into developing red cells through specific transferring receptors on their surface. As

senescent red cells are removed from circulation, hemoglobin is broken down into component

parts, and the iron is recycled. Excess iron is stored in the body into two forms, hemosiderin and

ferritin. Hemosiderin consists of large aggregates of iron with disorganized structure, whereas

ferritin is complexed with protein and appears highly organized. Iron deficiency anemia is

characterized by a microcytic, hypochromic anemia. Variation in the size and shape of the

erythrocytes is reflected in an increased RBW. Ovalocytes may be encountered, some of which

are very thin and are designated pencil cells. Because of the production defect in the marrow,

there is no associated reticulocytosis. IDA is accompanied by a mild throbocytosis. The bone

marrow displays erythroid hyperplasia, and many of the developing normoblasts have ragged

cytoplasmic borders. Prussian blue staining demonstrates an absence of storage iron. Serum iron

and ferritin levels are decreased by iron deficiency, whereas the total iron- binding capacity is

decreased. As a result, the percent saturation of tranferritin is conspicuously lowered. Increased

levels of free erythrocyte protoporhyrin and zinc protoporphyrin are characterized because of

impraired of iron into protoporphyrin.

Pernicious anemia is an autoimmune disorder in which patients develop antibodies

directed against parietal cells and intrinsic factor. The parietal cell antibodies also lead to

atrophic gastritis with achlorhydria. Primary intestinal disorders or previous intestinal surgery

can be associated with impaired absorption of vitamin B12. Microbiological competition for

vitamin B12 may lead to deficiency. This may arise from bacterial overgrowth of a blind loop or

infestation by the fish tapeworm, diphyllobothriumlatum. Rarely, an inherited defect in the

intestinal receptor of vitamin B12 is the cause of deficiency.

Related Studies

M.K. Sharma, D. Kumar, A. Huria, P. Gupta (2009) studied Maternal Risk Factors Of

Low Birth Weight In Chandigarh India. The result shows that primigravida mothers were

comparatively at lower risk of delivering LBW babies as compared to multi-gravida mothers.

Also, prevalence of LBW was found to be comparatively higher among less educated mothers

low income group. LBW prevalence was found maximum in case of maternal age above 30 years

and maternal weight below 45 kg. The prevalence rates of LBW in case of multi-gravida mothers

and age above 30 years were found to be significantly higher. The results in terms of birth order

two and above and maternal age above 30 years as risk factors found in this study do not agree

with respective findings wherein younger and primi mothers were found to be at higher risk of

delivery of LBW babies.

Many studies contradict the idea that increasing number of pregnancy affects the birth

weight of their newborn.

According to the study of Nahum GG, Stanislaw H.(2004) “Hemoglobin, altitude and

birth weight: does maternal anemia during pregnancy influence fetal growth?”it stated that birth

weight correlates negatively with maternal hemoglobin concentration. It is consistent with the

well-known effect of high-altitude exposure during pregnancy, which increases both haematocrit

and blood viscosity and lowers birth weight. The quantitative effect on birth weight of increasing

maternal hemoglobin concentration at constant altitude is within 13% of the change in birth

weight that can be attributed to the change in hemoglobin concentration associated with

increases in altitude.Term birth weight was reduced by 89 g for each 1.0 g/dL increase in

hemoglobin concentration. For every 1,000m increase in altitude, hemoglobin concentration

increased by 1.52 g/dL and birth weight decreased by 117 g.

It shows here that hemoglobin level of the mother together with the altitude level plays a

role in the birth weight of the newborn. As the altitude increases, the hemoglobin concentration

increases while the birth weight decreases.

The study of Lindsay H Allen (2000) entitled “Anemia and iron deficiency: effects on

pregnancy outcome” showed many gaps in our knowledge about the adverse effects of maternal

anemia and iron deficiency on pregnancy outcome. Such disparities include inadequate

documentation of anemia's effects on maternal mortality, morbidity, and well-being, and on

infant health and development. There is substantial evidence that maternal iron deficiency

anemia increases the risk of preterm delivery and subsequent low birth weight, and accumulating

information suggests an association between maternal iron status in pregnancy and the iron status

of infants postpartum. Certainly, iron supplements improve the iron status of the mother during

pregnancy and during the postpartum period, even in women who enter pregnancy with

reasonable iron stores.

From this previous study taken it is now a partial basis that maternal hemoglobin is a

possible predictor of neonatal health.

Kathleen Abu-Saad and Drora Fraser (2010) emphasizes in their study that maternal

nutrition plays a crucial role in influencing fetal growth and birth outcomes. It is a modifiable

risk factor of public health importance in the effort to prevent adverse birth outcomes,

particularly among developing/low-income populations. The existing intervention studies, which

primarily have involved single-nutrient interventions conducted for a limited period of time

during a single pregnancy, have shown a positive effect on birth outcomes in some cases; but the

evidence is far from consistent.

From this study it is shown that further research is needed to provide a strong evidence to

justify the relationship of maternal anemia to the birth outcomes or neonatal health.

From the study of Karaflahin, Ceyhan, Göktolga, Keskin, and Bafler (2007) entitled

Maternal Anemia and Perinatal Outcomes it focuses on pregnant women who had anemia in the

2nd trimester of pregnancy increases the risk of having preeclampsia, preterm birth, intrauterine

growth restriction, and meconium stain amniotic fluid that that of normal pregnant women. This

study showed evidence showing the relationship of maternal anemia to neonatal health.

From the journal written by Grace Rattue (2011) it stated that a team of researchers led

by Ola Anderson, consultant in neonatology at the Hospital of Halland in Sweden, and Magnus

Domellöf, associate professor of paediatrics at Umeå University, conducted a study in order to

examine the effects of delayed cord clamping vs. early clamping, on the iron levels of four

month old babies in a county hospital in Sweden.

In the study, 400 full term infants after low-risk pregnancies were examined by the researchers.

Some infants had their umbilical cords clamped within less than 10 second seconds after

delivery, while others had them clamped after at least 3 minutes. By delaying cord clamping, the

iron level of the newborn is increased and will minimize the incidence of neonatal anemia. This

study can be used as an intervention of preventing the possible effects of maternal anemia to the

newborn to improve the health of the newborn.

Relevant Theories

According to the theory of Sister Callista Roy (1997) in her Roy’s Adaptation Model,

which states and defines adaptation as “the process and outcome whereby the thinking and

feeling person uses conscious awareness and choice to create human and environmental

integration”, Roy focuses on the individual as a biopsychosocial adaptive system that employs a

feedback cycle of input, throughput, and output. The goal of Callista Roy’s model is to enhance

life processes through adaptation in four adaptive modes and it includes the physiologic mode

which involves the body’s basic physiologic needs and ways adapting with regard to fluid and

electrolytes, activity and rest, circulation of oxygen, nutrition and elimination, protection, the

senses, and neurologic and endocrine function (Kozier, 2008). The Theory of Roy is related to

this study because the variables like age, number of pregnancy andthe blood picture of the

mother will show whether the blood picture and birth weight of the newborn adapts in the

changes of the health status of the mother having maternal anemia being studied on the Maternal

Anemia: as a predictor of neonatal health from government hospital will be assessed.

PARADIGM OF THE STUDY

This study deals on the comparison of the evaluation of the blood pictures of mothers

with that of their infant in Southern Isabela Government Hospital. The researchers used the

Input-Process-Output paradigm to explain how the study was done and to elucidate the

relationships of the variables.

Input process output

CHAPTER III

FEEDBACK

Figure I. PARADIGM OF THE STUDY

The input talks about the respondents- a mother and the newborn. Through the

process, information was gathered about the mother’s age, hemoglobin level, and number of

pregnancy, and in newborn the birth weight, and hemoglobin level through documentary

analysis and unstructured interview. Those things were done by identifying the number of

mothers who have given birth in Southern Isabela General Hospital to improve maternal

health for better newborn health.

Improved maternal health

for better newborn health.

Profile of maternal

patient

>Age

>Number of pregnancy

>Hemoglobin level

during delivery

Profile of the baby

>Birthweight

>Hemoglobin level

Analysis of the data

through documentary

analysis and

unstructured interview.

RESEARCH DESIGN AND METHODOLOGY

This chapter presents the methodology of research particularly the research design,

respondents, sampling procedures, research locale, instrumentation, procedures for the data

collection and the statistical tools utilized by the researcher.

Research Design

The descriptive documentary analysis design was used in this study. This design aimed to

find out what prevails in the opinions and beliefs, processes and effects and developing trends

(Ardales, 1992). Furthermore, it describes the respondents’ profile in terms of age, number of

pregnancy, and the hemoglobin level before delivery, and also the birth weight, and hemoglobin

level for the baby. The research design also aims to determine the relationship of maternal

haemoglobin to the health of the newborn. Also, the information to be gathered is correlated and

found out that there exists a relationship among these variables.

Research Locale

This study was conducted in the government hospital, Southern Isabela General Hospial

in Santiago City, Province of Isabela, in the school year 2012-2013.

Respondents of the Study

The respondents of the study were mothers who gave birth and were admitted in the said

government hospital.

Research Instrument

The data needed by the researcher were collected from the documents or medical records

and performed unstructured interview. The medical records that were used in the study were

determined by the average number of the mother who gave birth from the period 3-6 months and

unstructured interview was for those who are currently admitted in the selected government

hospital in Santiago City.

Data Collection Procedures

1. The researcher asked permission from the Administrator of the hospital providing

a letter signed by the Research Adviser and the Dean of College of Nursing to

gain access to the medical records.

2. The researchers collected the data from the charts or records of the pregnant

women, or mother and their newly born baby, and performed interview to the

pregnant mothers who were admitted.

3. The data gathered were classified accordingly from age, haemoglobin count,

number of pregnancy, birth weight of the newborn.

Statistical Treatment and Tools

The researcher used the following statistical treatment to process the data and to give

more meaning to the data gathered:

1. Percentage. According to Calmorin (1997), the percentage is a way of expressing a

proportion, a ratio or fraction as a whole number by using 100 as denominator.

Formula: Percentage=ƒN

x 100%

Where: ƒ – Frequency

N- Population

2. Weighted mean. This refers to the set of data taken from the average of the population

(Broto, 2006)

Formula: WM=∑fx

Where: WM- weighted mean

∑ fx- Sum of the products of the frequency with weights

N- Sample size

3. Pearson product moment coefficient of correlation. It is an index of relationship

between two variables. This formula is used to test whether Maternal Hemoglobin and

Neonatal health is interrelated;

Formula: r=N ∑ xy−∑ x∑ y

√⌊n∑ x2−¿¿¿¿¿

¿

Where: r- coefficient of correlation

x and y- scores

N- Size of samples

4. T-Test. Is used to test the significance of the Pearson r, it is needed in order to know

whether the computed r is significant or not.

Formula: t=r √ n−21−r2

Where: t- test statistics

n- Sample size

r- Pearson r

r2- square root of the Pearson r