Maternal Factors Associated with Low Birth Weight among Newborns in Public Hospitals of Burao District, Somaliland, 2025

Maternal Factors Associated with Low Birth Weight among Newborns in Public Hospitals of Burao District, Somaliland, 2025 | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Maternal Factors Associated with Low Birth Weight among Newborns in Public Hospitals of Burao District, Somaliland, 2025 Jama Said Mohamed This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8320153/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Low birth weight (LBW), defined as birth weight less than 2,500 grams, remains a major public health concern and a leading predictor of neonatal morbidity and mortality, particularly in low- and middle-income countries. In Somaliland, evidence on maternal factors contributing to LBW is limited, especially in urban settings such as Burao District. Methods An institutional-based cross-sectional study was conducted from June to July 2025 in Burao General Hospital and Al-Khalifa Hospital, Somaliland. A total of 260 postpartum mothers were enrolled using a consecutive sampling technique. Data were collected through face-to-face interviews using a structured questionnaire and newborn weight measurement. Data were analyzed using SPSS version 27. Descriptive statistics summarized participant characteristics, while bivariate and multivariate logistic regression analyses identified factors associated with LBW. Statistical significance was declared at p < 0.05. Results In multivariate analysis, lack of formal maternal education (AOR = 2.6; 95% CI: 1.3–5.1), absence of iron supplementation during pregnancy (AOR = 2.9; 95% CI: 1.4–6.2), and preterm birth (<37 weeks) (AOR = 4.8; 95% CI: 2.1–10.9) were independently associated with LBW. Conclusion Low maternal education, inadequate iron supplementation, and preterm delivery were significant determinants of low birth weight in Burao District. Strengthening maternal education, improving iron supplementation coverage, and preventing preterm births through quality antenatal care are critical to reducing LBW in Somaliland. Low birth weight Maternal factors Antenatal care Iron supplementation Preterm birth Somaliland Background Low birth weight (LBW) remains a global public health challenge, accounting for a substantial proportion of neonatal morbidity and mortality. According to the World Health Organization, LBW contributes to 60–80% of neonatal deaths worldwide, with the highest burden occurring in low- and middle-income countries. Infants born with LBW are at increased risk of infections, delayed growth, neurodevelopmental impairment, and chronic diseases later in life. In Sub-Saharan Africa, the prevalence of LBW is estimated at approximately 13–14%, largely driven by maternal undernutrition, anemia, limited access to quality antenatal care, and obstetric complications. Somaliland faces persistent challenges related to maternal nutrition, health service utilization, and socioeconomic vulnerability, yet localized evidence on determinants of LBW remains scarce. Previous studies in Somaliland have reported LBW prevalence ranging from 12% to 19%, with maternal anemia, poor antenatal care attendance, and preterm delivery frequently identified as risk factors. However, data from Burao District are limited. This study aimed to assess maternal factors associated with low birth weight among newborns delivered in public hospitals in Burao District, Somaliland. Methods Study Design and Setting An institutional-based cross-sectional study was conducted between 1 June and 30 July 2025 in Burao General Hospital and Al-Khalifa Hospital, the two largest public hospitals in Burao District, Togdheer Region, Somaliland. Study Population The study population consisted of postpartum mothers who delivered live newborns in the selected hospitals during the study period. Inclusion and Exclusion Criteria Mothers who consented and were clinically stable were included. Mothers who were critically ill or declined participation were excluded. Sample Size and Sampling A sample size of 260 participants was calculated using a single population proportion formula based on a previous LBW prevalence of 19%. (Abdi, Mohamed et al.) A consecutive sampling technique was employed until the required sample size was achieved. Data Collection Data were collected using a structured interviewer-administered questionnaire and newborn weight measurement using a calibrated hanging scale. The questionnaire captured socio-demographic characteristics, nutritional status, and obstetric-related factors. Data collectors were trained, and a pretest was conducted on 5% of the sample. Data Analysis Data were analyzed using SPSS version 27. Descriptive statistics were used to summarize variables. Bivariate logistic regression identified candidate variables (p < 0.25), which were entered into multivariate logistic regression to identify independent predictors of LBW. Adjusted odds ratios (AOR) with 95% confidence intervals were reported. Ethical Considerations Ethical approval was obtained from Alpha University, Burao. Written informed consent was obtained from all participants. Confidentiality and anonymity were strictly maintained. Results Socio-demographic Characteristics The majority of mothers were aged 18–28 years (63.8%), resided in urban areas (69.2%), and were married (82.7%). Notably, 42.3% of mothers had no formal education. Nutritional and Obstetric Characteristics Most mothers (69.2%) reported not taking iron and folic acid supplements during pregnancy. Preterm births accounted for 13.8% of deliveries, and 28.5% of newborns were classified as low birth weight. Factors Associated with Low Birth Weight In multivariate analysis, three factors remained significantly associated with LBW: Lack of formal maternal education Absence of iron supplementation during pregnancy Preterm delivery (< 37 weeks) Discussion This study identified a Maternal education emerged as a strong determinant, consistent with studies from Ethiopia, Kenya, and Somaliland, highlighting the role of education in health-seeking behavior and nutrition. Iron supplementation was independently associated with birth weight, reinforcing evidence that maternal anemia and micronutrient deficiencies adversely affect fetal growth. Preterm birth showed the strongest association with LBW, in line with global literature identifying gestational age as a primary biological determinant of birth weight. Strengths and Limitations This study provides updated, localized evidence on LBW determinants in Somaliland. However, the cross-sectional design limits causal inference, and facility-based sampling may affect generalizability. Conclusion Low maternal education, inadequate iron supplementation, and preterm birth are key contributors to low birth weight in Burao District. Interventions targeting maternal education, nutritional supplementation, and quality antenatal care are essential to reduce LBW and improve neonatal outcomes in Somaliland. Declarations Ethics approval and consent to participate Approved by Alpha University, Burao. Written informed consent was obtained. Competing interests The authors declare no competing interests. Funding No external funding was received. Author Contribution Jama Said Mohamed conceived the study, collected and analyzed data, and drafted the manuscript. BMM supervised the study and reviewed the manuscript. All author approved the final version. Acknowledgement The author sincerely acknowledges Mr. Basher Mohamed Mohamoud (MPHN, MPPM) for his guidance, supervision, and constructive feedback throughout the development of this study. Appreciation is also extended to the data collectors and staff of Burao General Hospital and Al-Khalifa Hospital for their cooperation and support during data collection. The author further acknowledges the School of Postgraduate Studies, Alpha University Burao, for providing ethical approval and academic support. No professional writing services or external materials were used beyond those acknowledged. All individuals mentioned have provided permission to be included in this section. Data Availability Available from the corresponding author upon reasonable request. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8320153","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":564140523,"identity":"0c7cb501-4654-4019-ba4e-f289ef9115db","order_by":0,"name":"Jama Said Mohamed","email":"data:image/png;base64,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","orcid":"","institution":"","correspondingAuthor":true,"prefix":"","firstName":"Jama","middleName":"Said","lastName":"Mohamed","suffix":""}],"badges":[],"createdAt":"2025-12-09 17:08:20","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-8320153/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8320153/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":99611872,"identity":"9e16e9c1-575e-4122-81a9-e8c27353bb11","added_by":"auto","created_at":"2026-01-06 12:35:27","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":16890,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.docx","url":"https://assets-eu.researchsquare.com/files/rs-8320153/v1/43ab9c0835b237445ab8d5cb.docx"},{"id":99611884,"identity":"834caf34-0e2f-4c88-b2a7-2263d9ff403e","added_by":"auto","created_at":"2026-01-06 12:35:27","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":4370,"visible":true,"origin":"","legend":"","description":"","filename":"6fc9e67dbee14da9890cae638289b836.json","url":"https://assets-eu.researchsquare.com/files/rs-8320153/v1/c119e3cb96770b5fd8ab4fa2.json"},{"id":99793683,"identity":"ecf80c94-a391-464e-a6b7-2092901078e3","added_by":"auto","created_at":"2026-01-08 13:32:10","extension":"xml","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":18322,"visible":true,"origin":"","legend":"","description":"","filename":"6fc9e67dbee14da9890cae638289b8361enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-8320153/v1/903bbcb120aaa2aa74b1decb.xml"},{"id":99611873,"identity":"a4b8f889-288b-44f2-b8c4-ef8f38b1a4e9","added_by":"auto","created_at":"2026-01-06 12:35:27","extension":"xml","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":13593,"visible":true,"origin":"","legend":"","description":"","filename":"6fc9e67dbee14da9890cae638289b8361structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-8320153/v1/114c48bb7c830cb64cde6e36.xml"},{"id":99793861,"identity":"745ef7a5-b829-43d1-ad4f-09a25b8cc9f8","added_by":"auto","created_at":"2026-01-08 13:33:24","extension":"html","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":22520,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-8320153/v1/0fb20dd89b12d0c3601d370e.html"},{"id":100237282,"identity":"8536ed1c-dcc5-4b33-bf34-31eca26e96a4","added_by":"auto","created_at":"2026-01-14 12:41:25","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":420222,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8320153/v1/75ab83f8-20af-4b1a-bc2a-6db1bcc29e99.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Maternal Factors Associated with Low Birth Weight among Newborns in Public Hospitals of Burao District, Somaliland, 2025","fulltext":[{"header":"Background","content":"\u003cp\u003eLow birth weight (LBW) remains a global public health challenge, accounting for a substantial proportion of neonatal morbidity and mortality. According to the World Health Organization, LBW contributes to 60\u0026ndash;80% of neonatal deaths worldwide, with the highest burden occurring in low- and middle-income countries. Infants born with LBW are at increased risk of infections, delayed growth, neurodevelopmental impairment, and chronic diseases later in life.\u003c/p\u003e \u003cp\u003eIn Sub-Saharan Africa, the prevalence of LBW is estimated at approximately 13\u0026ndash;14%, largely driven by maternal undernutrition, anemia, limited access to quality antenatal care, and obstetric complications. Somaliland faces persistent challenges related to maternal nutrition, health service utilization, and socioeconomic vulnerability, yet localized evidence on determinants of LBW remains scarce.\u003c/p\u003e \u003cp\u003ePrevious studies in Somaliland have reported LBW prevalence ranging from 12% to 19%, with maternal anemia, poor antenatal care attendance, and preterm delivery frequently identified as risk factors. However, data from Burao District are limited. This study aimed to assess maternal factors associated with low birth weight among newborns delivered in public hospitals in Burao District, Somaliland.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design and Setting\u003c/h2\u003e \u003cp\u003eAn institutional-based cross-sectional study was conducted between 1 June and 30 July 2025 in Burao General Hospital and Al-Khalifa Hospital, the two largest public hospitals in Burao District, Togdheer Region, Somaliland.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy Population\u003c/h3\u003e\n\u003cp\u003eThe study population consisted of postpartum mothers who delivered live newborns in the selected hospitals during the study period.\u003c/p\u003e\n\u003ch3\u003eInclusion and Exclusion Criteria\u003c/h3\u003e\n\u003cp\u003eMothers who consented and were clinically stable were included. Mothers who were critically ill or declined participation were excluded.\u003c/p\u003e\n\u003ch3\u003eSample Size and Sampling\u003c/h3\u003e\n\u003cp\u003eA sample size of 260 participants was calculated using a single population proportion formula based on a previous LBW prevalence of 19%. (Abdi, Mohamed et al.) A consecutive sampling technique was employed until the required sample size was achieved.\u003c/p\u003e\n\u003ch3\u003eData Collection\u003c/h3\u003e\n\u003cp\u003eData were collected using a structured interviewer-administered questionnaire and newborn weight measurement using a calibrated hanging scale. The questionnaire captured socio-demographic characteristics, nutritional status, and obstetric-related factors. Data collectors were trained, and a pretest was conducted on 5% of the sample.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eData were analyzed using SPSS version 27. Descriptive statistics were used to summarize variables. Bivariate logistic regression identified candidate variables (p\u0026thinsp;\u0026lt;\u0026thinsp;0.25), which were entered into multivariate logistic regression to identify independent predictors of LBW. Adjusted odds ratios (AOR) with 95% confidence intervals were reported.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eEthical Considerations\u003c/h3\u003e\n\u003cp\u003e \u003cstrong\u003eEthical approval\u003c/strong\u003e \u003cp\u003ewas obtained from Alpha University, Burao. Written informed consent was obtained from all participants. Confidentiality and anonymity were strictly maintained.\u003c/p\u003e \u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eSocio-demographic Characteristics\u003c/h2\u003e \u003cp\u003eThe majority of mothers were aged 18\u0026ndash;28 years (63.8%), resided in urban areas (69.2%), and were married (82.7%). Notably, 42.3% of mothers had no formal education.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eNutritional and Obstetric Characteristics\u003c/h2\u003e \u003cp\u003eMost mothers (69.2%) reported not taking iron and folic acid supplements during pregnancy. Preterm births accounted for 13.8% of deliveries, and 28.5% of newborns were classified as low birth weight.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eFactors Associated with Low Birth Weight\u003c/h2\u003e \u003cp\u003eIn multivariate analysis, three factors remained significantly associated with LBW:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eLack of formal maternal education\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eAbsence of iron supplementation during pregnancy\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003ePreterm delivery (\u0026lt;\u0026thinsp;37 weeks)\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study identified a Maternal education emerged as a strong determinant, consistent with studies from Ethiopia, Kenya, and Somaliland, highlighting the role of education in health-seeking behavior and nutrition. Iron supplementation was independently associated with birth weight, reinforcing evidence that maternal anemia and micronutrient deficiencies adversely affect fetal growth. Preterm birth showed the strongest association with LBW, in line with global literature identifying gestational age as a primary biological determinant of birth weight.\u003c/p\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eStrengths and Limitations\u003c/h2\u003e \u003cp\u003e This study provides updated, localized evidence on LBW determinants in Somaliland. However, the cross-sectional design limits causal inference, and facility-based sampling may affect generalizability.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eLow maternal education, inadequate iron supplementation, and preterm birth are key contributors to low birth weight in Burao District. Interventions targeting maternal education, nutritional supplementation, and quality antenatal care are essential to reduce LBW and improve neonatal outcomes in Somaliland.\u003c/p\u003e"},{"header":"Declarations","content":" \u003cp\u003e \u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e \u003cp\u003eApproved by Alpha University, Burao. Written informed consent was obtained.\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eCompeting interests\u003c/h2\u003e \u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eNo external funding was received.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eJama Said Mohamed conceived the study, collected and analyzed data, and drafted the manuscript. BMM supervised the study and reviewed the manuscript. All author approved the final version.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eThe author sincerely acknowledges Mr. Basher Mohamed Mohamoud (MPHN, MPPM) for his guidance, supervision, and constructive feedback throughout the development of this study. Appreciation is also extended to the data collectors and staff of Burao General Hospital and Al-Khalifa Hospital for their cooperation and support during data collection. The author further acknowledges the School of Postgraduate Studies, Alpha University Burao, for providing ethical approval and academic support. No professional writing services or external materials were used beyond those acknowledged. All individuals mentioned have provided permission to be included in this section.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eAvailable from the corresponding author upon reasonable request.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Low birth weight, Maternal factors, Antenatal care, Iron supplementation, Preterm birth, Somaliland","lastPublishedDoi":"10.21203/rs.3.rs-8320153/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8320153/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLow birth weight (LBW), defined as birth weight less than 2,500 grams, remains a major public health concern and a leading predictor of neonatal morbidity and mortality, particularly in low- and middle-income countries. In Somaliland, evidence on maternal factors contributing to LBW is limited, especially in urban settings such as Burao District.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAn institutional-based cross-sectional study was conducted from June to July 2025 in Burao General Hospital and Al-Khalifa Hospital, Somaliland. A total of 260 postpartum mothers were enrolled using a consecutive sampling technique. Data were collected through face-to-face interviews using a structured questionnaire and newborn weight measurement. Data were analyzed using SPSS version 27. Descriptive statistics summarized participant characteristics, while bivariate and multivariate logistic regression analyses identified factors associated with LBW. Statistical significance was declared at p \u0026lt; 0.05.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn multivariate analysis, lack of formal maternal education (AOR = 2.6; 95% CI: 1.3–5.1), absence of iron supplementation during pregnancy (AOR = 2.9; 95% CI: 1.4–6.2), and preterm birth (\u0026lt;37 weeks) (AOR = 4.8; 95% CI: 2.1–10.9) were independently associated with LBW.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLow maternal education, inadequate iron supplementation, and preterm delivery were significant determinants of low birth weight in Burao District. Strengthening maternal education, improving iron supplementation coverage, and preventing preterm births through quality antenatal care are critical to reducing LBW in Somaliland.\u003c/p\u003e","manuscriptTitle":"Maternal Factors Associated with Low Birth Weight among Newborns in Public Hospitals of Burao District, Somaliland, 2025","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-06 12:35:22","doi":"10.21203/rs.3.rs-8320153/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"568d3e70-2cd1-43db-9dc1-6b64b2f084ae","owner":[],"postedDate":"January 6th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-03-18T09:57:53+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-06 12:35:22","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8320153","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8320153","identity":"rs-8320153","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}