Maternal determinants of low birth weight among Indian children: Evidence from the National Family Health Survey-4, 2015-16

OBJECTIVE: Low birth weight (LBW) is a serious public health problem in low- and middle-income countries and a leading cause of death in the first month of life. In India, about 18% of children are born with LBW (<2500 grams) in 2015-16. In this study, we aim to examine the influence of maternal factors and socio-demographic covariates on LBW in Indian children. METHODS: Data were drawn from the fourth round of the National Family Health Survey (NFHS-4), conducted in 2015-16. A cross-sectional study was designed using a stratified two-stage sampling technique. Cross-tabulation, Pearson's chi-squared test, and multivariate logistic regression analyses were employed to assess the impact of maternal factors and other covariates on children's LBW. RESULTS: Of total participants (n = 147,762), 17.5% of children were found to be born with LBW. The study revealed that women who had prior experience of stillbirth (Adjusted odds ratio AOR: 1.20, 95% CI: 1.04-1.38) and any sign of pregnancy complications (AOR: 1.08, 95% CI: 1.05-1.11) were more likely to have LBW children, even after adjusting for a range of covariates. Maternal food diversity was found to a protective factor against children's LBW. Women with underweight and anemic condition were associated with an increased likelihood of LBW children. Regarding maternity care, women who attended ≥4 ANC visits (AOR: 0.84, 95% CI: 0.80-0.88), took iron tablets/syrup during pregnancy (AOR: 0.94, 95% CI: 0.90-0.98), and delivered in a public health facility (AOR: 0.84, 95% CI: 0.79-0.88) were less likely to have LBW babies. Besides, various socio-demographic factors such as place of residence, caste, religion, education, wealth quintile, and geographical region were significantly associated with LBW of children. CONCLUSION: Interventions are needed for adequate ANC utilization, improvement in public facility-based delivery, providing iron supplementation, and uptake of balanced energy-protein diet among pregnant mothers. Besides, special attention should be given to the socio-economically disadvantaged women to address adverse pregnancy and birth outcomes including LBW.