Factors associated with low birth weight in maternity wards of Salvation Army health care facilities in Kinshasa, DRC, 2025

Background Low birth weight (LBW) remains a major global public health concern, as it is strongly associated with increased neonatal morbidity and mortality. This study aimed to identify factors associated with LBW among deliveries in maternity wards of health facilities under the Salvation Army Medical Service in Kinshasa, Democratic Republic of the Congo. Methods A total of 603 delivering women were included in the study. Categorical variables were summarized using frequencies and proportions. Associations between maternal and clinical characteristics and LBW (birth weight <2500 g) were assessed using chi-square tests and multivariable logistic regression. Data on maternal nutritional status, infection history, and obstetric complications were obtained through structured interviews and medical record reviews. Ethical approval was obtained, and informed consent was secured from all participants. Results The prevalence of LBW was 15.6%, highlighting its continued burden as a public health challenge. In both bivariate and multivariable analyses, several determinants remained significantly associated with LBW. A maternal history of LBW showed the strongest association, with mothers nearly twelve times more likely to deliver another LBW infant. HIV infection and pre-eclampsia were also strong predictors, each increasing the odds of LBW by approximately fourfold after adjustment. In addition, urinary tract infection and malaria during pregnancy remained significantly associated with LBW, each roughly doubling the risk. Conclusions LBW remains a pressing public health issue in Kinshasa. Maternal medical conditions and pregnancy complications were strongly associated with increased risk. Strengthening antenatal care through targeted screening, infection prevention and management, and improved nutritional support may help reduce LBW prevalence and improve neonatal outcomes.