Determinants of low birth weight in newborns at a referral hospital in the western Nepal: an unmatched case-control study

BACKGROUND: Low Birth Weight, birth weight of less than 2,500 g regardless of gestational age, is a significant public health issue globally. This study investigates risk factors of LBW in the western Nepal, a region that has not been extensively studied. METHODS: A hospital-based unmatched case-control study was conducted at Bheri Hospital in the western Nepal from July 2020 to June 2021. Three hundred mothers delivering live singleton babies, with 150 of them having newborns weighing less than 2,500 g (cases) and 150 of them weighing 2,500-4,000 g (controls) were selected using simple random sampling method. Data were collected through face-to-face interviews using structured questionnaire and review of hospital record reviews. Data were analyzed using STATA version 17. Multivariable logistic regression was performed to analyze the association, and adjusted odds ratio with 95% confidence interval and P-value < 0.05 were considered to be statistically significant. RESULTS: Mothers with a monthly income above Nepali Rupees15,000 had lower odds of having LBW infants (aOR: 0.2, 95% CI: 0.1-0.3). Lack of support from husbands and mothers-in-law during pregnancy significantly increased the odds of LBW, (aOR: 3.9, 95% CI: 1.2-12.3; aOR: 9.5, 95% CI: 4.6-19.5, rspectively). Maternal smoking during pregnancy also increased the odds of LBW significantly (aOR: 8.9, 95% CI: 1.9-40.2). Intended pregnancy was protective, reducing the odds of LBW (aOR: 0.2, 95% CI: 0.1-0.3). Women with a history of delivering LBW babies had a higher risk of recurrence (aOR: 12.2, 95% CI: 1.5-98.7), and those with a recent abortion exhibited increased odds of LBW (aOR: 5.6, 95% CI: 1.8-17.5). Attending four or more ANC visits and receiving nutritional counseling significantly lowered the odds of LBW (aOR: 0.2, 95% CI: 0.07-0.7 and aOR: 0.2, 95% CI: 0.1-0.4, respectively). Weight gain of 7 kg. or more during pregnancy also reduced LBW risk (aOR: 0.1, 95% CI: 0.01-0.14), whereas preterm birth increased the odds of LBW (aOR: 9.5, 95% CI: 4.5-20.2). CONCLUSIONS: Interventions to reduce LBW should address these modifiable risk factors, emphasizing maternal nutrition, promoting ANC coverage, integrating routine nutritional counselling into ANC services, smoking cessation and promoting family support in daily activities during pregnancy.