Associated Factors of Low Birth Weight among Newborns Delivered in Selected Hospitals of Uttar Pradesh: A Multicenter Analytical Study

Abstract

Low Birth Weight (LBW), defined as a birth weight of less than 2,500 g, remains a major public health concern and a leading cause of neonatal morbidity and mortality in developing countries. This multicenter cross-sectional analytical study was conducted to determine the prevalence of LBW and identify associated maternal risk factors among newborns delivered in selected hospitals of Uttar Pradesh. A total of 1,218 mother–newborn pairs with complete records were included in the final analysis. Data were collected using structured questionnaires and clinical record reviews, and associations between maternal factors and LBW were assessed using Chi-square tests and multivariable logistic regression analysis. The overall prevalence of LBW was found to be 22.41%. Bivariate analysis demonstrated significant associations between LBW and adolescent maternal age, low literacy status, rural residence, inadequate antenatal care (ANC) visits, maternal anemia, pregnancy-induced hypertension (PIH), low pre-pregnancy body mass index (BMI), and poor iron–folic acid (IFA) tablet compliance. Multivariable logistic regression revealed that severe maternal anemia was the strongest independent predictor of LBW (AOR = 3.86; 95% CI: 2.41–6.18), followed by pregnancy-induced hypertension (AOR = 2.24; 95% CI: 1.51–3.32) and inadequate ANC utilization (AOR = 2.12; 95% CI: 1.48–3.04). Adolescent pregnancy (AOR = 1.84; 95% CI: 1.26–2.68), moderate/mild anemia (AOR = 1.54; 95% CI: 1.06–2.24), and maternal underweight status (AOR = 1.48; 95% CI: 1.04–2.11) also significantly increased the odds of delivering a low-birth-weight infant. The findings indicate that maternal anemia, hypertensive disorders, inadequate antenatal care, adolescent pregnancy, and poor maternal nutritional status are major determinants of LBW in Uttar Pradesh. Strengthening maternal nutrition programs, improving ANC coverage and quality, promoting adherence to iron–folic acid supplementation, and ensuring early identification and management of high-risk pregnancies through nurse-led and community-based interventions are essential strategies for reducing the burden of low birth weight and improving neonatal health outcomes.