Bhagyashree Chavan*
The birth weight of an infant is the single most important determinant of its chances of survival, healthy growth and development. The World Health being Organization1 (WHO) defines Low Birth Weight (LBW) as a birth weight less than 2,500 grams irrespective of the period of gestation, the measurement taken preferably within the first hour of life. The number of LBW babies is concentrated in two regions of the developing world, Asia (72%) and Africa (22%), and India alone accounts for 40% of LBW births in the developing countries1,2. There are nearly 8 million LBW infants born in India, which accounts for about 28% of all live births.
LBW babies are approximately 20 times more prone for increased morbidity & mortality. The infant mortality rate in India is 29%, and the principal cause of infant mortality in India is LBW. There are numerous aspects contributing to LBW that include both maternal and foetal factors. Weight at birth is directly influenced by the general level of the health status of the mother. The factors that are considered potential determinants of LBW include maternal factors such as education of mother, socioeconomic status, inadequate nutrition, bad obstetric history, less frequent antenatal visits, low pre-pregnancy weight, short maternal stature, hypertension, severe anaemia and infections during pregnancy18. Most of risk factors are, however, modifiable34, thus the incidence of LBW babies can be reduced by early detection & prompt treatment in preventive, promotive and curative manner.
Therefore, the present study aimed to estimate the prevalence and predictors of LBW among newborn babies delivered in tertiary health care center of South-Western (Civil Hospital, GMC Alibag) Maharashtra.
AIM AND OBJECTIVES:
- To estimate the prevalence of Low Birth Weight among newborn babies delivered in tertiary health care center of South-Western Maharashtra (Civil Hospital, GMC Alibag).
- To study associated maternal risk factors for Low Birth Weight in study participants.
MATERIALS AND METHODS:
Study design & setting:
A cross-sectional study was conducted among pregnant women delivered in tertiary health care center of South-Western Maharashtra (Civil Hospital, GMC Alibag).
- Inclusion criteria: Pregnant women delivered in tertiary health care center and who gave consent to participate in study.
- Exclusion criteria: Those who are not willing to participate
Study period was extended from March 2025 to March 2026
SAMPLE SIZE & SAMPLING TECHNIQUE:
Considering p = prevalence of Low birth weight, p = 41.9 % taken from the study conducted by Shobha R et al (2017)16 at Level of significance: 95 % (z = 1.96) and Relative error (e): 20 % of prevalence
Sample size, n = z²×pq / e² = 133.11, Thus, the sample size was taken as 200.
Ten participants were selected randomly during each visit from delivery list of PNC wards & those who were willing to participate were included in the study.
ETHICAL CONSIDERATION:
Permission was taken from Head of Department of Obstetrics and Gynecology of tertiary health care center of South-Western Maharashtra (Civil Hospital, GMC Alibag). Study protocol was designed & send to Institutional Ethics Committee for approval. This study was approved by Institutional Ethic Committee. Informed consent from study participants was taken after establishing rapport and explaining the purpose of study.
METHODOLOGY:
Mothers from PNC wards delivered in tertiary health care center were enrolled in the study. A face-to face interview were taken and structured proforma were used for collection of data regarding sociodemographic characteristics, menstrual history, antenatal, postnatal and neonatal history. General & Systemic examination were done. Socioeconomic status was assessed by using Modified B.G. Prasad Scale (May 2025).
STATISTICAL ANALYSIS:
Data was entered in MS Excel window version 11 and analysed by using Open-Epi Software. Descriptive statistics, quantitative variables were measured as Mean, Standard Deviation, Range, while qualitative variables were presented in Numbers & Percentage. Bar chart & pai charts were used to summarise baseline characteristics of the study participants. Association between two categorical variables were analysed by using Chi-square (X2) test; p value < 0.05 was considered to be statistically significant, Odds Ratio was calculated.
RESULTS:
|
Table 1: Distribution of study participants according to Sociodemographic characteristics (n=200) |
|||
|
Variables |
Number |
Percentage |
|
|
1. Age (in years) |
<20 |
31 |
15.50 |
|
20- 25 |
68 |
34.00 |
|
|
25- 30 |
69 |
34.50 |
|
|
≥30 |
32 |
16.00 |
|
|
2. Residence |
Urban |
104 |
52.00 |
|
Rural |
96 |
48.00 |
|
|
3. Religion |
Hindu |
101 |
50.50 |
|
Muslim |
64 |
32.00 |
|
|
Others |
35 |
17.50 |
|
|
4. Type of family |
Nuclear |
91 |
45.50 |
|
Joint |
88 |
44.00 |
|
|
3 generation |
21 |
10.50 |
|
|
5. Type of Diet |
Vegetarian |
87 |
43.50 |
|
Mixed |
113 |
56.50 |
|
|
6. Education |
Illiterate |
34 |
17.00 |
|
Primary |
29 |
14.50 |
|
|
Middle |
35 |
17.50 |
|
|
≥ High school |
102 |
51.00 |
|
|
7. Occupation |
Homemaker |
125 |
62.50 |
|
Others |
75 |
37.50 |
|
|
8. Socioeconomic Status (Modified BG Prasad scale, May 2025) |
Class I |
11 |
05.50 |
|
Class II |
59 |
29.50 |
|
|
Class III |
62 |
31.00 |
|
|
Class IV |
42 |
21.00 |
|
|
Class V |
26 |
13.00 |
|
The study participants' sociodemographic characteristics (n=200) revealed that majority 137 (68.5%) were aged 20-30 years, followed by 69 (34.5%) in the 25-30 age group. 104 (52.0%) resided in urban areas and half of the participants 101 (50.5%) were Hindu. Majority 91 (45.5%) were from nuclear family. More than half 113 (56.5%) consumed a mixed diet and majority 102 (51.0%) had high school education or above. Majority participants 125 (62.5%) were homemakers and maximum belonged to Class III 62 (31.0%) and Class II 59 (29.5%) socioeconomic status.
|
Table 2: Obstetrics profile of study participants (n= 200) |
|||
|
Variables |
Number |
Percentage |
|
|
1.Parity |
Primiparity |
97 |
48.50 |
|
Parity 2 |
78 |
39.00 |
|
|
Parity 3 |
22 |
11.00 |
|
|
Grand multipara |
03 |
01.50 |
|
|
2. Period of Gestation at delivery (in weeks) |
<37 weeks |
48 |
24.00 |
|
37- 42 weeks |
144 |
72.00 |
|
|
≥42 weeks |
08 |
04.00 |
|
|
3.Mode of delivery |
Normal delivery |
97 |
48.50 |
|
Caesarean section |
103 |
51.50 |
|
|
4. Anaemia in pregnancy |
Present |
118 |
59.00 |
|
Absent |
82 |
41.00 |
|
|
5. Grade of anaemia (n= 118) |
Mild anaemia |
73 |
61.86 |
|
Moderate anaemia |
21 |
17.80 |
|
|
Severe anaemia |
20 |
16.95 |
|
|
Profound |
04 |
03.39 |
|
|
6. Number of ANC visits |
<4 visits |
77 |
38.50 |
|
≥4 visits |
123 |
61.50 |
|
|
7. Number of IFA tablets consumed during pregnancy |
Consumed < 100 |
78 |
39.00 |
|
Consumed ≥ 100 |
122 |
61.00 |
|
|
8. Birth spacing in consecutive pregnancies (n= 103) |
<18 months |
18 |
17.47 |
|
18-24 months |
55 |
53.40 |
|
|
≥ 24 months |
30 |
29.13 |
|
|
9. Pre-pregnancy weight |
<55 kg |
109 |
54.50 |
|
≥55 kg |
91 |
45.50 |
|
|
10. Weight gain during pregnancy |
<9 kg |
93 |
46.50 |
|
≥9 kg |
107 |
53.50 |
|
The study participants' obstetrics profile (n=200) revealed that majority 97 (48.0%) were primipara and 144 (72.0%) delivered between 37-42 weeks of gestation. Majority103 (51.5%) were delivered via caesarean section. Anaemia was present in 118 (59.0%) participants, with majority 73 (61.86%) having mild anaemia. Most participants 123 (61.5%) had ≥4 ANC visits and 122 (61.0%) had consumed ≥100 IFA tablets. Majority of participants with previous pregnancies 55 (53.40%) had a birth spacing of 18-24 months. More than half 109 (54.0%) had a pre-pregnancy weight <55 kg, and 107 (53.0%) gained ≥9 kg weight during pregnancy.
|
Table 3: Distribution of study participants as per pregnancy outcome (n=200) |
|||
|
Variables |
Number |
Percentage |
|
|
1. Sex of baby |
Male |
107 |
53.50 |
|
Female |
93 |
46.50 |
|
|
2. Weight of baby |
Very LBW (1.001-1500 gm) |
05 |
02.50 |
|
Low birth weight (1.501-2499 gm) |
74 |
37.00 |
|
|
Normal weight (2500- 4000 gm) |
115 |
57.50 |
|
|
Macrocosmic (>4001 gm) |
06 |
03.00 |
|
|
3. Gestational age at delivery |
Preterm (<37 weeks) |
48 |
24.00 |
|
Term (37- 42 weeks) |
144 |
72.00 |
|
|
Post term (≥42 weeks) |
08 |
04.00 |
|
The study participants' pregnancy outcome (n=200) revealed that Prevalence of LBW in this study was 39.50% (79/200), majority 107 (53.0%) had a male baby, and most 115 (57.0%) babies had a normal weight (2500-4000 gm). Majority 144 (72.0%) deliveries were term (37-42 weeks), while 48 (24.0%) were preterm (<37 weeks).
|
Table 4 Association between Sociodemographic characteristics & LBW (n= 200) |
||||||
|
Variable |
Total |
LBW |
OR |
95% CI |
p |
|
|
Present |
Absent |
|||||
|
1. Age of mother (in years) |
||||||
|
<20 years & ≥30 year |
63 |
40 |
23 |
4.47 |
2.817, 7.081 |
0.0001 |
|
20- 29 years |
137 |
39 |
98 |
|||
|
2. Place of Residence |
||||||
|
Rural |
96 |
42 |
54 |
1.47 |
0.9745, 2.227 |
0.0826 |
|
Urban |
104 |
37 |
67 |
|||
|
3. Religion |
||||||
|
Hindu |
101 |
36 |
65 |
0.75 |
0.4992,1.139 |
0.2164 |
|
Others |
99 |
43 |
56 |
|||
|
4. Type of family |
||||||
|
Nuclear |
91 |
43 |
48 |
1.84 |
1.215, 2.793 |
0.0053 |
|
Others |
109 |
36 |
73 |
|||
|
5. Education of mother |
||||||
|
<high school |
98 |
51 |
47 |
2.72 |
1.775, 4.155 |
0.0001 |
|
≥ high school |
102 |
28 |
74 |
|||
|
6. Occupation of mother |
||||||
|
Working mother |
75 |
52 |
23 |
7.97 |
4.979, 12.75 |
0.0001 |
|
Others |
125 |
27 |
98 |
|||
|
7. Socioeconomic status |
||||||
|
III, IV, V |
131 |
57 |
74 |
1.65 |
1.06, 2.577 |
0.0342 |
|
I, II |
69 |
22 |
47 |
|||
Table 4 shows, Association between sociodemographic characteristics & LBW. Mother of <20years & ≥30 years were found 4.47 times more prone for delivering of LBW babies as compare to those of 20-29 years & the association is statistically significant (OR= 4.47, 95% CI= 2.817- 7.081, p =0.00). Other factors such as mother from nuclear family (OR= 1.84), educated less than high school (OR= 2.72), working mothers (OR= 7.97) & those from lower socioeconomic (III, IV, V) class (OR= 1.65) were at risk of delivering LBW babies & this association is also statistically significant (p- value <0.05).
|
Table 5 Association between Maternal factors & LBW (n= 200) |
||||||
|
Variables |
Total |
LBW |
OR |
95% CI |
p |
|
|
Present |
Absent |
|||||
|
1. Parity |
||||||
|
Primipara & grand multipara |
100 |
48 |
52 |
1.90 |
1.252, 2.889 |
0.0034 |
|
Others |
100 |
31 |
69 |
|||
|
2. Period of Gestation |
||||||
|
37- 42 |
144 |
35 |
109 |
0.09 |
0.0523, 0.153 |
0.0001 |
|
Other |
56 |
44 |
12 |
|||
|
3. Anaemia during pregnancy |
||||||
|
Present |
94 |
48 |
46 |
2.49 |
1.632, 3.795 |
0.0001 |
|
Absent |
106 |
31 |
75 |
|||
|
4. Iron Folic acid tablets consumption |
||||||
|
<100 |
78 |
51 |
27 |
6.27 |
3.973, 9.88 |
0.0001 |
|
≥100 |
122 |
28 |
94 |
|||
|
5. ANC visits during pregnancy |
||||||
|
< 4 visits |
77 |
48 |
29 |
4.79 |
3.071, 7.478 |
0.0001 |
|
≥4 visits |
123 |
31 |
92 |
|||
|
6. Birth spacing in consecutive pregnancy (n= 103) |
||||||
|
<24 months |
73 |
39 |
34 |
2.22 |
1.204, 4.112 |
0.0100 |
|
≥24 months |
30 |
10 |
20 |
|||
|
7. Pre-pregnancy weight |
||||||
|
< 55 kg |
91 |
43 |
48 |
1.84 |
1.215, 2.793 |
0.0053 |
|
≥ 55 kg |
109 |
36 |
73 |
|||
|
8. Weight gain during pregnancy |
||||||
|
< 9 kg |
77 |
43 |
34 |
3.06 |
1.989, 4.71 |
0.0001 |
|
≥ 9 kg |
123 |
36 |
87 |
|||
|
9. Sex of baby |
||||||
|
Female |
93 |
39 |
54 |
1.25 |
0.8308, 1.895 |
0.3298 |
|
Male |
107 |
40 |
67 |
|||
Table 5 shows, Association between Maternal factors, sex of baby & LBW. Mother of primigravida and grand multigravida were 1.9 time more at risk of LBW deliveries as compare to others (OR= 1.90) and the association was statistically significant (p<0.05). Anaemic mothers (OR= 2.49), those who consume <100 IFA tablets during pregnancy (OR= 6.27), those having <4 ANC visits (OR= 4.79) were at risk of delivering a LBW baby (p <0.05). Mother having less birth spacing (OR= 2.22), those having less pre- pregnancy weight (OR= 1.84) and weight gain less than 9 kg during pregnancy (OR= 3.06) were more prone for development of LBW baby as compare to others (p <0.05). Sex of the baby and LBW delivery did not show any statistically significant association (p value= 0.3298)
DISCUSSION
This study of 200 participants found majority (68.5%) were aged 20-30 years, with a mean age of 24.69 years. Most resided in urban areas (52.0%) and were Hindu (50.5%). More than half consumed a mixed diet (56.5%) and had high school education or above (51.0%). Maximum participants were homemakers (62.5%) and belonged to Class II and III socioeconomic status. Similar findings were seen in the study conducted by Shastri A (2023)19, Keshavrao CM (2023)18, Girish Chavhan (2026)33, Ghanghas K et al6, Thapa P et al7, and others.
The obstetrics profile revealed majority were primipara, delivered between 37-42 weeks and had a caesarean section delivery. Anaemia was present in 59.0% participants, with majority having mild anaemia (61.86%). Most participants had ≥4 ANC visits (61.5%) and consumed ≥100 IFA tablets (61.0%). Pregnancy outcome showed majority (53.0%) had a male baby, and most babies had a normal weight (57.0%). Majority deliveries were term (72.0%). Similar findings were seen in studies conducted by Keshavrao CM (2023)18, Ghanghas K et al6, Shastri A (2023)19, Girish (2026)33 and others.
Mothers <20 years & ≥30 years were 4.47 times more prone to LBW babies (OR= 4.47, p=0.00). Other risk factors included nuclear family (OR= 1.84), educated less than high school (OR= 2.72), working mothers (OR= 7.97), and lower socioeconomic class (OR= 1.65). Primigravida and grand multigravida mothers were 1.9 times more at risk (OR= 1.90, p<0.05). Anaemic mothers, those with <100 IFA tablets, <4 ANC visits, less birth spacing, and less pre-pregnancy weight were also at risk (p<0.05). Similar findings were seen in the study conducted by Shastri A (2023)19, Ghanghas K et al8, Keshavrao CM (2023)18, Chaurasia A et al14, Girish Chavhan (2026)33, Gothi A, Ahankari A et al15 and others.
CONCLUSION
This study reveals a significant burden of Low Birth Weight (LBW) in South-Western Maharashtra, with 39.50% of newborns affected. Our findings highlight key maternal risk factors, including extreme maternal age, low education, working status, severe anaemia, and inadequate antenatal care. Additionally, primipara and grand multipara mothers and those with inadequate IFA tablets and ANC visits are more likely to deliver LBW babies. The odds of LBW are also higher among mothers with low pre-pregnancy weight and inadequate weight gain during pregnancy. These findings underscore the need for targeted interventions, including improved access to education, nutrition, and antenatal care.
By addressing these modifiable risk factors, we can reduce the burden of LBW and promote healthier outcomes for mothers and newborns in South-Western Maharashtra and beyond.
RECOMMENDATIONS:
1. Strengthen Antenatal Care (ANC) Services: Ensure all pregnant women, especially high-risk groups (working mothers, adolescents and those with low education), receive ≥4 ANC visits, IFA supplementation, and adequate nutrition counselling.
2. Promote Healthy Maternal Nutrition: Educate pregnant women and their families about the importance of balanced diets, adequate weight gain, and anemia prevention.
3. Enhance Community Engagement and Awareness: Organize awareness campaigns and community events to educate women and their families about LBW risks, benefits of institutional deliveries, and importance of ANC.
LIMITATIONS:
It is cross sectional study which did not allow us to establish a causal relationship.
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