Abstract
Background: Low birth weight (LBW), which is birth weight less than 2.5 kg, is a public health concern contributing to increased neonatal morbidity and mortality and long-term health problems. Despite global awareness, data on the risk factors associated with LBW in South African regional settings remain limited. In this study, we sought to determine the prevalence of LBW and identify maternal factors contributing to LBW deliveries at Potchefstroom regional hospital in Dr Kenneth Kaunda District, South Africa.
Methods: The study was a hospital-based record review with a cross-sectional quantitative design. Maternal sociodemographic, anthropometric, medical, obstetric and lifestyle factors were obtained from 352 randomly selected maternal-newborn records spanning October 2022 to September 2023. The prevalence of LBW (dependent variable) was determined, and Chi-square tests were first conducted to examine differences in LBW prevalence by maternal characteristics. This was followed by univariate and multivariable logistic regression used to determine associated risk factors for LBW. For all statistical tests, significance level was set at p < 0.05.
Results: The birthweight ranged from 840g to 5.6kg with a mean birthweight of 3.0 ± 0.56 kg. Mothers had a median age of 28 years (IQR: 10), majority were unemployed (72.4%) and delivered term infants (88.6%). The prevalence of LBW was 13.9%. There was a significant difference in the prevalence of LBW among mothers across body mass index (BMI) categories (p = 0.01) and gestational age (p < 0.001), suggesting potential associations. Univariate logistic regression models showed that gestational age, BMI and asthma were significantly associated with LBW. Specifically, overweight mothers (BMI of 25–29.9) had higher odds of delivering LBW infants compared to normal weight (BMI 18.5-24.9) mothers (OR = 3.48, 95% CI: 1.50–8.09, p = 0.012). Also, asthmatic mothers were more likely to have LBW infants (OR = 12.85, 95% CI: 1.14–144.53, p = 0.039) compared to the non-asthmatic; however, the wide confidence interval should be interpreted with caution, as it likely reflects the small number of asthmatic cases in the sample. Preterm birth was strongly associated with LBW (OR = 23.34, 95% CI: 10.74–50.71, p < 0.001). In the adjusted analysis, preterm delivery remained the strongest independent associated risk factor for LBW (AOR = 30.61, 95% CI: 11.64–80.46, p < 0.001) compared to term babies, and mothers with gravida ≥ 3 had higher odds of LBW deliveries compared to the 1–2 gravida group...