Prevalence And Predictors Of Low Birth Weight Among Newborn Delivered In Tertiary Health Care Centre Of South-Western Maharashtra (Civil Hospital, GMC Alibag): A Cross-Sectional Study

Bhagyashree Chavan; Rajashree Bhosale

doi:10.5281/zenodo.19925559

Research Paper | Open Access
Volume 03 | Issue 04 | Article Id IJSRT/260404301

Prevalence And Predictors Of Low Birth Weight Among Newborn Delivered In Tertiary Health Care Centre Of South-Western Maharashtra (Civil Hospital, GMC Alibag): A Cross-Sectional Study
Bhagyashree Chavan* Rajashree Bhosale
Department of Obstetrics & Gynaecology, Government Medical College, Alibag

Abstract

Background: Low Birth Weight (LBW), defined by the World Health Organization as birth weight less than 2,500 grams irrespective of gestational age, is a major public health concern due to its strong association with neonatal morbidity and mortality. Globally, the burden of LBW is concentrated in developing regions, particularly Asia and Africa, with India contributing a substantial proportion. Maternal nutritional status, socioeconomic conditions, antenatal care, and obstetric factors significantly influence birth weight. The present study aimed to estimate the prevalence of LBW and identify associated maternal risk factors among newborns delivered at a tertiary health care centre in South-Western Maharashtra (Civil Hospital, GMC Alibag). Methodology: A hospital-based cross-sectional study was conducted from March 2025 to March 2026 among 200 mothers who delivered at a tertiary health care centre in South-Western Maharashtra. Participants were selected using simple random sampling, with two days per week chosen for data collection. Data were collected through face-to-face interviews using a structured proforma that included sociodemographic, obstetric, antenatal, and neonatal information. Socioeconomic status was assessed using the Modified B.G. Prasad Scale (May 2025). Data were entered in MS Excel and analysed using OpenEpi software. Descriptive statistics were calculated, and associations between categorical variables were assessed using the Chi-square test. Odds ratios (OR) with 95% confidence intervals were computed, and p <0.05 was considered statistically significant. Results: The prevalence of LBW was 39.5% (79/200). A higher risk of LBW was observed among mothers aged <20 years or ?30 years (OR = 4.47), those with education below high school (OR = 2.72), working mothers (OR = 7.97), and those belonging to lower socioeconomic classes (OR = 1.65). Obstetric factors significantly associated with LBW included primiparity or grand multiparity (OR = 1.90), maternal anemia (OR = 2.49), consumption of fewer than 100 IFA tablets (OR = 6.27), fewer than four ANC visits (OR = 4.79), birth spacing less than 24 months (OR = 2.22), pre-pregnancy weight <55 kg (OR = 1.84), and pregnancy weight gain <9 kg (OR = 3.06). Preterm delivery was also strongly associated with LBW. Conclusion: The study demonstrates a high prevalence of LBW in South-Western Maharashtra and highlights several modifiable maternal risk factors such as inadequate antenatal care, anemia, poor nutrition, and insufficient birth spacing. Strengthening antenatal services, improving maternal nutrition, and promoting awareness regarding pregnancy care can substantially reduce the incidence of LBW and improve maternal and neonatal health outcomes.

Keywords

Low Birth Weight, Maternal Risk Factors, Antenatal Care, Maternal Nutrition, Neonatal Outcomes.

Introduction

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 countries^1,2. 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
2. Residence	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
5. Type of Diet	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
7. Occupation	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
3.Mode of delivery	Caesarean section	103	51.50
4. Anaemia in pregnancy	Present	118	59.00
4. Anaemia in pregnancy	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
6. Number of ANC visits	≥4 visits	123	61.50
7. Number of IFA tablets consumed during pregnancy	Consumed < 100	78	39.00
7. Number of IFA tablets consumed during pregnancy	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
9. Pre-pregnancy weight	≥55 kg	91	45.50
10. Weight gain during pregnancy	<9 kg	93	46.50
10. Weight gain during pregnancy	≥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
1. Sex of baby	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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Reference

World Health Organization and United Nations Children's Fund (UNICEF): Low birthweight: country, regional and global estimates. (2004). Accessed: March 11, 2023: https://apps.who.int/iris/handle/10665/43184
United Nations Children's Fund: Low birthweight. (2019). Accessed: March 11, 2023: https://data.unicef.org/resources/dataset/low-birthweight-data/.
Gothi A, Meena A, Dodiyar R et al. Incidence and major risk factors for term low birth weight babies in a southern district of Rajasthan. European Journal of Molecular & Clinical Medicine. 2023;10(2):1921-27
Islam M, Khan M, Khan A et al. Newborn Care Practices and Associated Factors Influencing Their Health in a Northern Rural India. MDPI Journal. 2023;10(408):1-13.
Devaguru A, Gada S, Potpalle D, et al. (May 05, 2023) The Prevalence of Low Birth Weight Among Newborn Babies and Its Associated Maternal Risk Factors: A Hospital-Based Cross-Sectional Study. Cureus 15(5): e38587. DOI 10.7759/cureus.38587
Ghanghas K, Chauhan M, Kansagara T et al. Analysis of Maternal and Obstetric Factors Affecting Birth Weight of Newborn: A Hospital-Based Cross Sectional Study. International Journal of Scientific Research in Dental and Medical Sciences. 2022;4(2):52-56
Thapa P, Poudyal A, Poudel R et al. Prevalence of low birth weight and its associated factors: Hospital based cross sectional study in Nepal. PLOS Global Public Health. 2022;2(11):1-11
Herawati S, Tridiyawati F. Risk Factor Analysis Of Low Birth Weight Events (LBW) At Kartika Husada Hospital. International Journal of Health and Pharmaceutical. 2021;646-51. https://ijhp.net
Patel S, Verma N, Padhi et al. Retrospective analysis to identify the association of various determinants on birth weight. Journal of Family Medicine & Primary Care.2021;10(1):496-1
Chaithra A, Chiniwar M, Menasinkai S et al. A study on maternal factors affecting low birth weight in institutional deliveries International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2020;9(10):4245-9
Sulakhe R, Lavanya K, Nageswara R et al. A cross sectional study on demographic factors affecting low birth weight. International Journal of Community Medicine and Public Health. 2019;6(11):4896-900
Tigistu Toru, WalellignAnmut et al. Assessment of Low Birth Weight and Associated Factors Among Neonates in Butajira General Hospital, South Ethiopia, Cross Sectional Study, 2019. International Journal of Pediatrics Volume 2020, Article ID 5841963, 6 pages https://doi.org/10.1155/2020/5841963
Choudhary M, Verma R, Jain S et al. Study of knowledge attitude practices and utilisation of existing health services by families with regard to newborn health at block level in rural India: a community based, cross sectional, observational study International Journal of Contemporary Paediatrics. 2019;6(2):704-12
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Girish Chavhan, Mahesh Chavhan*, Amrita Shastri, Bhagyashree Chavan, Prevalence, Determinants, Medication Use Patterns and Lived Experiences of Hypertension Among the Geriatric Population of Eastern Maharashtra: A Mixed-Method Study, Int. J. Sci. R. Tech., 2026, 3 (4), 174-182. https://doi.org/10.5281/zenodo.19413852
Bhagyashree K. Chavan et al. Insights into Maternal Care with Emphasis on High-Risk Pregnancy: A Cross Sectional Study at the Antenatal Clinic of a Tertiary Healthcare Centre in Eastern Maharashtra. IJSDR. 2025; 10 (12): b122-b130 | https://www.ijsdr.org/viewpaperforall.php?paper=IJSDR2512118

Bhagyashree Chavan

Corresponding author

Department of Obstetrics & Gynaecology, Government Medical College, Alibag

Rajashree Bhosale

Co-author

Department of Obstetrics & Gynaecology, Government Medical College, Alibag

Rajashree Bhosale, Bhagyashree Chavan*, Prevalence And Predictors Of Low Birth Weight Among Newborn Delivered In Tertiary Health Care Centre Of South-Western Maharashtra (Civil Hospital, GMC Alibag): A Cross-Sectional Study, Int. J. Sci. R. Tech., 2026, 3 (4), 1238-1248. https://doi.org/10.5281/zenodo.19925559

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Prevalence And Predictors Of Low Birth Weight Among Newborn Delivered In Tertiary Health Care Centre Of South-Western Maharashtra (Civil Hospital, GMC Alibag): A Cross-Sectional Study

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Bhagyashree Chavan

Rajashree Bhosale

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