Maternal Factors Associated with Low Birth Weight: A Case Control Study
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Abstract
Background: Low birth weight (LBW) remains a major contributor to neonatal morbidity and mortality globally. LBW remains an important maternal–neonatal health problem, particularly in high-risk referral settings. This study examined maternal and obstetric factors independently associated with LBW.
Methods: A retrospective case-control study used medical records of 270 mothers who delivered in 2025. Participants were selected by purposive sampling based on eligibility and record completeness, comprising 135 LBW cases and 135 controls. Eligible records included singleton deliveries without congenital anomalies; incomplete records and severe non-obstetric comorbidities were excluded. Maternal age, gestational age, birth spacing, parity, and documented preeclampsia were analyzed using chi-square tests and multivariable logistic regression. Variables with p < 0.25 entered the multivariable model.
Results: Preterm birth was strongly associated with LBW (AOR = 35.16, 95% CI: 16.92–73.09; p < 0.001), as was documented preeclampsia (AOR = 4.37, 95% CI: 1.94–9.80; p < 0.001). Maternal age and parity were not independently associated after adjustment, and birth spacing was not significant.
Conclusion: Preterm birth and documented preeclampsia showed the strongest adjusted associations with LBW. These findings support strengthened antenatal risk screening, preterm-birth surveillance, and timely referral, while providing context-specific evidence from a high-risk referral population.
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Afaya, A., Afaya, R. A., Azongo, T. B., Yakong, V. N., Konlan, K. D., Agbinku, E., Agyabeng-Fandoh, E., Akokre, R., Karim, J. F., Salia, S. M., Kaba, R. A., & Ayanore, M. A. (2021). Maternal risk factors and neonatal outcomes associated with low birth weight in a secondary referral hospital in Ghana. Heliyon, 7(5). https://doi.org/10.1016/j.heliyon.2021.e06962
Anil, K. C., Basel, P. L., & Singh, S. (2020). Low birth weight and its associated risk factors: Health facility-based case-control study. PLOS ONE, 15(6), e0234907. https://doi.org/10.1371/JOURNAL.PONE.0234907
Arabzadeh, H., Doosti-Irani, A., Kamkari, S., Farhadian, M., Elyasi, E., & Mohammadi, Y. (2024). The maternal factors associated with infant low birth weight: an umbrella review. BMC Pregnancy and Childbirth 2024 24:1, 24(1), 316-. https://doi.org/10.1186/S12884-024-06487-Y
Aradhya, S., Tegunimataka, A., Kravdal, O., Martikainen, P., Myrskyla, M., Barclay, K., & Goisis, A. (2023). Maternal age and the risk of low birthweight and pre-term delivery: a pan-Nordic comparison. International Journal of Epidemiology, 52(1), 156–164. https://doi.org/10.1093/IJE/DYAC211
Brouwers, L., de Gier, S., Vogelvang, T. E., Veerbeek, J. H. W., Franx, A., van Rijn, B. B., & Nikkels, P. G. J. (2024). Prevalence of placental bed spiral artery pathology in preeclampsia and fetal growth restriction: A prospective cohort study. Placenta, 156, 1–9. https://doi.org/10.1016/j.placenta.2024.08.010
Burute, S., & Parvin, S. (2026). Placental Dysfunction as a Common Pathway Linking Preeclampsia, Fetal Growth Restriction, and Preterm Birth: Current Evidence and Future Directions. Annals of African Medicine. https://doi.org/10.4103/AAM.AAM_256_26
Celentano, D. D., Szklo, M., & Farag, Y. (2024). Gordis Epidemiology (7th ed.). Elsevier.
Di, H. K., Gan, Y., Lu, K., Wang, C., Zhu, Y., Meng, X., Xia, W. Q., Xu, M. Z., Feng, J., Tian, Q. F., He, Y., Nie, Z. Q., Liu, J. A., Song, F. J., & Lu, Z. X. (2022). Maternal smoking status during pregnancy and low birth weight in offspring: systematic review and meta-analysis of 55 cohort studies published from 1986 to 2020. World Journal of Pediatrics: WJP, 18(3), 176–185. https://doi.org/10.1007/S12519-021-00501-5
Dimitriadis, E., Rolnik, D. L., Zhou, W., Estrada-Gutierrez, G., Koga, K., Francisco, R. P. V., Whitehead, C., Hyett, J., da Silva Costa, F., Nicolaides, K., & Menkhorst, E. (2023). Pre-eclampsia. Nature Reviews Disease Primers 2023 9:1, 9(1), 8-. https://doi.org/10.1038/s41572-023-00417-6
Ekoriano, M., Widiyantoau, A., Muthmainnah, M., Devi, Y. P., Cahyono, B. E., Nafsi, I., & Widodo, T. (2025). Profile and factors associated with low birth weight in Indonesia: a national data survey. Rural and Remote Health, 25(1). https://doi.org/10.22605/RRH9170
Fagundes Pasini, L., Fauth de Araújo, B., Girotto de Aguiar, L., da Silva Selistre, L., & Carla de Souza, V. (2025). Case-control study on long-term kidney outcomes in very low birth weight infants: impact of growth restriction and maternal preeclampsia. Jornal de Pediatria, 101(3), 400–406. https://doi.org/10.1016/J.JPED.2025.01.002
Flanagan, J., Beck, C. T., & Polit, D. (2024). Polit & Beck’s nursing research: Generating and assessing evidence for nursing practice. In 2024, International edition. (12th ed.). Lippincott Williams & Wilkins.
Goldstein, R. F., Bahri Khomami, M., Tay, C. T., Sethi, P., Liew, J., Moran, L., Harrison, C. L., Reddy, A., Lang, S., Brammall, B., Ranasinha, S., Flores-Urrutia, M. C., Muñoz-Manrique, C., Arruda Silva, M., Borghi, E., Phelan, S., Teede, H., & Mousa, A. (2025). Gestational weight gain and risk of adverse maternal and neonatal outcomes in observational data from 1.6 million women: systematic review and meta-analysis. BMJ, 391. https://doi.org/10.1136/BMJ-2025-085710
Haksari, E. L., Irawan, G., Lusyati, S. D., Wibowo, T., Yunanto, A., Rukmono, P., Sianturi, P., Alasiry, E., Primadi, A., Samad, Basalamah, M., Etika, R., Wilar, R., & Dharmasetiawani, N. (2025). Neonatal mortality and survival of low-birth-weight infants at hospitals in indonesia, a multi-center study. Scientific Reports 2025 15:1, 15(1), 31607-. https://doi.org/10.1038/s41598-025-16401-x
Hunter, P. J., Muthiani, Y., Näsänen-Gilmore, P. K., Koivu, A. M., Pörtfors, P., Bastola, K., Vimpeli, R., Luoma, J., Ashorn, U., & Ashorn, P. (2023). A modular systematic review of antenatal interventions to address undernutrition during pregnancy in the prevention of low birth weight. The American Journal of Clinical Nutrition, 117, S134–S147. https://doi.org/10.1016/J.AJCNUT.2023.01.024
Isnaini, Y. S., Ida, S., & Pihahey, P. J. (2021). Faktor-faktor yang berhubungan dengan kejadian Berat Lahir Rendah. Nursing Arts, 15(2), 47–55. https://doi.org/10.36741/JNA.V15I2.151
Kargbo, D. K., Nyarko, K., Sackey, S., Addo-Lartey, A., Kenu, E., & Anto, F. (2021). Determinants of low-birth-weight deliveries at five referral hospitals in Western Area Urban district, Sierra Leone. Italian Journal of Pediatrics 2021 47:1, 47(1), 212-. https://doi.org/10.1186/S13052-021-01160-Y
Lawn, J. E., Ohuma, E. O., Bradley, E., Okwaraji, Y. B., Yargawa, J., Blencowe, H., Idueta, L. S., Hazel, E., Erchick, D. J., Katz, J., Diaz, M., Black, R. E., Lee, A. C. C., Salasibew, M., Requejo, J., Hayashi, C., Moller, A. B., Borghi, E., Ashorn, P., … Prendergast, A. (2023). Small babies, big risks: global estimates of prevalence and mortality for vulnerable newborns to accelerate change and improve counting. The Lancet, 401(10389), 1707–1719. https://doi.org/10.1016/S0140-6736(23)00522-6
Mamari, E. Al, Hashmi, I. Al, & Omari, O. Al. (2025). Determinants of low birth weight among newborns of women from a Middle Eastern Country: a retrospective case - control study. Midwifery, 148, 104531. https://doi.org/10.1016/J.MIDW.2025.104531
Marasciulo, F., Orabona, R., Fratelli, N., Fichera, A., Valcamonico, A., Ferrari, F., Odicino, F. E., Sartori, E., & Prefumo, F. (2021). Preeclampsia and late fetal growth restriction. Minerva Obstetrics and Gynecology, 73(4), 435–441. https://doi.org/10.23736/S2724-606X.21.04809-7
Marsubrin, P. M. T., Sugiyarto, K. L. J., Oswari, J. S., Yulianti, D. A., Rohsiswatmo, R., Roeslani, R. D., Iskandar, R. A. T. P., Sukarja, D., Sjahrullah, M. A. R., Kautsar, A., & Chaudhari, T. (2025). E-Prem checklist-driven strategy to improve outcomes in extremely preterm and low birth weight infants: a quasi-experimental study at a national referral hospital in Indonesia. BMJ Open, 15(10), e102714. https://doi.org/10.1136/BMJOPEN-2025-102714
Mitrogiannis, I., Evangelou, E., Efthymiou, A., Kanavos, T., Birbas, E., Makrydimas, G., & Papatheodorou, S. (2023). Risk factors for preterm birth: an umbrella review of meta-analyses of observational studies. BMC Medicine, 21(1). https://doi.org/10.1186/S12916-023-03171-4
Ni, W., Gao, X., Su, X., Cai, J., Zhang, S., Zheng, L., Liu, J., Feng, Y., Chen, S., Ma, J., Cao, W., & Zeng, F. (2023). Birth spacing and risk of adverse pregnancy and birth outcomes: A systematic review and dose–response meta‐analysis. Acta Obstetricia et Gynecologica Scandinavica, 102(12), 1618. https://doi.org/10.1111/AOGS.14648
Okwaraji, Y. B., Krasevec, J., Bradley, E., Conkle, J., Stevens, G. A., Gatica-Domínguez, G., Ohuma, E. O., Coffey, C., Estevez Fernandez, D. G., Blencowe, H., Kimathi, B., Moller, A. B., Lewin, A., Hussain-Alkhateeb, L., Dalmiya, N., Lawn, J. E., Borghi, E., & Hayashi, C. (2024). National, regional, and global estimates of low birthweight in 2020, with trends from 2000: a systematic analysis. The Lancet, 403(10431), 1071–1080. https://doi.org/10.1016/S0140-6736(23)01198-4
Silaban, V. F., Masniar, M., Masna, M., & Marwani, M. (2024). Hubungan Usia Kehamilan, Jarak Kehamilan dan Komplikasi Kehamilan, Antenatal Care dengan Kejadian Bayi Berat Lahir Rendah (BBLR). MAHES : Malahayati Health Student Journal, 4(6), 2344–2353. https://doi.org/10.33024/MAHESA.V4I6.14497
Simbolon, D., Ningsih, L., Andriani, L., & Kamsiah. (2025). Is the incidence of low birth weight in indonesia due to preeclampsia during pregnancy? A meta-analysis. Media Gizi Indonesia, 20(3), 223–233. https://doi.org/10.20473/MGI.V20I3.223-233
Sławek-Szmyt, S., Kawka-Paciorkowska, K., Ciepłucha, A., Lesiak, M., & Ropacka-Lesiak, M. (2022). Preeclampsia and Fetal Growth Restriction as Risk Factors of Future Maternal Cardiovascular Disease—A Review. Journal of Clinical Medicine 2022, Vol. 11, Page 6048, 11(20), 6048. https://doi.org/10.3390/JCM11206048
Syahda, S., Hastuty, M., & Parmin, J. (2024). Analisis Faktor yang Berhubungan dengan Kejadian Berat Badan Lahir Rendah (BBLR) di RSUD Bangkinang Kabupaten Kampar. Jurnal Ners, 8(1), 192–198. https://doi.org/10.31004/JN.V8I1.23633
Ting, J. Y., Gupta-Bhatnagar, S., Choudhury, J., Yoon, E. W., Ethier, G., Sherlock, R., Toye, J., Beltempo, M., & Shah, P. S. (2024). Antimicrobial utilisation patterns between 2013 and 2022 in Canadian neonates born at less than 33 weeks gestation: a retrospective cohort study. The Lancet Regional Health - Americas, 40, 100942. https://doi.org/10.1016/j.lana.2024.100942
UNICEF. (2024). Low birthweight: Country, regional and global estimates. UNICEF.
Wang, Y., Zeng, C., Chen, Y., Yang, L., Tian, D., Liu, X., & Lin, Y. (2022). Short interpregnancy interval can lead to adverse pregnancy outcomes: A meta-analysis. Frontiers in Medicine, 9. https://doi.org/10.3389/FMED.2022.922053
WHO. (2022). Newborns: Improving survival and well-being. WHO.
Wulandari, F., Mahmudiono, T., Rifqi, M. A., Helmyati, S., Dewi, M., & Yuniar, C. T. (2022). Maternal Characteristics and Socio-Economic Factors as Determinants of Low Birth Weight in Indonesia: Analysis of 2017 Indonesian Demographic and Health Survey (IDHS). International Journal of Environmental Research and Public Health, 19(21). https://doi.org/10.3390/IJERPH192113892
Young, M. F., Oaks, B. M., Rogers, H. P., Tandon, S., Martorell, R., Dewey, K. G., & Wendt, A. S. (2023). Maternal low and high hemoglobin concentrations and associations with adverse maternal and infant health outcomes: an updated global systematic review and meta-analysis. BMC Pregnancy and Childbirth 2023 23:1, 23(1), 264-. https://doi.org/10.1186/S12884-023-05489-6
Yumni, fathiya luthfil. (2022). Studi Kasus Perubahan Termoregulasi BBLR Dalam Perawatan Metode Kanguru Di Ruang NICU RS Siti Khodijah Muhammadiyah Cabang Sepanjang. Sinar: Jurnal Kebidanan, 4(2), 9–17. https://doi.org/10.30651/SINAR.V4I2.12841