Maternal determinants of low birth weight among Indian children: Evidence from the National Family Health Survey-4, 2015-16

Abstract

Objective Low birth weight (LBW) is a serious public health problem in low- and middle-income countries and a leading cause of death in the first month of life. In India, about 18% of children are born with LBW (<2500 grams) in 2015–16. In this study, we aim to examine the influence of maternal factors and socio-demographic covariates on LBW in Indian children. Methods Data were drawn from the fourth round of the National Family Health Survey (NFHS-4), conducted in 2015–16. A cross-sectional study was designed using a stratified two-stage sampling technique. Cross-tabulation, Pearson’s chi-squared test, and multivariate logistic regression analyses were employed to assess the impact of maternal factors and other covariates on children’s LBW. Results Of total participants (n = 147,762), 17.5% of children were found to be born with LBW. The study revealed that women who had prior experience of stillbirth (Adjusted odds ratio [AOR]: 1.20, 95% CI: 1.04–1.38) and any sign of pregnancy complications (AOR: 1.08, 95% CI: 1.05–1.11) were more likely to have LBW children, even after adjusting for a range of covariates. Maternal food diversity was found to a protective factor against children’s LBW. Women with underweight and anemic condition were associated with an increased likelihood of LBW children. Regarding maternity care, women who attended ≥4 ANC visits (AOR: 0.84, 95% CI: 0.80–0.88), took iron tablets/syrup during pregnancy (AOR: 0.94, 95% CI: 0.90–0.98), and delivered in a public health facility (AOR: 0.84, 95% CI: 0.79–0.88) were less likely to have LBW babies. Besides, various socio-demographic factors such as place of residence, caste, religion, education, wealth quintile, and geographical region were significantly associated with LBW of children. Conclusion Interventions are needed for adequate ANC utilization, improvement in public facility-based delivery, providing iron supplementation, and uptake of balanced energy-protein diet among pregnant mothers. Besides, special attention should be given to the socio-economically disadvantaged women to address adverse pregnancy and birth outcomes including LBW.