Examining the combined effect of antenatal care visits and iron-folic acid supplementation on low birth weight: A pooled analysis of two national data sets from Nepal

Abstract

Abstract Introduction: The prevalence of low birth weight (LBW) has remained constant at approximately 12% for the past 15 years in Nepal, significantly impacting newborn survival. While antenatal care (ANC) visits and iron-folic acid supplementation are recognized as essential for reducing LBW, there is lack ofevidence regarding their combined effect. This study aimed to explore the potential synergistic impact of ANC and iron-folic acid supplementation on LBW in Nepal by analyzing data pooled from two national surveys. Methods: The nationally representative Nepal Demographic and Health Surveys of 2016 and 2022 were used, and the pooled dataset was analyzed. Birth weight and the prevalence of LBW were reported using descriptive statistics. The associations between LBW, ANC visits, and iron-folic acid supplementation were examined using logistic regression analyses. Results: The mean birth weight was 3011g, with an LBW prevalence of 11.2%. Not attending ANC (Adjusted Odds Ratio (AOR): 1.49; 95% Confidence Interval (CI): 1.15, 1.95) and not consuming iron-folic acid supplement (AOR 1.44; 95% CI: 1.12, 1.85) were independently associated with a higher likelihood of LBW. Jointly, mothers who attended less than four ANC visits and consumed iron-folic acid ≤90 days (AOR: 1.90; 95% CI: 1.37, 2.61) had the highest risk of giving birth to LBW infants after controlling for key confounding factors. Conclusion: Combining ANC visits and iron-folic acid supplementation appeared to have more impact than administering either intervention alone in reducing LBW births in Nepal.