Determinants of low birth weight in India: An investigation from the National Family Health Survey

Abstract

Objective: This study aimed to estimate the change in prevalence of low birth weight (LBW) over the last decade in India and to identify its associated factors-biological, demographic, socio-economic, and programmatic. Methods:We used the data from the National Family Health Survey of 2005-2006 (NFHS-3) and 2015 -2016. The sample of this study included 11 300 children from NFHS-3 and 99 894 from NFHS-4 data; all these children were the last full-term singleton live-births, born within the last 3 years prior to the survey.Results: In India, the prevalence of LBW has significantly declined from 20.4% (95%CI 19.4-21.4) to 16.4% (95% CI 16.1-16.8) in the last decade. The prevalence of LBW remained high in girl children (OR = 1.2, 95% CI 1.2-1.3; P < .001), whose mothers were adolescent (OR = 1.2, 95% CI 1.1-1.3; P < .001), and were stunted (OR = 1.3, 95% CI 1.3-1.3; P < .001). Prevalence of LBW declined among second or higher birth order child (OR = 0.8, 95% CI 0.8-0.9; P < .001), whose mothers educated up to secondary level and above (OR = 0.6 to 0.8), belonged to rich wealth quintiles (OR = 0.9 to 0.8), were from rural area (OR = 0.9, 95% CI 0.9-1.0; P < .001), received better nutrition and adequate antenatal care (OR = 0.8, 95% CI 0.8-0.8; P < .001), and were from eastern, northeastern, and southern regions of India (OR = 0.9 to 0.5). Conclusion:Although the prevalence of LBW in India has declined over the past decade, the extent of the decline is modest. In the coming years, health programs in India need to gear up with greater convergence between maternal health services and maternal nutrition to reduce LBW.

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

“…This result is in accordance with the findings from Ghana where mothers who consumed diversified and nutritious foods were less likely to have LBW babies [19]. Similarly, an Indian study reported that the intake of high protein foods by mothers (i.e., consumption of dairy products) significantly reduces the risk of LBW [10]. Proper nutritious foods are essential for a healthy pregnancy as a healthy diet during pregnancy stimulates the baby's growth and development.…”

“…Furthermore, our study revealed that underweight women were at a greater risk of LBW babies. This finding is corroborated with many earlier studies conducted in India and elsewhere [8,10,11]. Nevertheless, the magnitude of risk may vary depending on the healthcare management and monitoring system in different geographical settings [8].…”

“…Previous research has documented that LBW of children is determined by a complex interplay of biological, socioeconomic, obstetric, maternity care during pregnancy, nutrition, and environmental factors [9][10][11][12][13]. For instance, a recent study conducted in India using two consecutive large-scale sample surveys found a significant influence of biological characteristics, mothers' nutrition, programmatic factors, and socio-economic status on the occurrence of LBW [10]. Their study has revealed that mothers' daily consumption of nutritional foods, adequate utilization of antenatal care (ANC) and delivery care, and improved socio-economic status were protective against LBW of children [10].…”

“…For instance, a recent study conducted in India using two consecutive large-scale sample surveys found a significant influence of biological characteristics, mothers' nutrition, programmatic factors, and socio-economic status on the occurrence of LBW [10]. Their study has revealed that mothers' daily consumption of nutritional foods, adequate utilization of antenatal care (ANC) and delivery care, and improved socio-economic status were protective against LBW of children [10]. Of particular interest, an earlier study of India indicates that the nutritional status of the mother, measured from body mass index (BMI), is the most important determinant of LBW in children [11].…”

Predictors of Low Birth Weight at Lumbini Provincial Hospital, Nepal: A Hospital-Based Unmatched Case Control Study

“…e role of education and employment on infant birth weight might be due to various interactions among social determinants of health. Mothers with low educational attainment are prone to low health seeking behavior and more likely to be unemployed which further can lead to deprivation of nutritious food, good housing condition, and wealth which are found to be independent risk factors of LBW [19,[25][26][27].…”