Determinants and Outcomes of Low Birth Weight among Newborns at a Tertiary Hospital in Zambia: A Retrospective Cohort Study

CONTEXT: Newborns’ low birth weight (LBW) has been linked to early infant morbidity and mortality. However, our understanding of the determinants and outcomes of LBW in this population is still poor. AIM: This study aimed to assess determinants and outcomes of LBW among newborns at a tertiary hospital. SETTINGS AND DESIGN: Retrospective cohort study at Women and Newborn Hospital in Lusaka Zambia. SUBJECTS AND METHODS: We reviewed delivery case records and neonatal files between January 1, 2018, and September 30, 2019, for newborns admitted to the neonatal intensive care unit. STATISTICAL ANALYSIS USED: Logistic regression models were used to establish determinants of LBW and describe the outcomes. RESULTS: Women living with human immunodeficiency virus infection were more likely to deliver LBW infants (adjusted odds ratio [AOR] = 1.46; 95% confidence interval [CI]: 1.16–1.86). Other maternal determinants of LBW were; increased parity (AOR = 1.22; 95% CI: 1.05–1.43), preeclampsia (AOR = 6.91; 95% CI: 1.48–32.36), and gestational age <37 weeks compared to 37 weeks or more (AOR = 24.83; 95% CI: 13.27–46.44). LBW neonates were at higher odds of early mortality (AOR = 2.16; 95% CI: 1.85–2.52), developing respiratory distress syndrome (AOR = 2.96; 95% CI: 2.53–3.47), and necrotizing enterocolitis (AOR = 1.66; 95% CI: 1.16–2.38) than neonates with a birth weight of 2500 g or more. CONCLUSIONS: These findings underscore the importance of effective maternal and neonatal interventions to reduce the risk of morbidity and mortality for neonates with LBW in Zambia and other similar settings.