Exploring the association between adverse maternal circumstances and low birth weight in neonates: a nationwide population-based study in Bangladesh

OBJECTIVE: This study is concerned with helping to improve the health and care of newborn babies in Bangladesh by exploring adverse maternal circumstances and assessing whether these are contributing towards low birth weight (LBW) in neonates. STUDY DESIGNS AND SETTINGS: Data were drawn and analysed from the Bangladesh Demographic and Health Survey, 2014. Any association between LBW and adverse maternal circumstances were assessed using a Chi-square test with determinants of LBW identified by multivariate logistic regression analysis. PARTICIPANTS: The study is based on 4728 children aged below 5 years and born to women from selected households. RESULTS: The rate of LBW was around 19.9% (199 per 1000 live births) with the highest level found in the Sylhet region (26.2%). The rate was even higher in rural areas (20.8%) and among illiterate mothers (26.6%). Several adverse maternal circumstances of the women included in the survey were found to be significant for increasing the likelihood of giving birth to LBW babies. These circumstances included the women being underweight (adjusted odds ratio (AOR) 1.26, 95% CI 1.06 to 1.49); having unwanted births (AOR 1.22, 95% CI 1.03 to 1.44); had previous pregnancies terminated (AOR 1.28, 95% CI 1.05 to 1.57); were victims of intimate partner violence (AOR 1.23, 95% CI 1.05 to 1.45) and taking antenatal care <4 times (AOR 1.23, 95% CI 1.03 to 1.48). Other important risk factors that were revealed included age at birth <18 years (AOR 1.42, 95% CI 1.11 to 1.83) and intervals between the number of births <24 months (AOR 1.25, 95% CI 1.01 to 1.55). When taking multiple fertility behaviours together such as, the ages of the women at birth (<18 years with interval <24 months (AOR 1.26, 95% CI 1.02 to 1.57) and birth order (>3 with interval <24 months (AOR 1.68, 95% CI 1.18 to 2.37), then the risk of having LBW babies significantly increased. CONCLUSION: This study finds that adverse maternal circumstances combined with high-risk fertility behaviours are significantly associated with LBW in neonates. This situation could severely impede progress in Bangladesh towards achieving the sustainable development goal concerned with the healthcare of newborns.