Iranian Journal of Health Sciences 2017; 5(3): 58-64 http://jhs.mazums.ac.

ir

Original Article

Maternal risk factors associated with low birth weight

Victoria Momenabadi1 Mohammad Hossein Kaveh2 Seyed Masoud Mousavi3 Somayeh Alizadeh*4

1. PhD Candidate, Department of Health Education and Health Promotion, School of Health, Shiraz University of
Medical Sciences, Shiraz, Iran.
2. Associate Professor, Research Center for Health Sciences, Institute of Health, Shiraz University of Medical
Sciences, Shiraz, Iran.
3. MPH student in the elderly Health, MD, Kerman University of Medical Sciences.
4. PhD Candidate, Department of Health Education and Health Promotion, School of Health, Shahid Sadoughi
University of Medical Sciences, Yazd, Iran.

*Correspondence to: Somayeh Alizadeh

alizade2009@yahoo.com

Abstract
Background and purpose: Since a large proportion of fetal mortality is associated with low birth
weight (LBW) and considering the fact that fetal development is a vulnerable process influenced by
maternal risk factors, this study examined some maternal risk factors associated with LBW infants.
Materials and Methods: This cross-sectional study was conducted based on the medical records
of 250 infants born in Zeynabeieh Hospital. The required data were registered in a pre-developed
checklist. Then, the collected data were analyzed by Chi-square in SPSS Software using
descriptive and inferential statistics.
Results: The mean weight of the sample was 3.2 ± 0.25 (1.5-4.7) kg. About 18% of the infants
had birth weight of 2500 g or less. The most frequent educational level among the mothers was
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illiteracy and elementary education (60%), and the least was secondary education (9.2%). There
was found a significant correlation between the mothers’ education and low birth weight (P <
0.001). Regarding the association between the mothers’ age and low birth weight, 18- to 35-
year-old mothers comprised the highest number of mothers (75%), and upper 35-year-old
mothers did the lowest (11.2%). Based on chi-square test, a significant correlation was observed
between the mothers’ ages and low birth weight (p<0.001). In addition, concerning the
occupation of mother and low birth weight, there was documented a significant correlation
between their occupation and low birth weight (P < 0.001).
Conclusion: Maternal biosocial, medical, and obstetric factors have strong association with
LBW. To overcome this problem, special attention is required so as to strengthen the mother and
child healthcare services in the community.

Key words: LBW; Maternal Risk Factorsz; Shiraz

Citation: MomenabadiV, Hossein Kaveh M, MousaviSM, Alizadeh S*. Maternal risk factors associated with
low birth weigh 2017; 5 (3):58-64.
[ DOI: 10.29252/jhs.5.3.58 ]

Copyright © 2017, Published by Mazandaran University of Medical Sciences on behalf of Iranian Journal of Health Sciences and Health Sciences
Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International
License https://creativecommons.org/licenses/by-nc/4.0/which permits copy and redistribute the material just in noncommercial usages, provided the
original work is properly cited.

Iran J Health Sci 2017; 5(3): 58

 Maternal risk factors and low birth weight V. Momenabadi et al

1. Introduction the first month of life, and the majority of the

The birth weight of < 2500 g is one of the deceased infants have a birth weight of <
serious health problems of the infants in the 2500 g (12). Determining the indices of
world today (1). Low birth weight (LBW) height, weight, and head circumference
(neonate weighing<2500 g) is a multifactorial (anthropometric indices) is one of the most
phenomenon (2). Many maternal and fetal common and easiest methods of assessing
factors are found significantly to be development to examine the infants’ health of
associated with LBW (3). Regardless of a community (13). The reduction in LBW of
gestational age, LBW is a multifaceted public infants is also an important objective of
health problem with significant individual and millennium development goal 4, which seeks
societal impact worldwide, especially in to reduce child mortality by two-thirds by the
developing countries (4). Globally, an year 2015 (14). The main objective of this
estimated 20 million LBW infants are born study was then to determine the association
each year, with over 18 million of these in between socio-demographic, maternal,
developing countries, LBW infants are at a medical and obstetric risk factors, and low
disproportionately higher risk of mortality, birth weight.
morbidity, poor growth, and impaired
2.Materials and Methods
psychomotor, and cognitive development (5, In this cross-sectional study, 250 infants who
6). These LBW infants are also disadvantaged were born in 2015 in Zeynabeieh Hospital,
when they become adults, as they are more Shiraz city, Iran were chosen as sample via
susceptible to type 2 diabetes, hypertension, the census. This center covers a large
and coronary heart disease. LBW is related population, and is referred to from different
not only to basic maternal characteristics parts of the city. The data in the medical files
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during pre-pregnancy, but also to potential of the infants born in this center in the year
risk factors during pregnancy, including 2015 were collected for conducting the
maternal age, educational attainment, present study. The collection of data was
lifestyle, health status, and diseases (5), of performed through a predeveloped checklist
which maternal age, educational attainment, comprising items on maternal factors, such as
and marital status are more closely associated occupation of mother, age of mother,
with LBW. In addition, most current studies antenatal care, birth spacing, pre-delivery
of LBW risk factors have focused on weight, pregnancy weight gain, antenatal
environmental, psychosocial, behavioral, and care, economic status, maternal education,
medical factors (7-9). Many medical factors and mother hypertension. This study was not
and basic diseases are also reported to be an ethical consideration because not
related to LBW, including diabetes, mentioned on the name of people. The data
preeclampsia, and oligohydramnios (10). It were analyzed by appropriate statistical tests,
should be noted that across the world, such as Chi-square through SPSS Software
neonatal mortality is 20 times more likely for (Version 19), and the significance level was
LBW babies compared to heavier ones (≤ 2.5
[ DOI: 10.29252/jhs.5.3.58 ]

defined to be P < 0.050.

kg) (11). It is documented that in Iran, 289
children under 5 years of age die each day,
while 48% of these mortalities occur within

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 Maternal risk factors and low birth weight V. Momenabadi. et al

3. Results showed a significant correlation between the

Totally, 250 infants were studied for birth type of pregnancy (wanted or unwanted) and
weight. The mean weight was 3.2 ± 0.25 (1.5- low birth weight and height (P < 0.001),
4.7) kg. About 18% of the infants had birth meaning that unwanted pregnancy could
weight of 2500 g or less. Also, the mean cause an increase in low birth weight
height was 47.4 ± 0.25 (40-51) cm. About (p<0.001). At the same time, a significant
12.4% of the infants had birth height less than correlation was observed between pre-delivery
the standard birth height. The mean head weight and low birth weight (P < 0.001),
circumference of the infants was 34.00 ± 1.54 meaning that the pre-delivery weight<45kg
(28-39) cm. About 20% of the infants had a caused increased low birth weight. However,
head circumference of <32 cm. The most a significant correlation was observed
frequent educational level among the mothers between mothers’ antenatal care and low birth
was illiteracy and elementary (60%), and the weight (P < 0.001) meaning that increased
least was secondary (9.2%). At the same time, antenatal care had decreased low birth weight.
21.2% of the mothers had completed their One other significant correlation was also
guidance education at school, while 9.6% of noted between maternal weight gain and low
them had an academic education. The results birth weight and height (P < 0.001), meaning
of the analysis are presented in Table 1. As that increased maternal weight gain affected
can be observed, there was a significant the newborn child through causing decreased
correlation between the mothers’ education low birth weight.
and low birth weight (P < 0.001). On the One further significant correlation was seen
association between the mothers’ age and low between economic status and low birth weight
birth weight, 18- to 35-year-old mothers and height (P < 0.001), meaning that good
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comprised the highest number of mothers economic status decreased low birth weight
(75%), and over 35-year-old mothers did the (p<0.001). (The related results are shown in
lowest (11.2%). Based on chi-square test, a Table 1).
significant correlation was also documented In this study, logistic regression analysis was
between the mothers’ age and low birth also done to eliminate the effects of potential
weight (p<0.001). confounders, and to identify the independent
Concerning the occupation of mother and low effect of various risk factors. Hence, as shown
birth weight, a significant correlation was also in Table 2, it was found that the most
seen through Chi-square (P < 0.001); important risk factors associated with the low
however, no significant correlation was birth weight of babies were Age of mother (OR
observed between maternal hypertension levels =3.36), Occupation of mother (OR =3.32),
at the onset of pregnancy and low birth Mother’s education (OR =2.17), Type of
weight (p=0/06). It should be mentioned that pregnancy (OR =2.26), Birth spacing (OR
the birth spacing was <36 month in 24.8% of =3.36), pregnancy weight gain (OR =4.98), pre-
the studied mothers, resulting in a significant delivery weight (OR =3.81), antenatal care (OR
correlation between birth spacing and low birth =5.98), and Low economic status (OR =2.27).
[ DOI: 10.29252/jhs.5.3.58 ]

weight. The findings of the current study also

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 Maternal risk factors and low birth weight V. Momenabadi et al

Table1. Maternal risk factors associated with low birth weight

Variables low birth weight Result
yes No
Age of mother <18year 17 20 χ2 = 76.75 df = 2
18-35year 3 182 P < 0.001
>35year 11 17
total 31 219
Occupation of mother housewife 7 180 χ2 = 91.1 df = 1
Employee 24 39 P < 0.001

total 31 219
Mother’s education Illiterate and elementary 31 119 χ2 = 23.59 df = 3
Secondary 0 23 P < 0.001
guidance 0 53
Academicians 0 24
total 31 219
Type of pregnancy wanted 3 190 χ2 = 91.66 df = 1
unwanted 28 29 P < 0.001
total 31 219
Birth spacing <36 month 27 35 χ2 = 74.64 df = 1
>36month 4 184 P < 0.001
total 31 219
Pre-delivery weight <45kg 21 9 χ2 = 96.63 df = 1
>45kg 10 210 P < 0.001
total 31 219
Pregnancy weight gain <6kg 31 21 χ2 = 134.74 df = 2
6-9kg 0 142 P < 0.001
>9kg 0 56
total 31 219
Antenatal care <3 31 21 χ2 = 134.74 df = 2
3-5 0 142 P < 0.001
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>5 0 56
total 31 219
Maternal hypertension yes 0 27 χ2 = 4.28 df = 1
No 31 192 P =0.06
total 31 219
Economic status good 0 56 χ2 = 134.74 df = 2
moderate 2 142 P < 0.001
Weak 29 21
total 31 219

Table2. Logistic Regression Analysis

Factor Odds Ratio 95% CI P value
Age of mother 3.36 1.91-5.88 < 0.001
Occupation of mother 3.32 1.55-7.10 < 0.001
Mother’s education 2.17 1.67-2.04 < 0.001
Type of pregnancy 2.26 1.91-4.88 < 0.001
Birth spacing 3.36 1.91-5.88 < 0.001
Pre-delivery weight 3.81 2.53-8.15 < 0.001
[ DOI: 10.29252/jhs.5.3.58 ]

Pregnancy weight gain 4.98 2.64-9.39 < 0.001

Antenatal care 5.98 3.64-9.39 < 0.001
Maternal hypertension 1.11 0/60-2.00 0. 06
Low economic status 2.27 1.81-4.91 < 0.001

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 Maternal risk factors and low birth weight V. Momenabadi. et al

4. Discussion attendance, leading to the increased risk of

As observed in the present study, there was a LBW babies. Additionally, in this study,
significant association between low birth consistent with certain other studies (24-25), a
weight and some maternal risk factors, and significant relationship was observed between
the association between the infants’ weight the antenatal care and low birth weight. It
and mothers’ age was significant. In other should also be noted that the findings of this
words, the likelihood of giving birth to the study were in line with the results of some
infants with the weight of < 2500 g increased other studies in that there was a significant
for the mothers under 18 years old and over relationship between pregnancy weight gain,
35 (P < 0.001). However, the association of pre-delivery weight, and pregnancy type
another determinant of development, i.e., the (planned or unplanned), and birth weight
infants’ weight, with mothers’ age was not (17,20,25).
significant as determined by chi-square test. The results of the current research also
Whereas, in Tootoonchi’s study in Tehran, showed that educational healthcare centers
the mothers’ age of under 20 and over 35 was should study the risk factors during pregnancy
documented to be the risk factor for LBW more seriously. It is then hoped that further
(15). Based on the findings of Malik et al., the attention to be paid to general and regional
rate of LBW infants was higher in the women risk factors which influence the fetal
over 35 than those over 18 years of age (16). development initiated by these centers. Thus,
A significant association was also observed the findings of this study emphasized the need
between the mothers’ occupation and for improving the quality and utilizing
education, and low birth weight, which has antenatal care, providing nutritional education
been confirmed by other studies (17-19). In to improve weight gain during pregnancy,
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the present study, it has been well spacing, and preventing and managing
demonstrated that if Birth spacing increases, properly the risk factors.
the likelihood of declined low birth weight
Acknowledgement
will increase, and this is a result confirmed by The authors of this study are thankful to all
Klufio et al. (18). It should also be noted that personnel of Zeynabeieh Hospital for their
in the current study, no significant association cordial collaboration.
was documented between maternal
hypertension and decreased birth weight Conflict of interest: The authors declare that
(p=0.06). Several studies in the literature had they have no conflict of interest.
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