A health facility based case-control study on determinants of low birth weight in Dassie town, Northeast Ethiopia: the role of nutritional factors

Facility-based unmatched case-control study conducted from 3 February to 29 April 2017 in all public health facilities of Dessie Town, Northeast Ethiopia. Participants: 279 mothers and their newborns (93 LBW cases <2500 g; 186 controls ≥2500 g), including term singleton births; mothers aged 21–35 most; mean ages 27.3±5.5 (cases) and 26.2±4.7 (controls). Neonates: sex distribution with more males (52.7% cases, 62.9% controls). Exclusions: major congenital anomalies, mothers with diabetes, and unknown last menstrual period. Data: interviewer-administered structured questionnaire; anthropometric measurements; birth weights measured within 1 hour of delivery. Analysis: descriptive statistics, bivariate analyses, and multivariable logistic regression; significance set at p<0.05.

Iron and folic acid supplementation during pregnancy

Nutritional factors during pregnancy are determinants of LBW. Absence of iron/folate supplementation, lack of nutritional counseling, and not having an extra meal were associated with higher LBW risk. Maternal undernutrition (MUAC <23 cm), maternal anemia, and inadequate dietary diversity (MDD-W <5) were also significant determinants. Strengthening nutritional counseling, iron/folate supplementation, extra meals, and improving dietary diversity during pregnancy may reduce LBW incidence in Ethiopia. Key adjusted associations: no supplementation 2.84 (95% CI 1.15-7.03); no counseling 4.05 (95% CI 1.95-8.38); no extra meal 3.25 (95% CI 1.64-6.44); MUAC <23 cm 5.62 (95% CI 2.64-11.97); anemia 3.54 (95% CI 1.46-8.61); inadequate MDD-W 6.65 (95% CI 2.31-19.16).

Not including private health facilities; gestational age determined by maternal recall; potential recall bias for dietary intake, ANC visits, and supplement use; observational case-control design cannot establish causality; no dosage data for iron/folate supplementation; generalizability limited to Dessie Town public facilities.