Publication:

Determinants of low birth weight in a tertiary care setting of an aspirational district

Background Low birth weight (LBW) remains a critical challenge for neonatal survival and long-term health, particularly within India's aspirational districts. This study aims to identify the clinical, socioeconomic, and nutritional determinants of LBW in the high-altitude terrain of Himachal Pradesh.

Methods A retrospective, hospital-based cross-sectional audit was conducted at a tertiary care centre. The study analysed data from 151 LBW infants (<2500 g) born between 1 April and 30 June 2025, using records from the HMIS portal, medical record section, and antenatal clinic registers.

Results The facility reported a 15.5% LBW rate. Key determinants included poor antenatal care (ANC) utilization, with 50% of mothers failing to achieve early registration (within 12 weeks) and 79% attending fewer than the recommended four ANC visits. Nutritional factors; 32% of mothers were underweight at conception, and 44% achieved a gestational weight gain of less than 10 kg. Obstetric findings revealed that 80% of cases had birth intervals of less than three years, contributing to maternal nutrient depletion. Additionally, while 50% of pregnancies were categorized as high-risk, 95% of cases were non-referred, indicating that the tertiary facility is overburdened with routine deliveries.

Conclusions The high incidence of LBW is driven by late clinical registration, maternal undernutrition, and systemic healthcare burdens. Improving outcomes requires precision interventions, including strengthened grassroots outreach for 100% early registration and the establishment of dedicated high-risk pregnancy clinics.