Published: 2021-04-23

Incidence and risk factors for term low birth weight babies in a tertiary care hospital in Kerala

Sheela Jacob, Ancy T. Jacob


Background: Birth weight of <2.5 kg at birth is considered low birth weight and impacts the individual's health during their adult life. Babies are born with low birth weight, both in term and preterm deliveries. This study aims to find the incidence of term low birth weight babies (TLBW) and the maternal risk factors associated with the same.

Methods: This case-control study was conducted on 166 pregnant women who had term live births during the study period July 2019 to December 2020. Inclusion criteria: Women with a live singleton TLBW (<2.5 kg) - cases (63) and normal birth weight babies - controls (103). Control group selection was 1:2 proportion as per the cases. Exclusion criteria consisted of women with multiple gestations. Binary and categorical variables were presented using counts and percentages. Independent sample t-test was used to compare two continuous variables, and the chi-square test/Fisher's exact test was used to find the association of categorical variables.

Results: 1344 live births were reported during the study period, of which 63 cases were TLBW babies with an incidence of 4.68%. Among the baseline parameters, significant difference was observed only in body mass index (BMI). After assessing the common risk factors like anemia, urinary tract infection (UTI), genital tract infection, gestational diabetes mellitus (GDM), and gestational hypertension, only hypothyroidism showed significant association with TLBW (OR: 2.240, 95% CI:0.98-5.13, p=0.006).

Conclusions: The incidence of TLBW babies was 4.68%, which is low compared with other studies. Hypothyroidism shows significant association with TLBW in this study which was not observed in previous literature.


Term low birth weight, Hypothyroidism, Risk factors, Neonatal characteristics

Full Text:



Ganchimeg T, Ota E, Morisaki N, Laopaiboon M, Lumbiganon P, Zhang J, et al. Pregnancy and childbirth outcomes among adolescent mothers: a World Health Organization multicountry study. BJOG. 2014;121:40-8.

UNICEF. Low Birth Weight: Country, Regional, and Global Estimates. New York, NY, USA. 2004.

Singh M. Care of the new born revised. 2017. Available at: &lr=&id=Wv9qDwAAQBAJ&oi=fnd&pg=PP14&ots=5IdXb3UzB8&sig=dzkN_2evEG_V3FDAQp8q8ZTv5qI. Accessed on: 21 March 2021.

Khan A, Nasrullah FD, Jaleel R. Frequency and risk factors of low birth weight in term pregnancy. Pakistan J Med Sci. 1969;32(1):138-42.

Bhimwal RK, Makwana M, Chouhan HK, Gupta M, Lal K, Jora R. A study of various determinates and incidence of low birth weight babies born in Umaid hospital, Jodhpur (Western Rajasthan). Int J Contemp Pediatr. 2017;4(4):1302.

India MoH and FWG of Health and Family Welfare statistics in India, 2019-20. Ministry of Health and Family Welfare, Government of India. Available at: smokeless_ tobacco_and_public_health_in_india.pdf?ua=1%0A 2013/Compl ete/BOOK.pdf. Accessed on: 22 March 2021.

International Institute for Population Sciences. National Family Health Survey-4 (NFHS-4) State Fact Sheet, Odisha. Ministry of Health and Family Welfare. Government of India. 2016;90.

Ismail IM, Venugopalan PP. Case-control study on risk factors of low birth weight in a tertiary care hospital, Kerala. Ann Comm Health. 2016;4(3):5-12.

Thankappan RK, Valiathan MS. Health at low cost-The Kerala model. Lancet. 1998;351(351):1274-5.

U.S. Infant Mortality Rate 1950-2021. MacroTrends. Available at: /USA/united-states/infant-mortality-rate. Accessed on 22 March 2021.

Falcão IR, Ribeiro-Silva RDC, de Almeida MF, Fiaccone RL, Dos S Rocha A, Ortelan N, et al. Factors associated with low birth weight at term: a population-based linkage study of the 100 million Brazilian cohort. BMC Pregnancy Childbirth. 2020;20(1):536.

Pal A, Manna S, Das B, Dhara PC. The risk of low birth weight and associated factors in West Bengal, India: a community based cross-sectional study. Egypt Pediatr Assoc Gaz. 2020;68(1):27.

Mumbare SS, Maindarkar G, Darade R, Yengl S, Tolani MK, Patole K. Maternal risk factors associated with term low birth weight neonates: A matched-pair case control study. Indian Pediatr. 2012;49(1):25-8.

Yadav DK, Shukla GS, Gupta N, Shrestha N, Singh A, Kaphle HP. Maternal and Obstetric Factors Associated with Low Birth Weight. J Nepal Health Res Counc. 2020;17(4):443-50.

Bhaskar RK, Deo KK, Neupane U, Chaudhary Bhaskar S, Yadav BK, Pokharel HP, et al. A Case Control Study on Risk Factors Associated with Low Birth Weight Babies in Eastern Nepal. Int J Pediatr. 2015;2015:1-7.

Anand P, Gupta R, Sudan JK. Prevalence of Low Birth Weight and Associated Maternal Risk Factors among the Term Neonates during Normal Deliveries in Jammu, J&K. Int J Health Sci Res. 2019;9(8):376.

Deka A, Saharia NP, Bihani A. A study on maternal factors associated with low birth weight newborns. Index Copernicus Int. 2018;7(2):82-8.

Negi KS, Kandpal SD, Kukreti M. Epidemiological factors affecting low birth weight. JK Sci. 2006;8(1):31-4.

Dasgupta A, Basu R. Determinants of low birth weight in a Block of Hooghly, West Bengal: A multivariate analysis. Int J Biol Med Res. 2011;2(4):838-42.

Raman Tr, Devgan A, Sood S, Gupta A, Ravichander B. Low Birth Weight Babies : Incidence And Risk Factors. Med J Armed Forces India. 1998;54(3):191-5.

Sarika DM, Vishwakarma DR, Rao DR, Sarika DM, Vishwakarma DR, Rao DR. Study of low birth weight babies and their association with maternal risk factors. Pediatr Rev Int J Pediatr Res. 2020;7(7):379-87.

Metgud CS, Naik VA, Mallapur MD. Factors Affecting Birth Weight of a Newborn – A Community Based Study in Rural Karnataka, India. Szecsi PB, editor. PLoS One. 2012;7(7):e40040.

Kader M, Perera NP. Socio-economic and nutritional determinants of low birth weight in India. N Am J Med Sci. 2014;6(7):302.

Kumar V, Deshmukh PR, Taywade M, Gupta SS. Magnitude and correlates of low birth weight at term in rural Wardha, Central India. Online J Heal Allied Sci. 2016;15(1):1-5.

Agorinya IA, Kanmiki EW, Nonterah EA, Tediosi F, Akazili J, Welaga P, et al. Socio-demographic determinants of low birth weight: Evidence from the Kassena-Nankana districts of the Upper East Region of Ghana. PLoS One. 2018;13(11).

Ramakrishnan U. Nutrition and low birth weight: from research to practice. Am J Clin Nutr. 2004;79(1):17-21.

Justin SA, Johnson MS. A prospective study on evaluation of maternal and foetal outcomes of hypothyroidism with levothyroxine and prevalence of hypothyroidism in pregnancy in a tertiary care teaching hospital in Kerala. Int J Basic Clin Pharmacol. 2020;9(3):392.