Newborn LBW is a public health problem in developing nations including Ethiopia, as well the study area (1-2,6-8). The condition has multiple short and long term adverse consequences; increased risk of morbidity and mortality immediately after birth and in early childhood, impaired cognitive and physical development of children’s, and decrease work productivity of adults in later life (1). Preventing and controlling of LBW is therefore, the way forward to have healthy and productive future generation in Ethiopia. It is imperative to explore its determinant factors in various region or areas of the country for the employment of context specific aggressive intervention for stunning reduction of LBW. By this study; maternal age, family monthly income, gestational age, maternal hypertension, maternal anemia, dark green leafy vegetables intake, milk and milk products intake, WDDS and MUAC were the identified determinant factors that attributed to LBW newborn.
Maternal age; the odds of mothers in the age group of less than 20 years were around three times higher to deliver LBW newborns than those mothers in the age group of 21–35 years, which is in-line with study done in Tigray region, northern Ethiopia, 3.08 times, Bale zone, southern Ethiopia, 3.1 times, and India, 2.10 times, higher to give LBW newborn (21, 24 and 25). A systematic review meta-analysis also supported this funding, that is girl’s pregnancy younger than 19 years have 50 % increased risk of giving LBW newborn (26). This situation happened may be due to adolescent pregnancy, which is a special circumstance that has increased nutrient requirements and thus, in the growing adolescent there is a partition of growth in favor of her and at the cost of fetus. Especially, it is most important and true reason in developing countries, because of the common poor caring practice of maternal nutrition and health.
The odds of mothers with monthly income less than 2500 ETB were 3.5 times higher to deliver LBW newborns as compared to mothers with monthly income of greater than six thousand. The same token, those mothers with monthly income within 2501-4000 ETB were over two and half times higher to deliver LBW newborns as compared to mothers with monthly income of greater than six thousand. The present study agree with findings from India, Laos and Lahore; that was as per capita income of the family per month increases, the occurrence of low birth weight decrease or it was vice versa (27-29). This is due to the economic poverty that a cause for maternal malnutrition and poor health caring practices, which is the condition that can lead’s to have LBW newborns (29).
The odds of mothers who had less than thirty seven weeks of gestational age were four times higher to deliver LBW newborn than those who had greater than thirty seven and above. It consistent with studies done in Tigray, northern Ethiopia and Bale zone, south eastern Ethiopia respectively (21, 32) and again, is supported by a research done in Malaysia (30). This could be due do preterm birth or intrauterine growth restriction; both are the commonest causes for the occurrence of LBW newborns.
Maternal medical conditions; the odds of mothers with hypertension during their current pregnancy were two and half times greater to deliver LBW than mothers without hypertension during pregnancy. The condition can lead to a LBW for the baby or premature delivery which poses additional health risks to the child (1), and it supported that hypertensive disorders might play a critical role in the incidence of LBW as studies conducted in Malaysia and china indicated ( 30,31). It is known that hypertension during pregnancy reduces placental blood flow that leads to decreased fetal growth or increased risk of intrauterine growth restriction and finally LBW baby occurred (32).
Another medical condition observed to have association with LBW is anemia; the odds of mothers with history of anemia during their current pregnancy were found to have above three times higher to deliver low birth weight than mothers without history of anemia. The finding agreed with studies carried out in Northern Ethiopia (21) and Nagpur city, Maharashtra (32). Thus, anaemia during gestation is associated with impaired fetal development, preterm delivery and low birth weight (34,35). It is well noted that anemia can be occurred due to deficiency of iron, folic acid, vitamin B12 and other essential nutrients, which has negative impact on rapidly growing fetus that leads LBW.
Low consumption of DGLV appeared to have positive relation with low birth weight; the odds of mothers who didn’t take DGLV were more than two and half times higher to deliver low birth weight than those who took 3-4 times per week. The study agreed with finding from Iran; that was lower consumption of dark green leafy vegetables was significantly associated with increased risk of delivering low birth weight newborns (36). Beside, milk consumption has also association; the odds of mothers who didn’t drink milk were 2.3 times greater to have a risk of delivering low birth weight baby than who took on daily bases. The finding is consistent with study conducted in Denmark; milk intake during pregnancy was associated with higher birth weight (37), in Canadian; women’s low milk intake tended to associated with lower mean birth weight (38) and in rural Ethiopia; the proportion of women consuming dairy, animal-source foods, fruits, and vegetables was higher in mothers who gave normal birth weight newborns than those who gave low birth weight newborns (39).
Similarly, the study showed that the odds of mothers who had less than four dietary diversity score were above two and half times higher to deliver low birth weight than those mothers who had greater than six dietary diversity score. It is agreed with findings from Northern Ghana (39). This is because high dietary diversity score is a proxy indictor of likely to have micronutrient adequacy. Thus, low dietary diversity can associated with micronutrients inadequacy like iron, zinc vitamin A and others that lead to occurred low birth weight newborns.
Maternal nutrition states significantly associated with low birth weight delivery; the odds of delivering low birth weight newborns among mothers who had less than twenty three centimeters (cm) were two times higher than the odds of mothers who twenty three and above. The present result was similar with findings from Ethiopia, India, Canada and Brazil (23, 41-43). This is the reason that maternal nutrition before and during pregnancy is the essential determinate factor for birth weights. Embryo and the fetus receive all their required nutrients directly from the mother; good maternal nutrition is therefore imperative for optimal prenatal development and growth (44).