Magnitude and associated risk factors for low birth weight in Bentiu State Hospital in Unity State, Republic of South Sudan

John Bosco Alumai, Alege John Bosco, Kareodu Ronald


Background: Low Birth Weight which is birth weight of less than 2500g remains a significant public health problem from short to long term consequences. It is responsible for significant neonatal morbidities, mortalities and disability in infancy and childhood which is associated with long term impact on health outcomes in later life.

Methods: The study used facility based cross sectional study design that involved 285 postpartum mothers and 285 newborns in Bentiu Hospital, South Sudan. Sample size was determined using Kish Leslie’s formula of 1965. Purposive sampling technique was used to sample postpartum mothers at birth. Key Informants (10) were purposively selected from the hospital and data was collected using semi-structured questionnaire and key informant interview guide (KIIG). Data was entered into Epi-Info v3.3.1 and exported to SPSS version 20 for statistical analysis at 95% confidence interval. Chi-square test and Fisher’s exact test were used to analyze the relationship between independent and dependent variables. Statistically significant variables with probability values less than 0.05 were re-analyzed at multivariable logistic regression into odds ratios with subsequent 95% confidence intervals. Meanwhile, qualitative data were organized in ATLAS Ti and content analyzed into themes to aid triangulation.

Results: There were 285 mothers studied with mean age of 25 years, most mothers were aged between 20-24 and 25-29, 84(29.5% and 83(29.1%) respectively. Majority 219(76.8%) were married. LBW prevalence of 23.5% (67) [N=285, 95% CI: 0.187-0.287] while the majority 218(76.5%) of the postpartum mothers had normal weight babies.

In Multivariable logistic regression, mothers aged 25-29 (AOR=7.17, 95%CI: 1.176-43.765, p=0.033), those aged 30-34 (AOR=10.73, 95%CI: 1.629-70.743, p=0.014) and those ≥35 years (AOR=4.34 95%CI: 0.622-30.292, p=0.138) were significantly associated with LBW. Business women (AOR=0.19 95%CI: 0.055-0.682, p=0.011) and those in salaried employment (AOR=0.19 95%CI: 0.039-0.921, p=0.039) were less likely to have LBW babies. Low social support was significantly associated with LBW (AOR=3.65 95%CI: 1.77-7.525, p<0.001). Surprisingly, mothers with >4 ANC attendance were 68.99 times more likely to produce LBW compared to those with less than four visits (AOR=68.99 95%CI: 1.021-4661.183, p=0.049). Mothers with no pregnancy complication experience were less likely to bear LBW was (AOR=0.42 95%CI: 0.181-0.994, p=0.048). Mothers who did not take folic acid (AOR=4.82, 95%CI: 2.233-10.392 p<0.001) and antibiotics (AOR=8.74 95%CI: 3.597-21.248 p<0.001) during pregnancy were 4.82 and 8.74 times more likely to give birth to LBW babies compared to those who were given and consumed it.

Conclusion: Low Birth Weight was high at 23.5%, late reproduction, low social support, pregnancy complications, lack of social support, not taking folic acid and antibiotics increased prevalence of LBW. Reproducing at right age, providing social support, preventing pregnancy complications, ensuring access and intake of folic acid and antibiotics during ANC at health facility and during community outreaches can have valuable influence on pregnancy outcome.


Prevalence, associated risk factors, Bentiu State Hospital, South Sudan

Full Text:



AGARWAL, K., AGARWAL, A., AGARWAL, V.K. & AGARWAL, P., 2011. Prevalence and determinants of “low birth weight” among institutional deliveries. Annals of Nigerian Medicine, 5(2), pp.48-52.

ALMEIDA, J., MULREADY-WARD, C., BETTEGOWDA, V.R. & AHLUWALIA, I.B., 2014. Racial/Ethnic and nativity differences in birth outcomes among mothers in New York City: the role of social ties and social support. Journal of Maternal and Child Health, 18(1), pp.90-100.

BAYO, L., BUYUNGO, S., NAKIWALA, M. & NABIMBA, R., 2016. Prevalence and Factors Associated with Low Birth Weight among Teenage Mothers in New Mulago Hospital A Cross Sectional Study. Journal of Health Science, 4(2016), pp.192-99.

BEHROUZIAN, F., KHAJEDDIN, N., HODAEI, F. & N, Z., 2009. The relationship of job satisfaction and coping mechanism with general health, among private industrial's staff. Jundishapur Science Medical Journal, 8, pp.353–45.

BERKMAN, L.F., KAWACHI, I. & GLYMOUR, M.M., 2014. Social Epidemiology. 2nd ed. USA: Oxford.

BETEW, W. & MULUNEH, E.K., 2014. Determinants of Low Birth Weight among Children Aged 0 to 59 Months in Ethiopia. International Journal of Pure and Applied Sciences and Technology, 25(1), pp.14-25.

BHATTACHARJYA, H., DAS, S. & GHOSH, D., 2015. Proportion of low birth weight and related factors in a tertiary care institute of Tripura. International Journal of Medicine and Public Health, 5(1), pp.10-3.

BRITISH MEDICAL JOURNAL, 2017. Global Health. [Online] Available at: [Accessed 29th May 2018].

BUGSSA, G., DIMTSU, B. & ALEMAYEHU, M., 2014. Socio Demographic and Maternal Determinants of Low Birth Weight at Mekelle Hospital, Northern Ethiopia: A Cross Sectional Study. American Journal of Advanced Drug Delivery, 2(5), pp.609-18.

CDC, 2017. Reproductive and Birth Outcome. [Online] Available at: [Viewed 3rd June 2018].

CDC, 2018. Reproductive and Birth Outcomes. [Online] Available at: [Viewed 28th May 2018].

CORDAID, 2016. War Affected Bentiu Hospital Reopens. [Online] Available at: [Viewed 29th May 2018].

DASGUPTA, A. & BASU, R., 2011. Determinants of low birth weight in a Block of Hooghly, West Bengal: A multivariate analysis. International Journal of Biological and Medical Research, 2(4), pp.838-42.

DASGUPTA, A. & BAVU, R., 2011. Determinants of Low Birth Weight in a Block of Hooghly,West Bengal: A Multivariate Analysis. International Journal of Biology and Medical Research., 2(4), pp.838 – 842.

DE ZEGHER, F., FRANCOIS, I. & BOEHMER, A.L., 1998. Androgens and fetal growth. Horm Research, 50, pp.243–44.

ELHASSAN, M., AMEER, O.A., ABDERAHUIM, D.H. & ABUBAKER, M.S., 2010. Anaemia and low birth weight in Medani, hospital Sudan. BMC Research Notes, 3, p.181.

FOSU, M.O., ABDUL-RAHAMAN, I. & YEKEEN, R., 2013. Maternal Risk Factors for Low Birth Weight in a District Hospital in Ashanti Region of Ghana. Research in Obstetrics and Gynecology, 2(4), pp.48-54.

GEBREHAWERYA, T., GEBRESLASIE, K. & ADMASU, E.G.M., 2018. Determinants of Low Birth Weight among Mothers Who Gave Birth in Debremarkos Referral Hospital, Debremarkos Town, East Gojam, Amhara Region, Ethiopia. Journal of Neonatal and Pediatric Medicine, 4(1), p.145.

GEBREMEDHIN, M., AMBAW, F., ADMASSU, E. & BERHANE, H., 2015. “Maternal associated factors of low birth weight: a hospital based cross-sectional mixed study in Tigray, Northern Ethiopia,”. BMC Pregnancy and Childbirth, 15(1), p.222.

HAILU, L.D. & KEBEDE, D.L., 2018. Determinants of Low Birth Weight among Deliveries at a Referral Hospital in Northern Ethiopia. BioMed Research International, ID 8169615(2018), p.8.

HETHERINGTON, E., DOKTORCHIK, C., PREMJI, S.S. & MCDONALD, S.W., 2015. Preterm Birth and Social Support during Pregnancy: a Systematic Review and Meta-Analysis. Paediatric and Perinatology Epidemiology, 29(6), pp.523-35.

KADER, M. & PERERA, N.K.P., 2014. Socio-Economic and Nutritional Determinants of Low Birth Weight in India. North American Journal of Medical Sciences, 6(7), pp.302-8.

KATHARINA DA LOPES, S., OTA, E., SHAKYA, P. & DAGVADORJ, A., 2017. Effects of nutrition interventions during pregnancy on low birth weight: an overview of systematic reviews. British Medical Journal of Global Health , 2, p.389.

KAUSHAL, S.K., MISRA, S.K., GUPTA, S.C. & SINGH, R., 2012. A study of maternal factors and birth weight in a border district of Uttar Pradesh: A hospital based study. Indian Journal of Community Health, 24, pp.86-90.

KERAM, A. & ALJOHANI, A., 2016. Low Birth Weight Prevalence, Risk Factors, Outcomes in Primary Health Care Setting: A Cross-Sectional Study. International Journal of Obstetrics and Gynecology, 5(5), p.00176.

KHOJASTEH, F., ARBABISARJOU, A., BORYRI, T. & SAFARZADEH, A., 2016. The Relationship between Maternal Employment Status and Pregnancy Outcomes. Global Journal of Health Science, 8(9), pp.37-43.

KRAMER, M., 1987. Determinants of low birth weight: methodological assessment and meta-analysis. Bull World Health Organ, 65, pp.663–737.

KUMAR, S., KUMAR, R., TEWARI, A. & RICHA., 2018. Prevalenceand Determinants of Low Birth Weight: An Experience from a Secondary Referral Unit Of BurdwanDistrict, West Bengal (India). Journal of Dental and Medical Sciences, 17(3), pp.54-59.

MAHMOODI, Z., KARIMLOU, M., SAJJADI, H. & DEJMAN, M., 2015. Association of Maternal Working Condition with Low Birth Weight: The Social Determinants of Health Approach. Annal of Medical Sciences Research , 5(6), pp.385–91.

MAHUMUD, R.A., SULTANA, M. & SARKER, A.R., 2017. Distribution and Determinants of Low Birth Weight in Developing Countries. Journal of Preventive Medicine and Public Health, 50(1), pp.18-28.

MIRZARAHIMI, M., HAZRATI, S., AHMADI, P. & ALIJAHAN, R., 2013. Prevalence and risk factors for low birth weight in Ardabil Iran,. Iranian Journal of Neonatology, 4(1), pp.18-23.

MURIN, S., RAFI, R. & BILELLO, K., 2011. Smoking and smoking cessation in pregnancy. Clinical Chest Medical , 32(1), pp.75-91.

NIEDHAMMER, I., O'MAHONY, D., DALY, S. & MORRISON, J.J., 2009. Lifeways Cross-Generation Cohort Study Steering Group. Occupational predictors of pregnancy outcomes in Irish working women in the Lifeways cohort. British Journal of Obstetrics and Gynecology, 116, pp.943-52.

NOUREDDINE, E. & ABDELLATIF, B., 2015. Prevalence and Determinants of Low Birth Weight: A Case-Control Study in Marrakesh (Morocco). Iran Journal of Public Health, 44(3), pp.422-24.

NWAKO, A.B., 2018. Prevalence and determiannts of Low Birth Weight in Maseru Lesotho. Cape Town: University of the Western Cape.

OHLSSON, A., SHAH, P. & ECONOMICS, I., 2008. Determinants and Prevention of Low Birth Weight: A Synopsis of the Evidence. Alberta Perinatal Health Program. Institute of Health Economics.

OLADIPUPO, B. & IPADEOLA, S.B., 2013. Poverty levels and maternal nutritional status as determinants of weight at birth: An ordinal logistic regression approach. International Journal of Statistics and Applications, 3(3), pp.50-58.

OTA, E., HORI, H. & MORI, R., 2015. Antenatal dietary education and supplementation to increase energy and protein intake. Cochrane Database Syst Rev, 6(3), p.32.

PANERU, D.P., NAIK, V., NILGAR, B. & MALLAPUR, M., 2014. Obstetric risk factors for low birth weight amongst full term babies born at a tertiary care hospital of belgaum district, South India. Journal of Community Medicine, 5, pp.81-84.

PROMISING PRACTICES NETWORK, 2014. Promising Practices for Preventing Low Birth Weight. [Online] Available at: "" [Accessed 3rd June 2018].

ROY-MATTON, N., MOUTQUIN, J.M., BROWN, C. & CARRIER, N., 2011. The impact of perceived maternal stress and other psychosocial risk factors on pregnancy complications. Journal of Obstetrics and Gynaecology, 33(4), pp.344–52.

SEBAYANG, S.K., DIBLEY, M.J., KELLY, P.J. & SHANKAR, A., 2012. SUMMIT Study Group. Determinants of low birthweight, small-for-gestational-age and preterm birth in Lombok, IndoIndonesia: analyses of the birthweight cohort of the SUMMIT trial. Tropical Medicine of International Health, 17(8), pp.938-950.

SHAH, M.K., GEE, R., M.D & THEALL, K.P., 2013. Partner Support and Impact on Birth Outcomes among Teen Pregnancies in the United States. Journal of Paediatric and Adolescent Gynecology, 2013, pp.1-6.

SHAH, P.S., ZAO, J., AL-WASSIA, H. & SHAH, V., 2011. Pregnancy and neonatal outcomes of aboriginal women: a systematic review and meta-analysis. Women's Health Issues, 21(1), pp.28-39.

SHARMA, S.R.S., GIRI, S. & TIMALSINA, U., 2015. Low Birth Weight at Term and Its Determinants in a Tertiary Hospital of Nepal: A Case-Control Study. PLoS ONE, 10(4), p.e1371.

STRAUGHEN, J., CALDWELL, C.H., YOUNG, A.A.J. & D.P, M., 2013. Partner support in a cohort of African American families and its influence on pregnancy outcomes and prenatal health behaviors. BMC Pregnancy and Childbirth, 13, p.187.

TEKLEHAIMANOT, N., HAILU, T. & ASSEFA, H., 2014. Prevalence and factors associated with low birth weight in Axum and Laelay Maichew Districts, North Ethiopia: A comparative cross sectional study. International Journal of Nutrition and Food Sciences., 3(6), pp.560-66.

THOMRE, P., BORLE, A., NAIK, J. & RAJDERKAR, S., 2012. A Maternal Risk Factors Determining Birth Weight of Newborns: A Tertiary Care Hospital Based Study. International Journal of Recent Trends in Science and Technology, 5(1), pp. 03-08.

UNICEF, 2002b. Reduction of Low Birth Weight. Kathmandu, Nepal. United Nations Children’s Fund -Regional Office for South Asia. Nepal: UNICEF.

UNICEF, 2014a. Nutrition. [Online] Available at: [Viewed 28th May 2018].

UNICEF, 2015c. Facts and Figures. [Online] Available at: [Viewed 28th May 2018].

UNICEF & WHO, 2004. Low birth weight: Country, Regional and Global Estimates. Global Estimates. New York: WHO UNICEF and WHO.


WADO, Y.D., AFEWORK, M.F. & HINDIN, M.J., 2014. Effects of maternal pregnancy intention, depressive symptoms and social support on risk of low birth weight: a prospective study from southwestern Ethiopia. PloS One, 9(5), p.e96304.

WHO, 2016. WHO recommendation on Antenatal Care for a Positive Pregnancy Experience. Geneva: World Health Organisation.

WHOa, 2014. World Health Assembly (WHA) Global Nutrition Targets 2025:Low Birth Weight Policy Brief. Nutrition Targets 2025. Geneva: World Health Organisation WHO.

WHOb, 2018. Maternal, newborn, child and adolescent health: Care of the preterm and low-birth-weight newborn World Prematurity Day - "Let them thrive". Geneva: World Health Organisation WHO.

WHOc, 2018. Nutrition. Feto-maternal nutrition and low birth weight. Geneva: World Health Organisation WHO.

WHOd, 2012. Resolution WHA65.6: Comprehensive implementation plan on maternal, infant and young child nutrition. In: Sixty-fifth World Health Assembly Geneva, 21–26 May 2012 Resolutions and decisions, annexes. Geneva: World Health Organisation WHO.

YADAV, D., CHAUDHARY, U. & SHRESTHA, N., 2011. Risk factors associated with low birth weight. Journal of Nepal Health Research Council, 9(19), pp.159-64.

ZELEKE, B., ZELALEM, M. & MOHAMMED, N., 2012. Incidence and Correlates of Low Birth Weight at a Referral Hospital in Northwest Ethiopia. Pan African Medical Journal., 12(4).



  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Open Science Journal (OSJ) is multidisciplinary Open Access journal. We accept scientifically rigorous research, regardless of novelty. OSJ broad scope provides a platform to publish original research in all areas of sciences, including interdisciplinary and replication studies as well as negative results.