Factors Associated with Low Birth Weight and Premature Births Among Pregnant Women in District Tando Muhammad Khan

Abstract

Low birth weight (LBW) and premature births remain leading causes of neonatal morbidity and mortality, particularly in low-resource settings. In Pakistan, these outcomes are closely linked to maternal health, nutrition, and access to antenatal care, yet district-level data remains scarce. This study aimed to identify the factors associated with low birth weight and premature births among pregnant women in District Tando Muhammad Khan. A cross-sectional descriptive study was conducted among 377 pregnant women attending health facilities in District Tando Muhammad Khan, from November 2024 to April 2025, using a structured, pretested questionnaire. Data collection focused on maternal sociodemographic characteristics, nutritional status, antenatal care utilization, pregnancy complications, psychosocial stress, substance use, and environmental factors. Anthropometric measurements and gestational age were recorded to determine the prevalence of LBW and prematurity. Data were analyzed using SPSS version 29.0; descriptive statistics, frequency distributions, and cross-tabulations were applied to examine associations between variables. The prevalence of low birth weight was 53.8% and premature births were reported in 69.5% of cases. Among the participants 64.2% did not receive any antenatal care, and only 14.6% consumed a balanced diet during pregnancy. Hypertension (36.6%), infections (19.6%), and diabetes (11.4%) were the most common complications. Psychosocial stress was reported by 45.9%, and tobacco use was high at 51.7%, with 26.3% using illicit drugs. Additionally, 47.5% of the participants had the family history of low birth weight and premature births.Multifactorial maternal, behavioral, and environmental risks contribute to adverse birth outcomes in rural Sindh, highlighting the need for integrated maternal health interventions.