Association Between Birth Outcomes and Gestational Weight Gain Among Forcibly Displaced Rohingya and Nearby Host Community, in Cox’s Bazar, Bangladesh

Gestational weight gain (GWG) is a critical determinant of maternal and neonatal health, yet its patterns and consequences in displaced populations remain understudied. This study examined the association between GWG and birth outcomes among Forcibly Displaced Rohingya (FDR) women in Cox's Bazar, Bangladesh. We conducted a longitudinal cohort study from October 2022 to October 2024, enrolling 2888 pregnant women at different stages of pregnancy. Among them, 301 were recruited in the first trimester and followed through the third trimester, with 231 neonatal outcomes recorded within 72 hours of delivery. Overall, 66.8% of women experienced inadequate GWG. Despite the high prevalence of inadequate GWG, mean birth weight (2.79 kg) and mean gestational age at delivery (38.6 weeks) were within favorable ranges. Inadequate GWG was more common in mothers aged 30-39 years (<i>p</i> = 0.061) but significantly less common in underweight mothers (<i>p</i> = 0.012). GWG was positively associated with neonatal birth weight, length, and weight-length ratio (WLR) Z score, but not with gestational age. After adjusting for confounding factors, inadequate GWG showed a significant independent association with lower birth length (<i>p</i> = 0.016). These findings highlight the need for targeted interventions in displaced populations.