Determinants of low birth weight in term singleton neonate delivered at public health facilities in Bahir Dar city, Ethiopia, an institution-based case-control study

Low birth weight (LBW), defined as a birth weight of less than 2500 g, remains a major public health concern worldwide. Approximately 15–20% of all live births globally are affected, representing more than 20 million newborns each year, with the vast majority occurring in low- and middle-income countries. LBW is associated with increased risks of neonatal morbidity, mortality, impaired growth, and long-term developmental complications. Despite ongoing maternal and newborn health interventions in Ethiopia, determinants of LBW among term singleton neonates remain insufficiently explored. Therefore, this study aimed to identify factors associated with low birth weight among term singleton neonates delivered in public health facilities of Bahir Dar City, Ethiopia. An institution-based unmatched case–control study was conducted from June 1 to August 30, 2020, in public health facilities of Bahir Dar city, Ethiopia. Cases were consecutive live-born term singleton neonates weighing less than 2500 g, while controls were the next two live-born term singleton neonates weighing 2500 g or more delivered at the same facilities. Data were collected using a structured interviewer-administered questionnaire and medical record review. Data were entered and analyzed using statistical software. Bivariate logistic regression analysis was conducted to identify candidate variables, and crude odds ratios (CORs) with 95% confidence intervals (CIs) were computed. Variables eligible for inclusion were subsequently entered into a multivariable logistic regression model to identify independent determinants of low birth weight, with adjusted odds ratios (AORs) and 95% CIs reported. Most study mothers (85.3%) were aged 21–34 years. In multivariable analysis, being a housewife (AOR = 3.87; 95% CI: 1.01–14.8), primiparity (AOR = 4.12; 95% CI: 1.87–9.05), pregnancy-induced hypertension (AOR = 4.69; 95% CI: 1.32–16.74), unwanted pregnancy (AOR = 3.80; 95% CI: 1.11–12.92), and not taking additional food during the current pregnancy (AOR = 3.09; 95% CI: 1.37–6.99) were significantly associated with low birth weight. Low birth weight among term singleton neonates in Bahir Dar city was significantly associated with maternal, obstetric, and socioeconomic factors. Primiparity, pregnancy-induced hypertension, unwanted pregnancy, lack of additional dietary intake during pregnancy, and maternal occupation as a housewife were the main determinants. Strengthening antenatal care services with a focus on nutritional counseling, pregnancy planning, and early detection and management of hypertensive disorders may help reduce the burden of low birth weight.