Exploring the association between low birth weight and different forms of child malnutrition: A multi-country propensity score matching analysis in South Asia

This study investigated the association between low birth weight (LBW) and various forms of child malnutrition across five South Asian countries (Bangladesh, India, Pakistan, Nepal, and the Maldives). Data from the most recent demographic and health surveys were analyzed. Propensity score matching was applied to evaluate the association between LBW and five forms of child malnutrition: stunting, wasting, underweight, at least one form of child malnutrition (AOFOCM), and multiple concurrent forms of child malnutrition (MCFOCM). Subgroup analyses were performed to assess variability in effects across the countries studied. Analysis of 147,332 complete cases revealed an overall LBW prevalence of 16.23%, with country-specific prevalences of 13.67% (Bangladesh), 16.32% (India), 18.97% (Pakistan), 11.94% (Nepal), and 12.86% (Maldives). Regression analyses of matched samples revealed significant associations between LBW and all five forms of malnutrition. Subgroup analyses also revealed a significant association between LBW and all five forms of malnutrition across the five countries, with the exception of wasting, for which no statistically significant association was observed in Bangladesh and the Maldives. These findings emphasize the importance of context-specific interventions targeting LBW to reduce child malnutrition in South Asia, while taking the observational design and cross-country variability into consideration.