Factors associated with maternal reported small size at birth in Nigeria using nationally representative survey data

Abstract Background Small size at birth is an important indicator of neonatal health and survival, particularly in low- and middle-income countries. It is a preventable public health problem linked with higher risks of infant mortality and developmental delays. This study examined the individual, household, and community-level factors associated with maternal reported small size at birth among children in Nigeria. Methods This study utilized cross-sectional data from the NDHS children recode file. The analysis included 10,719 children with information on size at birth. The outcome variable was small size at birth, defined as babies reported as “very small” or “smaller than average.” Independent variables included child, maternal, household, and community characteristics. Data were analysed using Stata, accounting for the complex survey design through weighting, clustering, and stratification. Descriptive statistics, chi-square tests, and multivariable logistic regression were conducted. Results were presented as adjusted odds ratios (AORs) with 95% confidence intervals. Results The overall proportion of maternal-reported small size at birth was 12.6%. Sex of child (AOR 1.559; 95% CI 1.358–1.790), parity (AOR 1.437; 95% CI 1.080–1.912), ANC visits greater than four (AOR 0.709; 95% CI 0.516–0.973), wealth index (poorer vs. richest: AOR 0.611; 95% CI 0.425–0.877) and region (North-east vs. North-central vs. South-south: AOR 1.619; 95% CI 1.140–2.300) were significantly associated with small size at birth. Maternal education, maternal age, employment status, and place of residence were not significantly associated with small size at birth in the adjusted analysis. Conclusion Small size at birth in Nigeria is associated with multiple factors across individual, household, and community levels. Strengthening ANC utilization, reducing socioeconomic inequalities, and addressing regional disparities are essential for improving birth outcomes.