Predictors of low birth weight deliveries at a primary health care facility: Suhum Government Hospital, Ghana - a retrospective cross-sectional study.

INTRODUCTION

Low birth weight (LBW), defined as weight below 2500 g, remains a major contributor to neonatal morbidity and mortality. Ghana's LBW prevalence stands at 13.5%, but determinants at the primary health care level remain underexplored. This study examines maternal, health-related and behavioural factors influencing LBW among women delivering at Suhum Government Hospital, Eastern Region, Ghana.

METHODS

A retrospective cross-sectional study analysed 413 delivery records from 2021 to 2024. Maternal sociodemographic, health, antenatal care (ANC), immunisation and behavioural data were extracted from antenatal and delivery records. Bivariate analysis used χ² or Fisher's exact tests, as appropriate. Multivariable logistic regression identified factors independently associated with LBW, with aORs and 95% CIs reported.

RESULTS

Late ANC initiation was associated with higher odds of LBW compared with early initiation (aOR 2.78, 95% CI 1.28 to 6.17; p=0.009). Receipt of fewer than two tetanus-diphtheria (TD) vaccine doses was also associated with higher odds of LBW (aOR 4.07, 95% CI 1.79 to 9.26; p<0.001). Haemoglobin ≥11 g/dL at 36 weeks was associated with lower odds of LBW (aOR 0.097, 95% CI 0.011 to 0.903; p=0.040), as was normal body mass index (BMI) compared with obesity (aOR 0.386, 95% CI 0.156 to 0.953; p=0.039). Below-high-school education, Muslim religion and HIV-positive status were also associated with lower adjusted odds. However, these unexpected associations should be interpreted cautiously given the small number of LBW events and potential residual confounding and model instability.

CONCLUSION

In this single-facility study, late ANC initiation and fewer than two TD doses were associated with higher odds of LBW, while adequate haemoglobin at 36 weeks and normal BMI were associated with lower odds. Strengthening timely ANC, maternal anaemia monitoring and management and completion of recommended maternal immunisation may be relevant to similar primary healthcare settings; larger multicentre studies are needed to assess generalisability.