Low Birth Weight In India Research Articles

High ambient air pollution erodes the benefits of using clean cooking fuel in preventing low birth weight in India

A large fraction of the population in rural India continues to use biomass fuel for cooking and heating. In-utero exposure to the resulting household air pollution (HAP), is known to increase the risk of low birth weight (LBW). Mitigating HAP, by shifting to clean cooking fuel (CCF), is expected to minimize the risk associated with LBW. However, India also has high levels of ambient air pollution (AAP). Whether exposure to AAP modifies the effect of reducing HAP by switching to CCF on LBW is not known. The present study addressed this knowledge gap by analyzing the National Family Health Survey (2019–21) data of the most recent full-term, singleton, live births from rural households born after 2017 (n = 56 000). In-utero exposure to AAP was calculated from satellite-derived ambient fine particulate matter (PM2.5) concentration at the level of the primary sampling unit for the pregnancy duration of the mothers. The moderation by ambient PM2.5 level on the odds of LBW among CCF users was examined by logistic regression analysis with interaction. The adjusted odds ratio (aOR) of LBW was 7% lower among users of CCF. At the lowest Decile (20–37 μg m−3) of ambient PM2.5 exposure, the aOR of LBW among CCF users was 0.83 (95% CI:0.81–0.85). At every 10th percentile increase in ambient PM2.5 exposure (in the range 21–144 μg m−3), aOR increased gradually, reaching the value of 1 at PM2.5 level of 93 μg m−3. Our results, therefore, suggest that the benefit of using CCF during pregnancy may be downgraded by moderate to high ambient PM2.5 exposure.

Investigating the association between floods and low birth weight in India: Using the geospatial approach

BackgroundFrequent natural disasters like floods pose a major threat to India, with significant implications for public health. Low birth weight (LBW) is a critical global health concern, contributing to neonatal mortality. However, the association between floods and LBW remains underexplored. This study aims to address this gap by investigating the association between flood hazards and LBW in India using a geospatial approach. By analyzing data from the National Family Health Survey (NFHS-5) and flood zonation maps, the study aims to uncover the spatial dynamics of this association, offering insights into the implications of floods on birth weight across diverse geographical regions. MethodsThe study used the fifth round of NFHS data, 2019–21, which involved 202,194 children selected through a multi-stage stratified sampling technique. The Vulnerability Atlas of India 2019 maps were also utilized to classify areas as flood or non-flood zones. Birth weight data from the NFHS-5 were categorized into three groups: very low, low, and normal birth weight (VLBW, LBW and NBW). Control variables including flood exposure, socio-demographic attributes, and geographic region were considered. Bivariate analysis and multinomial logistic regression were employed for statistical analysis. The spatial analysis involved Moran's I statistics and Geographically Weighted Regression to explore spatial dynamics of the association between floods and birth weight in India. ResultsFloods predominantly affect India's lower Himalayan belts and western coastal regions. Flood-affected areas show higher proportions of VLBW and LBW infants. Groundwater usage and unimproved sanitation are associated with higher risk of VLBW and LBW. Sex, wealth, maternal education, residence type, and geographic region significantly influence birth weights. Multinomial logistic regression reveals 8 % and 27 % higher risks for LBW and VLBW in flood-affected regions. LISA cluster maps identify high-risk areas for both LBW and floods. Geographically Weighted Regression highlights 52 % of the variability in LBW occurrences can be attributed to the influence of flood hazards. Families hailing from the poorest wealth background and exposed to flood hazards bear a 5 % heightened likelihood of delivering LBW infants, in stark contrast to their counterparts from the same economic background yet unaffected by floods. ConclusionsThe significant association between floods and LBW underscores the importance of robust disaster preparedness and public health strategies. By unraveling the spatial intricacies of flood-induced LBW disparities, this research provides valuable insights for promoting healthier birth outcomes and reducing child mortality rates, particularly in flood-prone regions. These findings emphasize the importance of holistic policies that address both environmental challenges and socioeconomic inequalities to safeguard maternal and infant health across the nation.

In-utero exposure to ambient PM2.5 and the risk of low birth weight in India

In-utero exposure to ambient PM2.5 and the risk of low birth weight in India

Regional with urban–rural variation in low birth weight and its determinants of Indian children: findings from National Family Health Survey 5 data

BackgroundLow birth weight is a key indicator for child health, especially a concern in low-middle-income countries. However, health and medically-related reforms are being actively implemented in some middle-income countries like India. Identifying low birth weight (LBW) babies with their determinants across the whole country is essential to formulate regional and area-specific interventions. The objective of this study was to find out the burden and determinants of LBW on the regional and residential (rural–urban) divisions of India.MethodsThe present study was based on the NFHS-5 dataset (2019–21), a nationally representative survey in India. A total of 209,223 births were included in this study. A newborn weighing less than 2500 g was considered as LBW. According to the objectives, we used frequency distribution, chi-square test and binary logistic regression analysis for analysing the data.ResultsAbout 18.24% of the babies were LBW in India, significantly higher in rural areas than in urban areas (18.58% vs 17.36%). Regionally prevalence was more frequent in western (20.63%) and central (20.16%) rural areas. Regarding maternal concerns, in the eastern and southern regions of India, mothers aged 25–34 were less likely to have LBW children than mothers aged 35–49 years. It was found that the risk of LBW was more likely among the children born out of unintended pregnancies in almost all regions except for eastern part. In rural India, women who delivered children at home were more likely to have LBW children in India (AOR = 1.19, CI: 1.12–1.28, p < 0.001) and its central, northern, and southern regions than those who gave birth in institutions. The study indicates that LBW coexists with lower maternal education levels and poor household wealth index across all regions. About 58% and 57% of cumulative effects of independent variables on LBW can be distinguished in urban and rural India, respectively.ConclusionsTargeted-specific strategies need to be undertaken as per region and geographical variations. Then only India should be able to decline LBW as proposed by National Health Policy.

Household Wealth Gradient in Low Birthweight in India: A Cross-Sectional Analysis.

A low birthweight is a common complication that can result from numerous physiological, environmental, and socioeconomic factors, and can put babies at an increased risk for health issues such as breathing difficulties, developmental delays, and even death in severe cases. In this analysis, I aim to assess the differences in the burden of low birthweight based on household wealth status in India using data from the latest National Family Health Survey (NFHS 2019-21). The sample population includes 161,596 mother-child dyads. A low birthweight is defined as a weight that is <2500 g at birth. I used descriptive and multivariate regression analyses in R studio to analyse the data. The findings show that 16.86% of the babies had a low birthweight. At the state level, the percentage of low birthweights ranges from 3.85% in Nagaland to 21.81% in Punjab. The mean birthweights range from 2759.68 g in the poorest, 2808.01 g in the poorer, 2838.17 g in the middle, 2855.06 g in the richer, and 2871.30 g in the richest wealth quintile households. The regression analysis indicates that higher wealth index quintiles have progressively lower risks of low birthweight, with the association being stronger in the rural areas. Compared with the poorest wealth quintile households, the risk ratio of low birthweight was 0.90 times lower for the poorer households and 0.74 times lower for the richest households. These findings indicate that household wealth condition is an important predictor of low birthweight by which low-income households are disproportionately affected. As wealth inequality continues to rise in India, health policymakers must take the necessary measures to support the vulnerable populations in order to improve maternal and infant health outcomes.

Prevalence and correlates of low birth weight in India: findings from national family health survey 5

BackgroundChildhood mortality and morbidity has become a major public health issue in low-middle-income countries. However, evidence suggested that Low birth weight(LBW) is one of the most important risk factors for childhood deaths and disability.This study is designed to estimate the prevalence of low birth weight (LBW) in India and to identify maternal correlates associated with LBW.MethodsData has been taken from National Family Health Survey 5 (2019–2021) for analysis. 149,279 women belonging to reproductive age group (15–49) year who had last recent most delivery preceding the NFHS-5 survey.ResultsMother's age, female child, birth interval of less than 24 months, their low educational level, low wealth index, rural residence, lack of insurance coverage, women with low BMI, anaemia, and no ANC visits during pregnancy are predictors that contribute to LBW in India. After adjusting for covariates, smoking and alcohol consupmtion is strongly correlated with LBW.ConclusionMother’s age, educational attainment and socioeconomic status of living has a highly significant with LBW in India. However, consumption of tobacco and cigarrettes are also associated with LBW.

More is not enough: High quantity and high quality antenatal care are both needed to prevent low birthweight in South Asia

Antenatal care (ANC) is an opportunity to receive interventions that can prevent low birth weight (LBW). We sought to 1) estimate LBW prevalence and burden in South Asia, 2) describe the number of ANC visits (quantity) and interventions received (quality), and 3) explore associations between ANC quantity, quality and LBW. We used Demographic and Health Survey (DHS) data from Afghanistan (2015), Bangladesh (2018), India (2016), Nepal (2016), Pakistan (2018) and Sri Lanka (2016) (n = 146,284 children &lt;5y). Women were categorized as follows: 1) low quantity (&lt;4 ANC visits) and low quality (&lt;5 of 10 interventions received during ANC), 2) low quantity and high quality (≥5 of 10 interventions), 3) high quantity (≥4 visits) and low quality, 4) high quantity and high quality. We used fixed effect logistic regressions to examine associations between ANC quality/quantity and LBW (&lt;2500 grams). LBW prevalence was highest in Pakistan (23%) and India (18%), with India accounting for two-thirds of the regional burden. Only 8% of women in Afghanistan received high quantity and high quality ANC, compared to 42–46% in Bangladesh, India, and Pakistan, 65% in Nepal and 92% in Sri Lanka. Compared to the low quantity/quality reference group, children of women with high quantity/quality ANC had lower odds of LBW in India (Adjusted Odds Ratio 0.84, 95% CI 0.78–0.89), Nepal (0.57, 0.35–0.94), Pakistan (0.45, 0.23–0.86), and Sri Lanka (0.73, 0.57–0.92). Low quantity but high quality ANC was protective in India (0.90, 0.84–0.96), Afghanistan (0.53, 0.27–1.05) and Pakistan (0.49, 0.23–1.05). High quantity but low quality ANC was protective in Sri Lanka (0.76, 0.61–0.93). Neither frequent ANC without appropriate interventions nor infrequent ANC with appropriate interventions are sufficient to prevent LBW in most South Asian countries, though quality may be more important than quantity. Consistent measurement of interventions during ANC is needed.

Prevalence and Determinants of Low Birth Weight in India: Findings From a Nationally Representative Cross-Sectional Survey (2019-21).

Low birth weight (LBW) is an important public health indicator extensively linked to infant and child mortality, especially in lower-middle-income countries (LMICs). Globally, 15.5% of all infants are born with LBW while 95% of these occur in LMICs. This study aims to examine the prevalence and determinants of LBW in India. Data were obtained from the fifth National Family Health Survey (NFHS) round conducted during 2019-2021. The study sample included women aged 15-49 years who had a singleton pregnancy in the five years preceding the survey (N=175,240). A bivariate analysis was carried out and a logistic regression model was fitted to assess the maternal determinants affecting the birth weight among newborns. A total of 175,240 mothers were included in the present study. The proportion of newborns with LBW was 17.29% (n=26366, 95% confidence interval [CI] 17.01, 17.57), of which 6% (n=1450, 95% CI 5.61, 6.41) had very low birth weight (less than 1500 g). An increase in the education level of womenor wealth index also resulted in significantly reduced odds of LBW in the newborn. However, the number of antenatal care (ANC) visits lacked any statistically significant association with the odds of having a newborn with LBW. The burden of LBW in India in recent years has remained stable despite impressive economic growth and increased public health spending on food security and nutritional supplementation. Strengthening the quality of ANC services for pregnant women with a focus on sensitization and awareness generation for improving maternal nutrition requires high prioritization.

Maternal risk factors associated with term low birth weight in India: A review

Low birth weight is one of the leading factors for infant morbidity and mortality. To a large extent affect, various maternal risk factors are associated with pregnancy outcomes by increasing odds of delivering an infant with low birth weight. Despite this association, understanding the maternal risk factors affecting term low birth weight has been a challenging task. To date, limited studies have been conducted in India that exert independent magnitude of these effects on term low birth weight. The aim of this review is to examine the current knowledge of maternal risk factors that contribute to term low birth weight in the Indian population. In order to identify the potentially relevant articles, an extensive literature search was conducted using PubMed, Goggle Scholar and IndMed databases (1993 – Dec 2020). Our results indi­cate that maternal age, educational status, socio-economic status, ethnicity, parity, pre-pregnancy weight, maternal stature, maternal body mass index, obstetric history, maternal anaemia, gestational weight gain, short pregnancy outcome, hypertension during pregnancy, infection, antepartum haemorrhage, tobacco consumption, maternal occupation, maternal psychological stress, alcohol consumption, antenatal care and mid-upper arm circumference have all independent effects on term low birth weight in the Indian pop­ulation. Further, we argue that exploration for various other dimensions of maternal factors and underlying pathways can be useful for a better understanding of how it exerts independent association on term low birth weight in the Indian sub-continent.

Paternal characteristics associated with low birth weight in India

Paternal characteristics associated with low birth weight in India

Determinants of very low birth weight in India: The National Family Health Survey - 4.

Background Low birth weight (LBW) is susceptible to neonatal complications, chronic medical conditions, and neurodevelopmental disabilities. We aim to describe the determinants of very low birth weight (VLBW) in India and compare it with the determinants of LBW based on the National Family Health Survey - 4 (NHFS-4) Methods Data from the NFHS-4 on birthweight and other socio-demographic characteristics for the youngest child born in the family during the five years preceding the survey were used. Data of 147,762 infant-mother pairs were included. Multiple logistic regression models were employed to delineate the independent predictors of VLBW (birth weight<1500 g) or LBW (birth weight: 1500-2499 g). Results Of the 147,762 children included in the study, VLBW and LBW were observed in 1.2% and 15.8% of children, respectively. The odds of VLBW were higher in female children (aOR: 1.36, 95% CI: 1.15-1.60), among mothers aged 13-19 years (aOR: 1.58, 95% CI: 1.22-2.07), mothers with severe or moderate anaemia (aOR: 1.61, 95% CI: 1.34-1.94), mothers without recommended antenatal care (aOR: 1.47, 95% CI: 1.31-1.90), maternal height less than 150 cm (aOR: 1.54, 95% CI: 1.29-1.85) and among mothers with multiple pregnancy (aOR: 21.34, 95% CI: 14.70-30.96) in comparison to their corresponding counterparts. In addition to the variables associated with VLBW, educational status of mothers (no education; aOR: 1.08, 95% CI: 1.02-1.15 and primary education; aOR: 1.16, 95% CI: 1.08-1.25), caste of the children (scheduled tribe; aOR: 1.13, 95% CI: 1.03-1.24), and wealthiness of the family (poorest wealth quintiles; aOR: 1.11, 95% CI: 1.03-1.19) were associated with LBW. Conclusions Interventions targeting improvements in antenatal care access, maternal health, and nutritional status may reduce the number of VLBW infants. Social determinants of LBW require further detailed study to understand the high propensity of low birth-weight phenotypes in the disadvantaged communities in India.

Maternal Nutrition and Birth Weight in Dual Nutrition Burden Era

In the 1970s low dietary intake, pre-pregnancy under-nutrition and low weight gain during pregnancy were thought to be the major factors responsible for over 1/3rd of infants being born with low birth weight in India. Over decades there has been improvement in nutritional status of women; currently both maternal under-nutrition and over-nutrition are major public health problems. Despite improvement in maternal nutritional status, there has been no improvement in birth weight. A study was taken up in women from urban low-middle-income families, to assess maternal nutritional status, weight gain during pregnancy and birth weight; in a sub-group of women the magnitude of residual post-pregnancy weight retention was investigated. Urban women from low-middle-income families (1235) attending antenatal clinics in primary health care institution or receiving antenatal care in community settings, were enrolled for this longitudinal observational study. Gestational age and weight were recorded in 1235 women during 4467 antenatal visits. Mean weight gain in 2nd and 3rd trimester was 7.5 kg. Data on birth-weight was available in 853 women; mean birth-weight was 2.7 kg. In 145 women in whom pre- and post-pregnancy weight was available; the post-pregnancy weight retention was 1.9 kg. Women were heavier before and during pregnancy and there has been improvement in pregnancy weight gain as compared to two decades ago but there was no change in mean birth-weight. Screening, identifying under- or over-nourished pregnant women and providing them with appropriate nutrition and health care can enable improvement in maternal nutrition and birth weight.

Determinants of very low birth weight in India: The National Family Health Survey – 4

Background Low birth weight (LBW) is susceptible to neonatal complications, chronic medical conditions, and neurodevelopmental disabilities. We aim to describe the determinants of very low birth weight (VLBW) in India and compare it with the determinants of LBW based on the National Family Health Survey – 4 (NHFS-4) Methods Data from the NFHS-4 on birthweight and other socio-demographic characteristics for the youngest child born in the family during the five years preceding the survey were used. Data of 147,762 infant–mother pairs were included. Multiple logistic regression models were employed to delineate the independent predictors of VLBW (birth weight<1500 g) or LBW (birth weight: 1500-2499 g). Results Of the 147,762 children included in the study, VLBW and LBW were observed in 1.2% and 15.8% of children, respectively. The odds of VLBW were higher in female children (aOR: 1.36, 95% CI: 1.15–1.60), among mothers aged 13–19 years (aOR: 1.58, 95% CI: 1.22–2.07), mothers with severe or moderate anaemia (aOR: 1.61, 95% CI: 1.34–1.94), mothers without recommended antenatal care (aOR: 1.47, 95% CI: 1.31–1.90), maternal height less than 150 cm (aOR: 1.54, 95% CI: 1.29–1.85) and among mothers with multiple pregnancy (aOR: 21.34, 95% CI: 14.70–30.96) in comparison to their corresponding counterparts. In addition to the variables associated with VLBW, educational status of mothers (no education; aOR: 1.08, 95% CI: 1.02–1.15 and primary education; aOR: 1.16, 95% CI: 1.08–1.25), caste of the children (scheduled tribe; aOR: 1.13, 95% CI: 1.03–1.24), and wealthiness of the family (poorest wealth quintiles; aOR: 1.11, 95% CI: 1.03–1.19) were associated with LBW. Conclusions Interventions targeting improvements in antenatal care access, maternal health, and nutritional status may reduce the number of VLBW infants. Social determinants of LBW require further detailed study to understand the high propensity of low birth-weight phenotypes in the disadvantaged communities in India.

Decadal change in the association between the status of young mother\u2019s Body Mass Index and anaemia with child low birth weight in India

BackgroundThe study aims to investigate the changes in the socio-economic and demographic status of young mothers of age 15–24 years and to examine the association between mothers’ nutrition, i.e., Body Mass Index (BMI) and anaemia with child low birth weight for almost two decades during 1998–2016 in India.MethodsNational Family Health Survey (NFHS) round II and IV were used. The sample of this study included 3405 currently married young mothers from NFHS II and 44,742 from NFHS IV who gave birth at least one child in the last three years preceding the surveys. Logistic regression and Blinder-Oaxaca decomposition analysis have been used in this study to examine the corresponding association between the concerned variables.ResultsThe analysis showed that the prevalence of low birth weight (LBW) babies has decreased from 26.1 to 22.8 for the 15 to 19 age group and from 20.4 to 18.7 for the 20 to 24 age group over time. Young mothers with low BMI or severe anaemia have shown higher odds of having LBW babies. For instance, the odds of having a LBW child was 1.44 (p-value = 0.000; 95% CI: 1.05, 1.65) for mothers with low BMI and 1.55 (p-value = 0.000; 95% CI: 1.27, 1.90) with severe anaemia. Over the decade, the association of LBW babies with mothers’ nutrition has decreased. The odds of LBW with mothers with low BMI decreased from 1.63 (p-value = 0.004; 95% CI: 1.21, 2.21) to 1.41 (p-value = 0.000; 95% CI: 1.27, 1.55). Similarly, mothers with severe anaemia, the odds of LBW child decreased from 2.6 (p-value = 0.000; 95% CI: 1.75, 3.8) in 1998 to 1.3 (p-value = 0.024; 95% CI: 1.02, 1.65) in 2016.ConclusionsThe maternal and child health improvement in India has been moderate over the decade. Still, a significant proportion of the women are suffering from poor health and young mothers are at more risk to deliver LBW babies. It is highly recommended to integrate maternal and child health programmes with the ongoing health policies to improve the situation while taking additional care of the young pregnant mother and their nutritional health.

Determinants of very low birth weight in India: The National Family Health Survey – 4

Background Low birth weight (LBW) is susceptible to neonatal complications, chronic medical conditions, and neurodevelopmental disabilities. We aim to describe the determinants of very low birth weight (VLBW) in India based on the National Family Health Survey – 4 (NHFS-4). Methods Data from the NFHS 4 on birthweight and other socio-demographic characteristics for the youngest child born in the family during the five years preceding the survey were used. Data of 147,762 infant–mother pairs were included. Multiple logistic regression models were employed to delineate the independent predictors of VLBW (birth weight&lt;1500 g) or LBW (birth weight &lt;2500 g). Results Of the 147,762 children included in the study, VLBW and LBW were observed in 1.2% and 15.8% of children, respectively. The odds of VLBW were higher in female children (aOR: 1.36, 95% CI: 1.15–1.60), among mothers aged 13–19 years (aOR: 1.58, 95% CI: 1.22–2.07), mothers with severe or moderate anaemia (aOR: 1.61, 95% CI: 1.34–1.94), mothers without recommended antenatal care (aOR: 1.47, 95% CI: 1.31–1.90), maternal height less than 150 cm (aOR: 1.54, 95% CI: 1.29–1.85) and among mothers with multiple pregnancy (aOR: 21.34, 95% CI: 14.70–30.96) in comparison to their corresponding counterparts. In addition to the variables associated with VLBW, educational status of mothers (no education; aOR: 1.08, 95% CI: 1.02–1.15 and primary education; aOR: 1.16, 95% CI: 1.08–1.25), caste of the children (scheduled tribe; aOR: 1.13, 95% CI: 1.03–1.24), and wealthiness of the family (poorest wealth quintiles; aOR: 1.11, 95% CI: 1.03–1.19) were associated with LBW. Conclusions Interventions targeting improvements in antenatal care access, maternal health, and nutritional status may reduce the number of VLBW infants. Social determinants of LBW require further detailed study to understand the high propensity of low birth-weight phenotypes in the disadvantaged communities in India.

Maternal Factors Associated With the Birth Weight of the Babies in a Rural Area of North Karnataka: A Cross Sectional Study

Introduction: Birth weight is a reliable indicator of intrauterine growth and is one of the major factors that determine child survival and its physical and mental development. There is no indicator in human biology which tells us so much about the past events and the future life, as the weight of an infant at birth. Low birth weight (LBW) is still a major public health problem in developing countries and majority of it is seen in Africa and Asia. The prevalence of LBW in India has although reduced over the past decade, but it still remains high in some of the states of the country. Objective: To estimate the prevalence of Low birth weight and to study the maternal factors associated with it. Method: A Cross-sectional study was conducted in a village of north Karnataka from December 2015 to May 2017. Sample size calculated was 337. The study participants comprised of postnatal mothers with singleton live born baby. Weight of the newborn was recorded. Chi square test was used to find the association. Results: The prevalence of LBW was found to be 21.1%. A number of factors such as mother’s age, height, number of hours of rest, tobacco consumption, passive smoking, gravidity, parity, previous history of LBW, time of antenatal care (ANC) registration, haemoglobin, bad obstetric history, type of delivery and gestational age at delivery were found to be significantly associated with LBW. Conclusion: Adverse pregnancy outcome is the result of a multiple factors. Prevalence of LBW can be reduced by regular ANC, balanced diet and adequate rest during antenatal period, and avoiding tobacco consumption. Thus, it calls for overall improvement in the ANC.

Trends in prevalence of low-birth-weight babies in India

Low birth weight (LBW) affects newborns’ survival and is a global concern especially for developing countries. It is the most common health indicator for assessing neonates’ health conditions. The present study was conducted to determine the prevalence of LBW in India in background of global perspective. A systemic review of the literatures was done, available in the principle medical databases including PubMed (including Medline), Google scholar, Web of science and Scopus from 2000 to 2021. A total of 65 articles were identified in the described database. Altogether 24 articles met the inclusion criteria and were eligible for data analysis. According to the all four national family health survey (NFHS) a decreasing trend is observed in the prevalence of LBW. The prevalence of LBW in India is 16.4 % in NFHS-4, 20.9% in NHFS-3, 22.9% in NFHS-2 and 25.2% in NHFS-4 respectively. A number of socio-demographic and maternal factors are responsible for LBW babies in India. LBW babies are global public health concern. Special emphasis should be given to the underlying factors responsible for LBW babies in India.

Associations of forms of intimate partner violence with low birth weight in India: findings from a population-based Survey

Background Many studies report a significant association between a lifetime measure of intimate partner violence (IPV) and low birth weight (LBW) in low-income and economically developed countries. However, it remains relatively unclear how different forms of IPV affect LBW in low-income countries. This study examines the associations of various forms of IPV with two measures of birth outcomes - LBW and birth weight in India. Methods This study used the National Family Health Survey (NFHS-4) 2015–2016 data of India. The analysis included 11,423 women aged 15–49 years. Using both logistic and linear regression analyses, we assessed the associations of various forms of IPV with binary and continuous measures of birth weight. The analysis controlled for several potential covariates. Results In fully-adjusted regression models, women who experienced any IPV, compared to those who had not experienced any IPV, were 1.19 times (95% CI: 1.02–1.37) as likely to give birth to an LBW baby. Compared to those who had not experienced any physical violence (PV), women who experienced any PV were 1.16 times (95% CI: 1.00–1.35) as likely to have an LBW baby. Moreover, compared to those who had not experienced any emotional violence (EV), women who experienced any EV were 1.29 times (95% CI: 1.06–1.56) as likely to have LBW babies. Linear regression analysis found that any IPV exposure was associated with a significant decrease in birth weight in the fully-adjusted model (b = −32.39; 95% CI: −63.39 to −1.73). Further, experience of any PV (b = −28.40; 95% CI: −60.13 to 3.36) and any EV (b = −51.69; 95% CI: −93.97 to −9.42) appear to be negatively associated with a continuous measure of birth weight. Conclusion Findings have implications for public health policies and interventions that protect women from exposure to intimate partner violence for ensuring better maternal health and birth outcomes.

The association of in-utero exposure to ambient fine particulate air pollution with low birth weight in India

A growing body of research indicates that in-utero exposure to ambient fine particulate matter (PM2.5) is a risk factor for low birth weight (LBW). However, research on India, where the high and rising level of ambient air pollution is a significant health concern, is limited. In this study, we analyze the association between ambient PM2.5 and LBW in India. We match data on birth weight from the National Family and Health Survey (NFHS) conducted in India in 2015–16 with high-resolution spatial data on annual ambient PM2.5 concentration to calculate in-utero exposure based on the residential location of each child. We estimate the association of in-utero exposure to ambient PM2.5 with birth weight and LBW, after adjusting for child level, maternal, and household level characteristics that predict birth weight. In our sample (n = 149 416), in comparison to the reference category of in-utero PM2.5 level less than 26.7 µg m−3, the adjusted OR of LBW increases non-linearly from 1.098 (95% CI: 0.954, 1.263) for children in the exposure band 39.3–44.7 µg m−3 (i.e., the fourth octile) to 1.241 (95% CI: 1.065, 1.447) for those in the exposure band 44.7–51.6 µg m−3 (i.e., the fifth octile) and 1.405 (95% CI: 1.126,1.753) for those with in-utero PM2.5 level greater than 77.3 µg m−3 (i.e., the last octile). Our findings show that exposure to ambient PM2.5 is strongly associated with LBW in India and suggest that policies that improve air quality may be necessary for achieving the World Health Assembly target of 30% reduction in LBW by 2025.

Maternal exposure to cooking smoke and risk of low birth weight in India

Over half of the households in India are using unclean cooking fuels (UCF) and exposed to harmful pollutants that has adverse effects on weight of new born baby. Though studies examined the contextual determinants of birth weight, the association of cooking practices and kitchen location with low birth weight (LBW) is limited in India. This paper investigates the comprehensive effects of household air pollution (HAP) on LBW, mean birth weight (MBW) and birth size in India. Data from 93,721 full-term singleton births from the fourth round of National Family Health Survey, conducted during 2015–16 is used in the analyses. Binary logistic and linear regression methods were used to assess the effect of cooking practices on the outcome variables. Children born in households using clean cooking fuels (CCF) (2877 g, 95% CI: 2876–2877) had 80 g higher birth weight compared with UCF (2797 g, 95% CI: 2796–2798). Households using UCF and cooking without separate kitchen (2779 g, 95% CI:2778–2780) had 59 g and 98 g lower MBW as compared to the households using UCF and cooking in separate kitchen (2817 g, 95% CI:2816–2818) and CCF respectively. Significant associations of LBW observed with the place of cooking and cooking practices but no significant association found for cooking fuels. The HAP from poor cooking practices is associated with risks of LBW in India. Transition from unclean to clean fuels, provision of the separate kitchen should be encouraged to reduce the maternal exposure to HAP and improve birth outcomes.