Document Type : Original Article


1 Department of Epidemiology, Abadan University of Medical Sciences, Abadan, Iran

2 Department of Health Education, Abadan University of Medical Sciences, Abadan, Iran

3 Department of Social Sciencesdemography, Abadan University of Medical Sciences, Abadan, Iran


Background: Low birth weight (LBW) can cause complications and disorders in the future life of newborns. This study aimed to investigate maternal risk factors affecting low birth weight among term newborns in the affiliated cities of Abadan University of Medical Sciences based on a nested case-control study.
Methods: In this study, based on the nested case-control design, namely with the risk set sampling approach, the case and control groups were selected. All in-term newborns born since the beginning of 2018, with less than 2500g birth weight, were considered as the case group. Two were randomly selected as controls from newborns born in the same time frame and geographical location and with over 2500g birth weight. The selection ratio of the cases to control was 1:2. The questionnaires were completed from the beginning of 2019 to the end of 2020. To describe the data, descriptive statistical indicators including mean, standard deviation, frequency, and logistic regression were used in this method.
Results: The results of this study indicate that the factors affecting LBW are maternal age, number of pregnancies, number of abortions, history of stillbirth, history of bleeding, mother’s BMI, number of births, twins, and gestational intervals.
Conclusion: It is suggested that health policymakers should pay special attention to the necessary interventions for mothers with special pregnancy care conditions. In addition, it is necessary to pay more attention to the continuation and improvement of the quality of educational programs for health and medical personnel to increase the mothers’ awarenessregarding the maintenance of a healthy lifestyle during pregnancy.


Neda Amoori (Google Scholar)
Haydeh Ghajari (Google Scholar)


  1. Stephens BE, Walden RV, Gargus RA, Tucker R, Mckinley L, Mance M, Et Al. First-Week Protein And Energy Intakes Are Associated With 18-Month Developmental Outcomes In Extremely Low Birth Weight Infants. Pediatrics. 2009;123(5):1337-43. doi: 10.1542/peds.2008-0211.
  2. Eghbalian F. Low Birth Weight Causes Survey In Neonates. Iranian Journal Of Pediatrics. 2007;17(Suppl 1):27-33.
  3. Zahedpasha Y, Esmaeilli M, Hajiahmadi M, Askardon G, Ghadimi R, Mehrangiz B, Et Al. The Effect Of Some Risk Factors For Low Birth Weight (LBW). Journal Of Babol University Of Medical Sciences. 2003;6(2):18-24.
  4. Barros FC, Barros AJ, Villar J, Matijasevich A, Domingues MR, Victora CG. How many low birthweight babies in low- and middle-income countries are preterm? Rev Saude Publica. 2011;45(03):607–16. doi: 10.1590/S0034-89102011005000019.
  5. Kramer MS. The epidemiology of low birth weight. In: Bhatia J, Bhutta ZA, Kalhan SC, eds. Maternal and Child Nutrition: the First 1,000 Days. Nestlé Nutrition Workshop Series, 74th vol. Basel: Karger. 2013;1–10 . doi: 10.1055/s-0038-1667341.
  6. Islami Z, Fallah R, Mosavian T, Pahlavanzadeh MR. Growth Parameters Of NICU Admitted Low Birth Weight Preterm Neonates At Corrected Ages Of 6 And 12 Months. Iranian Journal Of Reproductive Medicine. 2012;10(5):459. PMID: 25246912. PMCID: PMC4169684.
  7. Islam MM. Increasing Incidence Of Infants With Low Birth Weight In Oman. Sultan Qaboos University Medical Journal. 2015;15(2):E177. PMID: 26052449. PMCID: PMC4450779.
  8. Zarbakhsh Bhari MR, Hoseinian S, Afrooz GH, Hooman HA. Prevalence Of Low Birth Weight And Comparison Of Many Biological Characteristics Of Low Birth Weight–Newborns, Mothers With Those Of Normal Weight-Newborns’ Counterparts. Journal Of Guilan University Of Medical Sciences. 2012;21(81):37-44.
  9. Mehdi Shokri, Parviz Karimi, Hadis Zamanifar, Fatemeh Kazemi, Milad Azami, Gholamreza Badfar, Epidemiology of low birth weight in Iran: A systematic review and meta-analysis, 2020;6(5):e03787. doi: 10.1016/j.heliyon.2020.e03787.
  10. Dolatian M, Mahmoodi Z, Alavi‐Majd H, Moafi F, Ghorbani M, Mirabzadeh A. Psychosocial Factors In Pregnancy And Birthweight: Path Analysis. Journal Of Obstetrics And Gynaecology Research. 2016;42(7):822-30. doi: 10.1111/jog.12991.
  11. Tchamo ME, Prista A, Leandro CG. Low Birth Weight, Very Low Birth Weight And Extremely Low Birth Weight In African Children Aged Between 0 And 5 Years Old: A Systematic Review. Journal Of Developmental Origins Of Health And Disease. 2016;7(4):408-15. doi: 10.1017/S2040174416000131.
  12. Zeyghami B, TABATABAEI S, PARISAI Z. A Study On Correlation Of Mother's Risk Factors With Low Birth Weight Of Newborns At A Multiple Regression Model In Kohghiloyeh And Boyerahmad Province In 2004-2005. URL:
  13. Eichenwald EC, Stark AR. Management And Outcomes Of Very Low Birth Weight. New England Journal Of Medicine. 2008;358(16):1700-11. doi: 10.1056/NEJMra0707601.
  14. Grote NK, Bridge JA, Gavin AR, Melville JL, Iyengar S, Katon WJ. A Meta-Analysis Of Depression During Pregnancy And The Risk Of Preterm Birth, Low Birth Weight, And Intrauterine Growth Restriction. Archives Of General 2010;67(10):1012-24. doi: 10.1001/archgenpsychiatry.2010.111.
  15. Moradi G, Khazaei Z, Esmailnasab N, Roshani D, Zokaii M, Ghaderi E, Nouri B. The Relationship Between Maternal Diseases During Pregnancy And Low Birth Weight: A Nested Case-Control Study In Rural Areas Of Kurdistan Province (West Of Iran). International Journal Of Pediatrics. 2017;5(8):5501-14. doi: 10.22038/ijp.2017.22666.1894.
  16. Fadakar Soogheh K, Ghav A, Niknami M, Kazemnejad Leili E. Relationship Between Mothers’ Nutritional Status And Weight Gain During Pregnancy With Low Birth Weight. Journal Of Guilan University Of Medical Sciences. 2012;21(83):27-35.
  17. Abedi P, Najar S, Zadeh MHH. The Adaptation Rate Of Preconception Care With The National Standard At Ahvaz Health Care Centers In. Journal Of Health Sciences And Surveillance System. 2014;2(3):125-33.
  18. Steer PJ. Maternal Hemoglobin Concentration And Birth Weight. The American Journal Of Clinical Nutrition. 2000;71(5):1285s-7s.
  19. Emamghoreishy F, Iranmahbob E, Rezaei M. Iron Status Of Mothers And Their Newborns. Hormozgan Medical Journal. 2003;7(3):145-9.
  20. Rayco-Solon P, Fulford AJ, Prentice AM. Differential Effects Of Seasonality On Preterm Birth And Intrauterine Growth Restriction In Rural Africans. The American Journal Of Clinical Nutrition. 2005;81(1):134-9.
  21. Tukenova M, Diallo I, Anderson H, Hawkins M, Garwicz S, Sankila R, El Fayech C, Winter D, Rubino C, Adjadj E, Haddy N. Second Malignant Neoplasms In Digestive Organs After Childhood Cancer: A Cohort-Nested Case-Control Study. International Journal Of Radiation Oncology* Biology* Physics. 2012;82(3): E383-90. doi: 10.1016/j.ijrobp.2011.05.069.
  22. Khazaei Z, Bagheri MM, Goodarzi E, Moayed L, Abadi NE, Bechashk SM, Et Al. Risk Factors Associated With Low Birth Weight Among Infants: A Nested Case-Control Study In Southeastern Iran. Int J Prev Med. 2021; 12:159. doi: 10.4103/ijpvm.IJPVM_300_20. PMID: 35070192. PMCID: PMC8724633.
  23. Dupont WD. Power Calculations For Matched Case-Control Studies. Biometrics. 1988:1157-68. doi: 10.2307/2531743
  24. Chaman R, Naieni KH, Golestan B, Nabavizadeh H, Yunesian M. Neonatal Mortality Risk Factors In A Rural Part Of Iran: A Nested Case-Control Study. Iranian Journal Of Public Health. 2009;38(1):48-52.
  25. Ebadi F, Ghashghaee A, Luigi Bragazzi N, Martini M, Sepehrian R, Ghaemmohamadi M, Saeedi Shahri SS, Behzadifar M, Aryankhesal A, Behzadifar M. Low Birth Weight In Iran: Implications From A Systematic Review Of The Literature And Meta-Analysis In The Period 1999-2017. Med J Islam Repub Iran. 2018;32:13. doi: 10.14196/Mjiri.32.13.
  26. Momenabadi V, Kaveh M H, Mousavi S M, Alizadeh S. Maternal Risk Factors Associated with Low Birth Weight. Iran J Health Sci. 2017;5(3):58-64.
  27. Mohamadi N, Ahmadinia H, Vazirinejad R, Manshoori A, Ostadebrahimi H, Rezaeian M. Maternal Risk Factors Affecting Low Birth Weight in Rafsanjan Township in 2018: A Case Control Study. JRUMS. 2020;19(6):603-18.
  28. Abdulbari Bener, Najah Mohammed Saleh, Khalil Mohd Khalil Salameh, Basma Basha, Sharen Joseph, Rama Al Buz. Socio - demographic and consanguinity risk factors associated with low birth weight. JPMA. 2013;63(5). PMID: 23757988.
  29. Mosayebi Z, Fakhraee SH, Movahedian AH. Prevalence And Risk Factors Of Low Birth Weight Infants In Mahdieh Hospital, Tehran. Feyz J Kashan Uni Med Sci. 2004;8:58‑67.
  30. Momeni M, Esfandyarpour R, Danaei M. The Neglected Sociobehavioral Risk Factors Of Low Birth Weight. Soc Determ Health. 2016;1:97‑103.
  31. Mirzarahimi, Mehrdad, Et Al. "Prevalence And Risk Factors For Low Birth Weight In Ardabil, Iran." Iranian Journal Of Neonatology IJN. 2013;18-23.‏
  32. Asgarian A, Sourani K, Afrashteh S, Mohammadbeigi A, Aligol M. Low Birth Weight Incidence In Newborn’ Neonate In Qom, Iran: Risk Factors And Complications. J Med Sci. 2020; 40:162‑6. doi: 10.4103/jmedsci.jmedsci_164_19.
  33. Safari M, Samiee A, Salehi F, Ahmadi SN, Ahmadi SS. The Prevalence And Related Factors Of Low Birth Weight. Int J Epidemiol Res. 2016;3:214‑21.
  34. Yadav H, Lee N. Maternal Factors In Predicting Low Birth Weight Babies. Med J Malaysia. 2013;68:44‑39. PMID: 23466766.
  35. Asefa F, Nemomsa D. Gestational Weight Gain And Its Associated Factors In Harari Regional State: Institution Based Cross-Sectional Study, Eastern Ethiopia. Reprod Health. 2016;13:101. doi: 10.1186/s12978-016-0225-x.
  36. Tootoonchi P. Low Birth Weight Among Newborn Infants At Tehran Hospitals. Iran J Pediatr. 2007;17:186‑92.
  37. Sharma SR, Giri S, Timalsina U, Bhandari SS, Basyal B, Wagle K, Et Al. Low Birth Weight At Term And Its Determinants In A Tertiary Hospital Of Nepal: A Case-Control Study. Plos One. 2015;10:E0123962. doi: 10.1371/journal.pone.0123962.
  38. Pinzón‑Rondón ÁM, Gutiérrez‑Pinzon V, Madriñan‑Navia H, Amin J, Aguilera‑Otalvaro P, Hoyos‑Martínez A. Low Birth Weight And Prenatal Care In Colombia: A Cross‑Sectional Study. BMC Pregnancy Childbirth. 2015;15:118. doi: 10.1186/s12884-015-0541-0.
  39. Dai L‑L, Mao Y‑Y, Luo X‑M, Shen Y‑P. Prenatal Care In Combination With Maternal Educational Level Has A Synergetic Effect On The Risk Of Neonatal Low Birth Weight: New Findings In A Retrospective Cohort Study In Kunshan City, China. Plos One. 2014;9:E113377. doi: 10.1371/journal.pone.0113377.
  40. Badshah S, Mason L, Mckelvie K, Payne R, Lisboa PJ. Risk Factors For Low Birthweight In The Public‑Hospitals At Peshawar, NWFP‑Pakistan. BMC Public Health. 2008;8:197. doi: 10.1186/1471-2458-8-197.
  41. feresu SA, Harlow SD, Woelk GB. Risk factors for low birthweight in Zimbabwean women: a secondary data analysis. PloS One. 2015;10:e0129705. doi: 10.1371/journal.pone.0129705.
  42. Jain A, Piparsania S, Doharey NC, Mohta A, Soni RK. Maternal Determinants Of Low Birth Weight Newborns In Central India. Med J Babylon. 2020;17:272-7. doi: 10.4103/MJBL.MJBL_36_20.
  43. Takai IU, Bukar M, Audu BM. A Prospective Study Of Maternal Risk Factors For Low Birth Weight Babies In Maiduguri, North-Eastern Nigeria. Niger J Basic Clin Sci. 2014;11:89-98. doi: 10.4103/0331-8540.140353.
  44. Brown, J. S., T. Adera, And S. W. Masho. "Previous Abortion And The Risk Of Low Birth Weight And Preterm Births." Journal Of Epidemiology & Community Health. 2008;16-22. doi: 10.1136/jech.2006.050369.
  45. Kermani RM, Zoljalali S, Kouhpayezadeh J, Nateghi MR, Shahzadehfazeli A, Nedaifard L. Evaluation of the growth process of infants conceived by assisted reproductive techniques at royan institute from birth to 9 months. Iran J Pediatr. 2011;21(4):449-54. PMID: 23056830. PMCID: PMC3446135.