Factors Related to Term Singleton Low Birthweight: A Multicenter Case - Control Study


  • Anuchat Sujita Nong Han Hospital, Udon Thani Province.
  • Metha Songthamwat Department of Obstetrics and Gynecology, Udon Thani Hospital
  • Srisuda Songthamwat Department of Obstetrics and Gynecology, Udon Thani Hospital
  • Yaowaret Kittithanesuan Ang Thong Hospital, Ang Thong Province.
  • Nopporn Limwatanapan Wanonniwat Hospital, Sakon Nakhon Province.
  • Sunanthaporn Phaiphan Lomsak Hospital, Phetchabun Province.
  • Pimjai Maleerat Ban Phue Hospital, UdonThani Province.
  • Koollachart Saejueng Ban Dung Hospital, UdonThani Province.
  • Ueamporn Summart Faculty of Nursing, Roi Et Rajabhat University, Roi Et Province.


associated factor, term low birthweight, low birthweight


Background and Objectives: Low birthweight (<2,500 gram) is a crucial world health problem that still needs much more knowledge and the understanding. This study aimed to the factors associated with term singleton low birthweight infants. The knowledge gain will be use for the prevention and treatment of this condition.

Methods: A multicenter case - control study was conducted. The subjects were mothers and infants who delivered in Udon thani Hospital, Nonghan Hospital, Ban phue Hospital, Wanonniwat Hospital, Ban dung Hospital, Lom sak Hospital, and Ang thong Hospital during January 1, 2018 to December 31, 2022 and met the study criteria. Data were collected from the electronic database then analyzed using descriptive statistics and multiple logistic regression analysis.

Results: There were 22,489 term singleton infants with 1,138 term low birth weight infants (5.06%). The multiple logistic regression was conducted, the factors associated with the term low birthweight were nulliparous, low body mass index mother, poor pregnancy weight gain, maternal anemia, hypertensive disorder during pregnancy and female infant. The pregnancy outcomes of term low birthweight group had significantly higher stillbirth rate, birth asphyxia rate and neonatal intensive care ward admission rate. The term low birthweight neonatal intensive care ward admission rate was 12.74% and the birth asphyxia rate was 6.33%. The tenth percentile cut off point for the term low birthweight determination was 2,625 grams and 2,500 grams in low body mass index mother group. The infant weight < 2,300 grams significantly increased the birth asphyxia and neonatal intensive care unit admission rate.

Conclusion: The associated factors that affects the term low birthweight were nulliparous, low body mass index mother, poor pregnancy weight gain, maternal anemia, hypertensive disorder during pregnancy, and female infant. The mother with these conditions should be closely monitored and treated prenatally to prevent the serious complications. The cut point for term low birthweight determination was 2,625 grams and 2,500 grams in low body mass index mother. The risk of birth asphyxia and neonatal intensive care admission increased when the birth weight was < 2,300 gram.


World Health Organization (WHO). Global nutrition targets 2025: low birthweight policy brief [Internet]. 2014 [cited Feb 6,2023]. Available from: https://www.who.int/publications/i/item/ WHO-NMH-NHD 14.2.

United Nations International Children's Emergency Fund (UNICEF). Low birthweight [Internet]. 2023 [cited Feb 26, 2024]. Available from: https://data. unicef.org/topic/nutrition/low-birthweight.

Goldenberg RL, Culhan JF. Low birthweight in the United States. Am J Clin Nutr 2007;85(2):584s-90s. doi: 10.1093/ajcn/85.2.584S.

Roth J, Hendrickson J, Schilling M, Stowell WD. The risk of teen mothers having low birthweight babies: implications of recent medical research for school health. J Sch Health 1998;68(7):271-5. doi:10.1111/j.1746-1561.1998.tb00581.x.

Khunpradit S. Low birth weight infant: fetal origins of adult disease. Chulalongkorn Medical Journal 2004;48(5):309-22. doi :10.58837/CHULA.CMJ. 48.5.4.

Tontivuthikul P. Fetal growth restriction or intrauterine growth restriction [Internet].2014 [cited Feb 6, 2023]. Available from: https://w1. med.cmu.ac.th/obgyn/lecturestopics/topic-review/3256/.

Chen Y, Li G, Ruan Y, Zou L, Wang X, Zhang W. An epidemiological survey on low birthweight infants in China and analysis of outcomes of full-term low birthweight infants. BMC Pregnancy Childbirth 2013;13:242. doi: 10.1186/1471-2393-13-242.

The American College of Obstetricians and Gynecologists. Practice Bulletin No. 130: prediction and prevention of preterm birth. Obstet Gynecol 2012;120(4):964-73. doi: 10.1097/AOG.0b013 e3182723b1b.

RTCOG Clinical Practice Guideline. The manage¬ment of preterm labour and preterm premature rupture of membranes 2015 [Internet]. [cited Feb 6,2024]. Available from https://www.rtcog.or.th/fi les/1695091574_742852553aec29c37b5f.pdf.

Ngamjarus C. N4studies sample size calculation for an epidemiological study on a smart device. Siriraj Med J 2016;68(3):160-70.

Falcão IR, Ribeiro-Silva RC, de Almeida MF, Fiaccone RL, Dos S Rocha A, Ortelan N, et al. Factors associated with low birth weight at term: a population-based linkage study of the 100 million Brazilian cohort. BMC Pregnancy Childbirth 2020;20(1):536. doi: 10.1186/s12884-020-03226-x.

Health news information group. Strategy and planning division. Office of the permanent secretary ministry of public health. Public health statistics 2018 [Internet]. 2018 [cited Sep, 2023]. Available from: https://spd.moph.go.th/wp-con¬tent/uploads/2022/11/Hstatistic60.pdf.

World Health Organization (WHO). Forthcoming: UNICEF-WHO low birth weight estimates: levels and trends [Internet]. 2023 [cited Feb 6, 2023]. Available from: https://www.who.int/teams/ nutrition-and-food-safety/monitoring-nutrition¬al-status-and-food-safety-and-events/joint-low-birthweight-estimates.

Songthamwat M, Promnimit J, Summart U, Songthamwat S. Cervical length measurements in the management of threatened preterm labor: a randomized controlled trial. J Med Assoc Thai 2020;103(10):967-70.

Mumbare SS, Maindarkar G, Darade R, Yenge S, Tolani MK, Patole K, et al. Maternal risk factors associated with term low birthweight neonates: a matched-pair case control study. Indian Pediatr 2012;49(1):25-8. doi: 10.1007/s13312-012-0010-z.

Hendrixson DT, Manary MJ, Trehan I, Wall LL. Undernutrition in pregnancy: evaluation, management, and outcome in resource-limited areas [Internet]. 2021 [cited Aug 3,2022]. Available from: https://www.uptodate.com/contents/ undernutrition-in-pregnancy-evaluation-manage¬ment-and-outcome-in-resource-limited-areas/ print.

Nahar S, Mascie-Taylor CG, Begum HA. Impact of targeted food supplementation on pregnancy weight gain and birth weight in rural Bangladesh: an assessment of the Bangladesh Integrated Nutrition Program (BINP). Public health nutrition 2009;12(8):1205-12. doi: 10.1017/S13689800 08003765.

Maleerat P, Songthamwat M, Saeng-aroon P, Kittithanesuan Y, Songthamwat S, Summart U, et al. Pregnancy outcome in undernutrition mothers: a multicenter retrospective cohort study. Srinagarind Med J 2022;37(6):565-75.

Institute of Medicine. Weight gain during pregnancy: reexamining the guidelines. Washington DC: The National Academies Press; 2009.

Reichman NE, Pagnini DL. Maternal age and birth outcomes: data from New Jersey. Fam Plann Perspect 1997;29(6):268-72, 295. doi: 10.2307/ 2953415.

Li CY, Sung FC. Socio-economic inequalities in low-birth weight, full-term babies from singleton pregnancies in Taiwan. Public Health 2008; 122(3): 243-50. doi: 10.1016/j.puhe.2007.05.011.

Atiya A. Maternal and fetal factors associated with non detection of fetal growth restriction at term: a retrospective study. Int J Reprod Contracept Obstet Gynecol 2020;9(10):4164-8. doi: 10.18203/ 2320-1770.ijrcog20204307.

Rupich RC, Specker BL, Lieuw-A-Fa M. Gender and race differences in bone mass during infancy. Calcif Tissue Int 1996;58(6):395-7. doi: 10.1007/ BF02509436.

Lampl M, Gotsch F, Kusanovic JP, Gomez R, Nien JK, Frongillo EA, et al. Sex differences in fetal growth responses to maternal height and weight. Am J Hum Biol 2010;22(4):431-3. doi: 10.1002/ ajhb.21014.



How to Cite

Sujita A, Songthamwat M, Songthamwat S, Kittithanesuan Y, Limwatanapan N, Phaiphan S, Maleerat P, Saejueng K, Summart U. Factors Related to Term Singleton Low Birthweight: A Multicenter Case - Control Study . SRIMEDJ [Internet]. 2024 Apr. 24 [cited 2024 Jun. 19];39(2):126-3. Available from: https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/261701



Original Articles