Prevalence and determinants of low birth weight in Ethiopia: A multilevel meta-analysis and systematic review.

Objectives: Worldwide in 2015, approximately 20.5 million infants were born underweight, with Sub-Saharan Africa and Asia bearing the highest burden. Numerous studies have investigated low birth weight (LBW) and its contributing factors in Ethiopia, enlightening notable variations in reported prevalence and associated factors. The goal of this study was to estimate the pooled prevalence of LBW and identify determinants using a multilevel meta-analytic approach.

Study design: A multilevel meta-analysis was conducted with R (version 4.4.0) using the metafor package.

Methods: We searched the PubMed/MedLine, Google Scholar, and Cochrane databases from January 2018 to May 2024. multilevel random effects model, with the restricted maximum likelihood method used by accounting for the nested structure of the data, with studies nested within clusters.

Results: The pooled proportion of low birth weight based on the three-level meta-analysis model was 0.36 (95%CI: 0.32-0.39; p < 0.0001). The estimated variance components were Level₃ = 5.13 % and Level₂ = 92.30 %. Subgroup analyses were done based on different factors. However, there is no significant difference between groups. maternal age (OR: 2.46; 95 % CI: 1.96 to 3.09), AnteNatal Care follow-up (OR: 3.00; 95 % CI: 1.86 to 4.84), Gestational Age (OR: 9.68; 95 % CI: 5.88 to 15.94), Birth Interval (OR: 3.97; 95 % CI: 1.13 to 13.97), Pregnancy Induced Hypertension (OR: 2.83; 95 % CI: 1.34 to 5.97), and maternal anaemic status (OR: 3.32 95 % CI: 1.14 to 9.69) were the possible factors.

Conclusions: This study found a 36 % double arcsin transformed proportion of low birth weight, with significant factors including maternal age, ANC follow-up, gestational age, birth interval, pregnancy-induced hypertension, and maternal anaemia. Interventions like promoting a good diet, sufficient antenatal care, and maintaining a clean environment are needed to meet global nutrition goals by 2025.