<![CDATA[Background: Low birth weight (LBW) remains a major contributor to neonatal morbidity and mortality globally. LBW remains an important maternal–neonatal health problem, particularly in high-risk referral settings. This study examined maternal and obstetric factors independently associated with LBW. Methods: A retrospective case-control study used medical records of 270 mothers who delivered in 2025. Participants were selected by purposive sampling based on eligibility and record completeness, comprising 135 LBW cases and 135 controls. Eligible records included singleton deliveries without congenital anomalies; incomplete records and severe non-obstetric comorbidities were excluded. Maternal age, gestational age, birth spacing, parity, and documented preeclampsia were analyzed using chi-square tests and multivariable logistic regression. Variables with p < 0.25 entered the multivariable model. Results: Preterm birth was strongly associated with LBW (AOR = 35.16, 95% CI: 16.92–73.09; p < 0.001), as was documented preeclampsia (AOR = 4.37, 95% CI: 1.94–9.80; p < 0.001). Maternal age and parity were not independently associated after adjustment, and birth spacing was not significant. Conclusion: Preterm birth and documented preeclampsia showed the strongest adjusted associations with LBW. These findings support strengthened antenatal risk screening, preterm-birth surveillance, and timely referral, while providing context-specific evidence from a high-risk referral population.]]>
