Spatial Distribution of Low Birth Weight and Factors Associated With Birth Weight Among Live Births in the 2 Years Before the Survey in Jordan 2023 Using the Log-Gamma Mixed-Effect Model

Introduction: Low birth weight (LBW), defined by the WHO as a birth weight under 2500 g, is a significant risk factor for perinatal death, health issues, and an increased risk of chronic diseases in adulthood. The purpose of this study was to examine the geographic distribution of LBW and identify the factors influencing birth weight in Jordan.

Method: This study analyzed secondary data from the 2023 Jordan Population and Family Health Survey, including 4886 neonates. Spatial autocorrelation was used to examine the clustering of LBW cases, while spatial scan statistics and ordinary kriging interpolation helped identify local hotspots and predict high-risk areas. A log-gamma mixed-effects model assessed individual and community-level factors linked to LBW. The Global Moran’s I test was applied to determine if LBW patterns in Jordan were randomly distributed, spread out, or clustered. Adjusted rate ratio (ARR) with 95% confidence intervals was reported for the log-gamma model.

Results: LBW was spatially clustered in Jordan. Hotspot areas (clusters with high frequencies of LBW) were observed in the Rabid, Ajloun, Jarash, and borders of the Mafraq regions of Jordan. Neonates who were born from primary education (ARR = 0.786, 95% CI: 0.721–0.856) and secondary education and above (ARR = 0.814, 95% CI: 0.755–0.878), women with normal weight (ARR = 0.899, 95% CI: 0.829–0.976), women with one child (ARR = 0.442, 95% CI: 0.287–0.680), women with two children (ARR = 0.450, 95% CI: 0.293–0.693), women with three or more child (ARR = 0.442, 95% CI: 0.287–0.679), women with multiple births (ARR = 0.806, 95% CI: 0.752–0.864), women delivered by caesarean section (ARR = 0.932, 95% CI: 0.909–0.956), and regions Ma’an, Karak, Irbid, and Mafraq had significantly associated with LBW babies.

Conclusion: This study identifies key factors affecting LBW in Jordan, including maternal education, weight, parity, gender, multiple births, and delivery method. Hotspots of LBW were found in Irbid, Ajloun, Jarash, and Mafraq, highlighting areas for targeted interventions. Regional differences were observed, with Ma’an and Karak showing higher birth weights, while Irbid and Mafraq had lower birth weights compared with Amman. These findings stress the importance of region-specific strategies to reduce LBW and enhance maternal and child health in Jordan.