Risk factors for low birth weight in Rio Grande do Sul State, Brazil: classical and multilevel analysis

The objective of this study was to identify risk factors for low birth weight in singleton live born infants in Rio Grande do Sul State, Brazil, in 2003, based on data from the Information System on Live Births. The study used both classical multivariate and multilevel logistic regression. Risk factors were evaluated at two levels: individual (live births) and contextual (micro-regions). At the individual level the two models showed a significant association between low birth weight and prematurity, number of prenatal visits, congenital anomalies, place of delivery, parity, sex, maternal age, maternal occupation, marital status, schooling, and type of delivery. In the multilevel models, the greater the urbanization of the micro-region, the higher the risk of low birth weight, while in less urbanized micro-regions, single mothers had an increased risk of low birth considering all live births. Low birth weight varied according to micro-region and was associated with individual and contextual characteristics. Although most of the variation in low birth weight occurred at the individual level, the multilevel model identified an important risk factor in the contextual level.