Abstract
BACKGROUND: Low birth weight (LBW) is associated with adverse short-term and long-term health outcomes for neonates. The impact of maternal geographical location on rates of LBW in Australia is conflicted in existing literature. AIMS: The aim was to identify if a difference in rates of LBW exist between neonates born to rural versus metropolitan maternal residence. Secondary aim was to identify any associated factors influencing LBW. MATERIALS AND METHODS: A secondary data analysis of retrospective health surveillance data from all births from 2018 to 2022 in the Hunter New England Local Health District (New South Wales, Australia) was performed. Logistic regression was used to determine odds ratio and adjusted odds ratio of LBW for rural versus metropolitan residence. RESULTS: A total of 39,579 neonates were included in this analysis, with 50.9% of the maternal cohort residing rurally. Median maternal was age 29.2 years. Rates of LBW were higher in rural maternal residence (5.7%) compared to metropolitan residence (5.2%). Odds of neonatal LBW did not differ between rural and maternal metropolitan residence after adjusting for confounders (adjusted Odds Ratio (aOR) = 0.90, 95% CI 0.79-1.01, p = 0.07). Socioeconomic disadvantage was significantly identified as an issue associated with LBW. CONCLUSIONS: LBW neonates were more likely to be born to rural maternal residence and LBW risk factors disproportionately affected those living in rural locations. To reduce LBW in neonates, it is imperative that access to safe and affordable healthcare is available, and resources addressing LBW risk factors are specific to geographical locations.