Published in PLOS One on 2026-07-29, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. HealthSignal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Wubet Tazeb Wondie, Chalachew Adugna Wubneh, Gebrehiwot Berie Mekonen, Bruck Tesfaye Legesse, Belay Tafa Regassa, Daniel Niguse Mamo, Zenebe Abebe Gebreegziabher, Mariam Alemayehu Abebaw, Gezahagn Demsu Gedefaw, Leweyehu Alemaw Mengstie, Alemu Birara Zemariam
Source: PLOS One • DOI 10.1371/journal.pone.0344213
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Low birth weight neonates are twentyfold at risk of death. Notably, it is a major public health concern in sub-Saharan Africa, including Ethiopia. Despite the presence of several primary studies on this issue in Ethiopia, the study findings are inconsistent. Hence, this review aimed to assess the pooled incidence and proportion of mortality and predictors among low birth weight neonates.
A search of articles from databases (PubMed, CINAHL, Global Index Medicus, and HINAR), and other sources (Google, Google Scholar) were done. All observational studies that assess mortality of low birth weight neonates were included. The Joana Brigs Quality appraisal checklist was used. The pooled incidence rate, proportion, and the effect size of predictors were estimated using a random-effects model. Heterogeneity was assessed using I2 test. Subgroup and sensitivity analysis was conducted. Eggers test and funnel plot were used to assess publication bias. Trim and fill analysis was conducted.
Fifteen studies with 7539 study participants were included. The pooled incidence rate of mortality was found to be 36.31 (95 CI: 26.37–46.25) per 1000 neonates’ day observation and the proportion of mortality was 26.67% (95% CI: 21.83–31.51). Preeclampsia (AHR = 1.38; 95% CI: 1.09–1.75), respiratory distress syndrome (AHR: 1.67; 95% CI:1.25–2.23), perinatal asphyxia (AHR: 1.66; 95% CI: 95%:1.35–2.05), sepsis (AHR: 2.04; 95% CI: 1.59–2.63), not breastfeeding (AHR:5.16; 95% CI: 2.61–9.96), not using KMC (AHR: 4.46, 95% CI: 2.19–9.10), extremely low birth weight (AHR: 3.67; 95% CI: 2.55–5.29), very low birth weight (AHR = 1.75; 95% CI: 1.44–2.12), and prematurity (AHR: 1.55; 95% CI: 1.07–2.24) were predictors.
Based on the pooled proportion of mortality, above one-fourth of low birth weight neonates died in Ethiopia, and the incidence rate of mortality was significantly high. Preeclampsia, respiratory distress syndrome, perinatal asphyxia, sepsis, not breastfeeding, not using kangaroo mother care, hypothermia, extremely low and very low birth weight, and prematurity were predictors of mortality. Hence, the concerned stakeholder should focus on LBW neonates presented with these predictors. Maternal and neonatal screening, kangaroo mother care, and breastfeeding need to be strictly practiced to reduce mortality. Furthermore, community-based essential newborn care needs to be strengthened.
CRD42024524189.
Background
The mortality of Low Birth Weight (LBW) neonates is a significant global public health concern, particularly in Low, and Middle-Income Countries (LMIC) [1]. Globally, LBW neonates are twentyfold at risk of death relative to normal-weight neonates [2, 3], and in some resource-limited settings, these neonates are more than twenty-five fold at risk of death [4]. Each year, approximately 2.5 million neonates die worldwide, over 80% of whom are low birth weight, with the majority of these deaths occurring in Sub-Saharan Africa (SSA), and Southeast Asia [1,5].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider public health desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Wubet Tazeb Wondie, Chalachew Adugna Wubneh, Gebrehiwot Berie Mekonen, Bruck Tesfaye Legesse, Belay Tafa Regassa, Daniel Niguse Mamo, Zenebe Abebe Gebreegziabher, Mariam Alemayehu Abebaw, Gezahagn Demsu Gedefaw, Leweyehu Alemaw Mengstie, Alemu Birara Zemariam. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by HealthSignal. The researchers are the authors of the source study, not members of HealthSignal’s staff.
Explore connected evidence
- Evidence brief: Neonatal survival and mortality predictors among low-birth-weight neonates: A Retrospective cohort study from Suhul Hospital, northern Ethiopia
- Evidence brief: Survival status and predictors of mortality among preterm neonates admitted to the neonatal intensive care unit at public hospitals of Harari region and Dire Dawa administration, eastern Ethiopia: Retrospective cohort study 2025
- Evidence brief: Causes and trends of under-five mortality in the Gilgel Gibe Health and Demographic Surveillance System, 2005 to 2019, Southwest Ethiopia: Cohort study
