Maternal Dietary Diversity and Determinants of Low Birth Weight in the Binza Météo Area, a Disadvantaged Urban Area of Kinshasa: A Multicenter Case–Control Study

Background: Low birth weight (LBW) remains a significant contributor to neonatal morbidity and mortality worldwide. Maternal nutrition, particularly dietary diversity, plays a crucial role in fetal growth. This study aims to investigate the association between maternal dietary diversity and the occurrence of LBW in a case-control design. Methods: A total of 192 mothers were enrolled, including 64 with LBW infants and 128 with normal birth weight. Maternal dietary intake was assessed using 24-hour recalls and food frequency questionnaires to calculate dietary diversity scores (DDS). Multivariate logistic regression analyses were conducted to identify determinants of LBW, controlling for potential confounders. Findings: The results revealed that mothers of LBW infants had significantly lower dietary diversity scores (mean DDS 5.36, SD 1.19) compared to controls (mean DDS 5.77, SD 1.37; p = 0.0407). Notably, only 42.2% of mothers of LBW infants met the Minimum Dietary Diversity for Women (MDD-W) criteria in weekly assessments, compared to 71.9% of controls (p < 0.001). Multivariate analysis indicated that a maternal mid-upper arm circumference (MUAC) of less than 230 mm and lower dietary diversity were significantly associated with increased odds of LBW (adjusted OR 5.29, 95% CI 1.40–19.91; adjusted OR 0.72, 95% CI 0.54-0.95, respectively). Interpretation: This study demonstrates that inadequate maternal dietary diversity is a modifiable risk factor for low birth weight, emphasizing the urgent need for public health interventions focused on improving maternal nutrition. Addressing dietary deficiencies and promoting diverse food consumption during pregnancy could substantially reduce the incidence of LBW, with significant implications for maternal and neonatal health.