Gebremichael Aregawi Teklehaimanot ^1,2* Kahsay Zenebe Gebreslasie ³ Woldu Mammo Werid ^1,2 Berhanu Gebresilassie ^1,2 Gebregziabher Kidanemariam ² Etsay Weldekidan Tsegay ⁴ Zenawi Hagos Gufue ⁵ Meresa Berwo Mengesha ^1,2

• ¹ College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
• ² Adigrat University, Adigrat, Tigray, Ethiopia
• ³ Mekelle University, Mekelle, Tigray Region, Ethiopia
• ⁴ Department of Modern and Traditional Medicine Research, Tigray Health Research Institute, Mekelle, Ethiopia
• ⁵ Department of Public Health, College of Medicine and Health Sciences, Adigrat University, Adigrat, Tigray, Ethiopia

Background: Low birth weight is a key determinant of child survival, significantly influencing rates of infant and childhood mortality, morbidity, and disability. While some studies have been conducted in our region, there remains gap of evidence in assessing maternal characteristics associated with low birth weight.Hence this study aimed to determine the proportion of newborn low birth weight and determinant factors, maternal characteristics in particular.A facility-based cross-sectional study was conducted from March 21 to April 20, 2020, involving mothers and their newborns at selected public health facilities in Mekelle city. The sample included 447 participants, with two public hospitals and three health centers chosen by lottery. Systematic random sampling was applied to select mother-newborn pairs. Data were collected using structured interviewer administered questionnaire and analyzed with the Statistical Package for Social Sciences (SPSS) version 21.Bivariate and multivariate logistic regression with a 95% confidence interval was used to identify factors associated with low birth weight.The study included 447 mothers of newborns, achieving a response rate of 100%. The proportion of low birth weight was 14.3%. Significant factors associated with low birth weight included attending the first antenatal care visit in the third trimester (AOR = 3.66, 95% CI: 1.28-10.44), not receiving additional nutrition (AOR = 4.16, 95% CI: 1.38-12.58), experiencing obstetric complications during the current pregnancy (AOR = 7.72, 95% CI: 2.76-21.59), and a gestational age at birth of less than 37 weeks (AOR = 5.36, 95% CI: 1.96-14.67)This study revealed a substantial incidence of low birth weight. The initiation of the first antenatal care visit in the third trimester, the failure to supplement nutrition, and the occurrence of obstetric complications during pregnancy, as well as the gestational age at birth being less than 37 weeks, were all found to be significantly correlated with this condition. It is recommended that policymakers should strengthen maternal and child health services, especially through the focused ANC program, to improve outcomes. Health facilities should promote awareness of the importance of initiating ANC visits early, with an emphasis on nutritional counseling throughout pregnancy.