Dragana Grbic ^1* Zorica Terzic-Supic ² Jovana Todorovic ² Dejan Nesic ³ Svetlana Karic ⁴ Aleksandar Jurisic ¹ Sanja Sava Kocic ⁵ Zoran Bukumiric ⁶ Andja Cirkovic ⁶ Svetlana Jankovic ¹

• ¹ Gynecology and Obstetrics Clinic Narodni front, Belgarde, Serbia
• ² Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
• ³ Institute of Medical Physiology Richard Burian, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
• ⁴ Department of Studies for Preschool and Nursery Teachers, Academy for Professional Studies, Sabac, Serbia
• ⁵ Department of Social medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
• ⁶ Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

Introduction: Low birth weight, defined as a birthweight below 2500 grams, represents a significant public health concern with a multifactorial risk dimension. Socio-demographic factors and individual characteristics of women and their social environment could influence low birth weight. The aim of this study was to analyze the association between the socio-demographic and reproductive characteristics of women living in low-income households and low birth weight in Serbia, Kosovo, and Montenegro. Methods: This study was conducted as secondary data analysis during the Multiple Indicator Cluster Survey - Round 6 in Serbia, Kosovo, and Montenegro. The household questionnaire and the individual questionnaire for women aged 15-49 were used as standard research instruments. We analyzed 1019 women whose households belonged to the first (poorest) or second (poor) wealth index quintiles and who had given birth to a live child within the two years preceding the study. A multivariate logistic regression was applied with low-birth-weight of newborns as the outcome variable. Results: The univariate regression analysis showed that women with low birthweight newborns were significantly more likely to live in settlements inhabited mainly with Roma, reside in urban areas, marry or enter a union before age 18, have lower education levels, experience higher illiteracy rates, and antenatal care not provided by a medical doctor compared to women whose newborns weighed 2.5 kg or more. A multivariate logistic regression model with low birth weight of newborns as an outcome variable showed the association between women’s illiteracy (OR: 1.741; 95% CI: 1.060–2.859) and antenatal care not provided by a medical doctor (OR: 2.735; 95% CI: 1.229–6.087). Discussion: Illiteracy and limited access to medical doctor services during pregnancy were factors that increased the likelihood of low birth weight in newborns born to women living in low-income households in the selected Western Balkans populations. The cross-sectional design of this study does not allow the establishment of causal relationships among variables, but it can provide important evidence for future prevention strategies. Interventions are needed to enhance the education of women and to improve access to antenatal care across Serbia, Kosovo, and Montenegro.