The Impact of Prematurity and Low Birth Weight Among Food-Secure and Food-Insecure Households: A Comparative Study in Surabaya, Indonesia

Background: /Objectives: Prematurity and low birth weight (LBW) drive infant morbidity and mortality, requiring nutritional interventions, especially in food-insecure settings. In Indonesia, regional disparities in food security hinder adequate nutrition for premature and LBW infants, exacerbating health challenges. The aim of study is to investigate and determine predictors of food insecurity that impact health outcomes in children born with prematurity and/or low birth weight. Methods: A cross-sectional study with 657 mothers with children aged 36-59 months was conducted using random sampling. Data was collected via standardized questionnaires and analyzed using chi-square tests and logistic regression. Results: Children of food-insecure households had a higher risk of LBW (AOR=1.89; 95% CI: 1.02–3.48). Low maternal education was associated with an increased risk of preterm birth (AOR=2.95; 95% CI:1.66–5.25). The increase in prematurity may increase the risk of underweight status (AOR=2.19; 95% CI:1.27–3.82). Food insecurity correlated with maternal education and maternal employment status (AOR=2.46; 95% CI: 1.31–4.63 and AOR=1.46; 95% CI: 1.03–2.07, respectively). Conclusion: Food insecurity exacerbates risks for underweight children, particularly in the prevalence of prematurity. Initiative strategies to improve child health outcomes are essential, including enhancing maternal nutrition knowledge to improve child feeding practices, promoting gender equality in career development, and reducing food insecurity.