To explore the maternal and neonatal factors associated with premature birth and low birth weight in an Ecuadorian tertiary hospital.
Cross-sectional study.
The Calderón General Teaching Hospital (CGTH). Maternal and delivery characteristics were obtained from medical records.
All live births from April 2017 to October 2020 were considered as the source population.
The study included 13,407 reported births. The proportion of low birth weight neonates was 12.4%. The frequencies of neonates with gestational ages of less than 34 and from 34 to 37 weeks were 1.8% and 8.8%, respectively. According to INTERGROWTH-21st standards, 14% and 5.5% of the neonates were classified as small- (90th centile), respectively. A higher proportion of low birth weight was observed among newborns of illiterate mothers, younger mothers, and with gestational hypertension. The proportion of small-for-gestational-age infants was lower among younger mothers, while large-for-gestational-age infants were more frequent among older mothers. Maternal obesity (proportion ratio [PR] 2.80, 95%CI 1.69 – 4.64), and gestational diabetes (PR 3.24, 95%CI 2.12 – 4.96) were associated with an increased percentage of large-for-gestational-age births.
The proportion of low birth weight in Calderón General Teaching Hospital is large compared to those found in studies conducted in Latin America, and the preterm birth rate is close to that estimated in less developed countries. Despite the advances in maternal and child health observed in Ecuador, the present study shows that interventions are still needed in this population.

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