Background. Low birth weight (LBW), an outcome of maternal undernutrition, is a major public health concern in Bangladesh where the problem is most prominent. Women’s decision-making autonomy is likely an important factor influencing maternal and child health outcomes. The aim of the study was to assess the effect of women’s decision-making autonomy on infant’s birth weight (BW). Methods. The study included data of 2175 enrolled women (14–45 years of age) from the Maternal and Infant Nutritional Intervention in Matlab (MINIMat-study) in Bangladesh. Pearson’s chi-square test, analysis of covariance (ANCOVA), and logistic regression analysis were applied at the collected data. Results. Women with lowest decision-making autonomy were significantly more likely to have a low birth weight (LBW) child, after controlling for maternal age, education (woman’s and her husband’s), socioeconomic status (SES) (odds ratio (OR) = 1.4; 95% confidence interval (CI) 1.0, 1.8). BW was decreased significantly among women with lowest decision making autonomy after adjusting for all confounders. Conclusion. Women’s decision-making autonomy has an independent effect on BW and LBW outcome. In addition, there is a need for further exploration to identify sociocultural attributes and gender related determinants of women decision-making autonomy in this study setting. 1. Background WHO has defined low birth weight (LBW) as birth weight (BW) less than 2500？g at birth which is a global public health concern [1]. About one half of the world’s low birth weight (LBW) babies are born in South Asia and Bangladesh has the highest incidence (31–47%) [1, 2]. BW is an important predictor of infant growth and survival and is strongly associated with early mortality and morbidity with adverse long-term outcomes [3, 4]. Low weight at birth is either the result of preterm delivery or intrauterine growth retardation (IUGR) [5]. BW is affected by various factors including maternal age, parity, BMI, quality of antenatal care, anaemia, and pregnancy induced hypertension (PIH) [6–10]. However, in developing countries like Bangladesh maternal undernutrition is a major determinant of LBW [11–15]. It has been reported that in many South Asian countries including Bangladesh women’s socioeconomic status is low and gender inequality persists in many sectors starting from intrahousehold food allocation, education, work, and property rights to decision-making matters. The majority of women have limited access to and control over resources and restriction in their mobility and are often under threat of
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