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BACKGROUND: Low birth weight and prematurity are associatedwith increased morbidity, mortality and multiple short and long-term complications, exerting impacts on the individual, thefamilies, the community and the health care system. Fetal,maternal and environmental factors have been associated with lowbirth weight and prematurity, based primarily on researches fromhigh-income countries. It is unknown whether these risk factorsare the same in low and middle income countries. The aims of thisstudy are to determine the prevalence of low birth weight andprematurity and associated factors in Jimma University SpecializedHospital, Ethiopia.METHODS: This observational study was conducted at JimmaUniversity Specialized Hospital, Ethiopia, from December 2014 toSeptember 2016. Multivariable logistic regression was used todetermine the associated factors, with results reported as oddsratios (OR) and 95% confidence intervals (CI).RESULTS: The prevalence of low birth weight and prematuritywere 14.6% and 10.2%, respectively. The mean birth weight was2,975g (standard deviation 494). Prematurity (OR 23.54, 95%CI15.35-36.08, p<0.001) and unmarried marital status (OR 5.73,95%CI 1.61-20.40, p=0.007) were positively associated with lowbirth weight. Female sex (OR 1.69, 95%CI 1.18-2.42, p=0.004) andunmarried marital status (OR 4.07, 95%CI 1.17-14.14, p=0.027)were positively associated with prematurity.CONCLUSION: The prevalence of lower birth weight andprematurity in this study is lower than other studies reported fromsimilar facilities. Prematurity and unmarried marital status areassociated with LBW whereas female sex and unmarried maritalstatus are associated with prematurity in this population.