Low birth weight – Causes, consequences and interventions to achieve reduction

Abstract

About a third of Indian neonates weigh less than 2.5 kg at birth. There has not been any substantial decline in the incidence of LBW over the last four decades. Majority of Indian low birth-weight (LBW) infants are mature ( born after 37 weeks of gestation). Preterm birth rates in India are about 12-14%.

LBW rates are higher among lower income groups, among infants born to short statured parents, in primi-para and those with four or more children. LBW associated with these factors cannot be reduced rapidly. LBW rates are higher in women with anaemia, systemic disorders prior to pregnancy, pregnancy induced hypertension with or without gestational diabetes. It is estimated early detection and effective treatment of these health problems through improvement in coverage, content and quality of antenatal care can bring about 5% reduction in low birth weight.

Inadequate dietary intake and high physical activity resulting in low pre-pregnancy weight and poor weight gain during pregnancy are associated with LBW. Identification of undernourished women and providing food supplements to her can bring about reduction in low birth weight rate in this at risk group, but food supplements  to all  pregnant women  does not bring about  substantial increase in  birth  weight or reduction in  low birth weight .

Given this scenario the country will not be able to achieve the WHA/SDG target of 30% reduction in low birth weight by 2025. Despite high low birth weight rates, infant mortality rates in India are not very high, because the mature Indian LBW infants survive when they are provided with essential new born care. Therefore India will be able to achieve the  IMR  targets for 2030 even though LBW targets are not met .