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 low birth weigth (LBW) over the last four decades. Majority of Indian LBW infants are mature, being born after 37 weeks of gestation. Pre-Term 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 that 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 under-nourished women and providing food supplements to them can bring about reduction in low birth weight rate in this 'at risk' group, but food supplements to all pregnant women do not bring about substantial increase in the birth weight or reduction in the 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 the year 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.