Incidence and determinants of low birth weight in a tertiary hospital at South Andaman: a prospective study
Keywords:Low birth weight, IUGR, Prematurity- risk assessment and prevention, Andaman and Nicobar islands
Background: Birth weight is an important predictor of an individual’s survival and well-being and the complications of children born with low birth weight (LBW) continue till adulthood. The incidence and risk factors of LBW are not known in the Andaman and Nicobar Islands and research answers can help institute appropriate preventive measures. The aim of the study was to determine the proportion of LBW due to intrauterine growth restriction (IUGR) and preterm birth (PTB) and its association with selected factors.
Methods: The prospective study was conducted in Andaman and Nicobar Islands Institute of Medical Sciences amongst pregnant women admitted between January-June 2021. Women<18 years, with gestational age<28 weeks, and belonging to tribal groups were excluded. After delivery, birth-weight was recorded to the nearest 10 g in first hour.
Results: The incidence of LBW was 24% with 57% due to IUGR. It was significantly higher in recent immigrants, gravidity beyond three, smokeless tobacco uses during pregnancy, high risk pregnancies including multiple miscarriages and preterm deliveries. Five or more antenatal check-ups and > 6 Kg weight gain during pregnancy were protective.
Conclusions: Ensuring adequate antenatal check- ups and weight gain during pregnancy, control of tobacco exposure and quality care for women with recurrent abortions and high risk pregnancy is imperative, particularly targeting recent migrants. Strengthening ongoing family planning programmes to increase spacing, identifying pregnancies at risk of preterm deliveries and improved care of premature newborns should be a priority.
WHO. WHA Global Nutrition Targets 2025: Low birth weight policy brief. Available at: https://apps.who.int/iris/bitstream/handle/10665/0/WHO_NMH_NHD_14.5_eng.pdfua=1. Accessed on 07 January 2020.
Cutland CL, Lackritz EM, Mallett-Moore T, Bardají A, Chandrasekaran R, Lahariya C, et al. Low birth weight: Case definition & guidelines for data collection, analysis, and presentation of maternal immunization safety data. Vaccine. 2017;35(48):6492-500.
McCormick MC. The contribution of low birth weight to infant mortality and childhood morbidity. N Engl J Med. 1985;312(2):82-90.
Million Death Study Collaborators. Changes in cause-specific neonatal and 1-59-month child mortality in India from 2000 to 2015: a nationally representative survey. Lancet. 2017;390(10106):1972-80.
Christian P, Lee SE, Donahue AM, Adair LS, Arifeen SE, Ashorn P, et al. Risk of childhood undernutrition related to small-for-gestational age and preterm birth in low- and middle-income countries. Int J Epidemiol. 2013;42(5):1340-55.
Gu H, Wang L, Liu L, Luo X, Wang J, Hou F, et al. A gradient relationship between low birth weight and IQ: A meta-analysis. Sci Rep. 2017;7(1):18035.
Jornayvaz FR, Vollenweider P, Bochud M, Mooser V, Waeber G, Marques-Vidal P. Low birth weight leads to obesity, diabetes and increased leptin levels in adults: the CoLaus study. Cardiovasc Diabetol. 2016;15:73.
Chen LH, Chen SS, Liang L, Wang CL, Fall C, Osmond C, Veena SR, Bretani A. Relationship between birth weight and total cholesterol concentration in adulthood: A meta-analysis. J Chin Med Assoc. 2017;80(1):44-9.
Knop MR, Geng TT, Gorny AW, Ding R, Li C, Ley SH, et al. Birth Weight and Risk of Type 2 Diabetes Mellitus, Cardiovascular Disease, and Hypertension in Adults: A Meta-Analysis of 7 646 267 Participants From 135 Studies. J Am Heart Assoc. 2018;7(23):e008870.
Blencowe H, Krasevec J, de Onis M, Black RE, An X, Stevens GA, et al. National, regional, and worldwide estimates of low birthweight in 2015, with trends from 2000: a systematic analysis. Lancet Glob Health. 2019;7(7):849-60.
UNICEF. Low Birth weight, 2020. Available at: https://data.unicef.org/topic/nutrition/lowbirthweight. Accessed on 07 January 2020.
International Institute for Population Sciences (IIPS) and ICF. National Family Health Survey (NFHS-5), 2019-21: India. Mumbai: IIPS, 2021. Available at: http://rchiips.org/nfhs/NFHS-5Reports/NFHS-5_INDIA_REPORT.pdf. Accessed on 08 June 2022.
Balaji K, Sankar S, Nandagopal B. Low birth weight of newborns: magnitude of the problem seen in a 100 bed hospital of a rural area in vellore district, Tamil Nadu (India). Indian J Community Med. 2010;35(2):362-4.
Kumar M, Verma R, Khanna P, Bhalla K, Kumar R, Dhaka R,et al. Prevalence and associated factors of low birth weight in North Indian babies: a rural based study. Int J Community Med Public Health. 2017;4(9):3212-7.
Metgud CS, Naik VA, Mallapur MD. Factors affecting birth weight of a newborn--a community based study in rural Karnataka, India. PLoS One. 2012;7(7):e40040.
Bhilwar M, Upadhyay RP, Yadav K, Kumar R, Chinnakali P, Sinha S, Kant S. Estimating the burden of 'weighing less': A systematic review and meta-analysis of low birth-weight in India. Natl Med J India. 2016;29(2):73-81.
Kumari S, Garg N, Kumar A, Guru PKI, Ansari S, Anwar S, et al. Maternal and severe anaemia in delivering women is associated with risk of preterm and low birth weight: A cross sectional study from Jharkhand, India. One Health. 2019;8:100098.
International Institute for Population Sciences. District level health survey, Andaman and Nicobar Island, fact sheet, 2020. Available at: http://rchiips.org/pdf/dlhs4/report/AN.pdf. Accessed on 07 January 2020.
Sachdev HPS. Low birthweight in South Asia. Int J Diab Dev Countries. 2001;21:13-31.
Johnson CD, Jones S, Paranjothy S. Reducing low birth weight: prioritizing action to address modifiable risk factors. J Public Health (Oxf). 2017;39(1):122-31.
Silvestrin S, Silva CH, Hirakata VN, Goldani AA, Silveira PP, Goldani MZ. Maternal education level and low birth weight: a meta-analysis. J Pediatr (Rio J). 2013;89(4):339-45.
Marimuthu Y, Sarkar S, Kattimani S, Krishnamoorthy Y, Nagappa B. Role of Social Support and Spouse Abuse in Low Birth Weight: A Case-control Study from Puducherry, India. Indian J Community Med. 2019;44(1):12-6.
WHO. Indoor air pollution from solid fuels and risk of low birth weight and stillbirth : report from a symposium held at the Annual Conference of the International Society for Environmental Epidemiology (ISEE, 2020), 2020. Available at: https://apps.who.int/iris/bitstream/handle/10665/43766/9789241505735_eng.pdf?sequen ce=1. Accessed on 07 January 2020.
Sen J, Roy A, Mondal N. Association of maternal nutritional status, body composition and socio-economic variables with low birth weight in India. J Trop Pediatr. 2010;56(4):254-9.
Salunkhe AH, Pratinidhi AK, Salunkhe JA, Kakade SV, Mohite VR, Patange RP. Antenatal Risk Scoring Scale for Predication of Low Birth Weight and Its Validity. Indian J Community Med. 2019;44(2):97-101.
Kramer MS. Determinants of low birth weight: methodological assessment and meta-analysis. Bull World Health Organ. 1987;65(5):663-737.
Patel A, Prakash AA, Das PK, Gupta S, Pusdekar YV, Hibberd PL. Maternal anemia and underweight as determinants of pregnancy outcomes: cohort study in eastern rural Maharashtra, India. BMJ Open. 2018;8(8):e021623.
Wani RT. Socioeconomic status scales-modified Kuppuswamy and Udai Pareekh's scale updated for 2019. J Family Med Prim Care. 2019;8(6):1846-9.
WHO. Preterm, 2020. Available at: https://www.who.int/newsroom/factsheets/detail/preterm-birth. Accessed on 07 January 2020.
ACOG. Committee opinion on Definition of term pregnancy, 2020. Available at: https://www.acog.org//media/CommitteeOpinions/CommitteeonObstetricPractice/co579.pdf?dmc=1&ts=20200108T0948587742. Accessed on 08 January 2020.
Kumar M, Verma R, Khanna P, Bhalla K, Kumar R, Dhaka R, et al. Prevalence and associate factors of low birth weight in North Indian babies: a rural based study. Int J Community Med Public Health 2017;4:3212-7.
Pal A, Manna S, Das B. The risk of low birth weight and associated factors in West Bengal, India: a community based cross-sectional study. Egypt Pediatric Association Gaz. 2020;68:27.
Geetha E. Prevalence of Low Birth Weight And Its Determinants In An Urban Area Of Kancheepuram District, Tamil Nadu. Annals of RSCB. 2021;25(1):2889-901.
Bhue PK, Acharya HP, Pradhan SK, Biswal P, Swain AP, Satapathy DM. Sociodemographic factors associated with low birth weight in a tertiary care hospital of Odisha. Int J Community Med Public Health 2018;5:1797-802.
Agarwal A, Goel K, Kumar V, Goel P, Garg M, et al. Maternal Risk Factors Associated with Low Birth Weight Neonates in a Tertiary Care Hospital, Northern India. J Comm Med Health Edu. 2012;2:9.
Lee AC, Katz J, Blencowe H, Cousens S, Kozuki N, Vogel JP, et al. National and regional estimates of term and preterm babies born small for gestational age in 138 low-income and middle-income countries in 2010. Lancet Glob Health. 2013;1(1):e26-36.
UNICEF. 1 in 7 babies worldwide born with a low birthweight - The Lancet Global Health, UNICEF, WHO, 2022. Available at: https://www.unicef. releases/globalhealtunicef-who. Accessed on 13 June 2022.
Hamilton ER, Choi KH. The mixed effects of migration: community-level migration and birthweight in Mexico. Soc Sci Med. 2015;132:278-86.
Urquia ML, Glazier RH, Blondel B, Zeitlin J, Gissler M, Macfarlane A, et al. International migration and adverse birth outcomes: role of ethnicity, region of origin and destination. J Epidemiol Community Health. 2010;64(3):243-51.
Mekie M, Taklual W. Magnitude of low birth weight and maternal risk factors among women who delivered in Debre Tabor Hospital, Amhara Region, Ethiopia: a facility based cross-sectional study. Ital J Pediatr. 2019;45(1):86.
Brown JS, Adera T, Masho SW. Previous abortion and the risk of low birth weight and preterm births. J Epidemiol Community Health. 2008;62(1):16-22.
Rahman LA, Hairi NN, Salleh N. Association between pregnancy induced hypertension and low birth weight; a population based case-control study. Asia Pac J Public Health. 2008;20(2):152-8.
Getaneh T, Negesse A, Dessie G, Desta M. The impact of pregnancy induced hypertension on low birth weight in Ethiopia: systematic review and meta-analysis. Ital J Pediatr. 2020;46(1):174.
Silveira LRPD, Schmidt MI, Reichelt AAJ, Drehmer M. Obesity, gestational weight gain, and birth weight in women with gestational diabetes: the LINDA-Brasil (2014-2017) and the EBDG (1991-1995) studies. J Pediatr (Rio J). 2021;97(2):167-76.
Inamdar AS, Croucher RE, Chokhandre MK, Mashyakhy MH, Marinho VC. Maternal Smokeless Tobacco Use in Pregnancy and Adverse Health Outcomes in Newborns: A Systematic Review. Nicotine Tob Res. 2015;17(9):1058-66.
Gupta PC, Subramoney S. Smokeless tobacco use, birth weight, and gestational age: population based, prospective cohort study of 1217 women in Mumbai, India. BMJ. 2004;328(7455):1538.
Centers for Disease Control and Prevention (US); National Center for Chronic Disease Prevention and Health Promotion (US); Office on Smoking and Health (US). How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta, GA: Centers for Disease Control and Prevention; 2010.