Too Many Babies Born Too Small, WHO Says


The World Health Organisation (WHO) on Thursday alerted that too many babies were born too small as over 20 million babies were born with a low birthweight (less than 2500g; 5.5 pounds) in 2015.

This is about one in seven of all births worldwide.

These findings are documented in a new research paper developed by experts from the WHO, UNICEF and the London School of Hygiene and Tropical Medicine, published in The Lancet Global health on Thursday.


The study, the first-ever estimates documenting this major health challenge, noted that birth weight is an important gauge of maternal and foetal health as well as an important determinant of perinatal, neonatal and post neonatal outcomes.

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It said that approximately 80 per cent of newborns (2.5 million newborns) who die every year are Low Birth Weight (LBW), under 2500g, because they were either born preterm or small for gestational age or both.

On the implications of this outcome, it said: “Birth weight matters because of its strong association with neonatal health and survival, child growth, and Non-Communicable Diseases (NCDs) risk in adulthood.

“Girls whose height and weight remain low into motherhood risk giving birth to another generation of nutritionally disadvantaged children,’’ it said.

Also, the low birth weight babies who survive have a greater risk of stunting, and developmental and physical ill health later in life, including diabetes and cardiovascular disease.

However, “ A birth weight of less than 2500g, the WHO definition of LBW is an imperfect measure.

“This is as it conflates babies who are small because they are born preterm, those who reach full term but have had their growth restricted in utero, and babies who are both preterm and growth restricted. But although gestational age is even more predictive of risk than birth weight, the latter is much easier to measure’’.

Dr Mercedes de Onis, Department of Nutrition at WHO, who is a Co-author said: “Low birth weight is a complex clinical entity composed of intrauterine growth restriction and preterm birth.

“This is why reducing low birth weight requires an understanding of the underlying causes in a given country.

“For example, in Southern Asia a large proportion of low birth weight babies are born at term but with intrauterine growth restriction, which is associated with maternal undernutrition, including maternal stunting.

“Conversely, preterm birth is the major contributor to low birth weight in settings with many adolescent pregnancies, high prevalence of infection, or where pregnancy is associated with high levels of fertility treatment and caesarean sections (like in USA and Brazil).

“Understanding and tackling these underlying causes in high-burden countries should be a priority.’’

To make improvements, the study suggested that reducing the incidence of low birth weight requires a comprehensive global strategy, which must include improving maternal nutritional status.

It must also incorporate treating pregnancy-associated conditions such as pre-eclampsia (hypertensive disease of pregnancy); and providing adequate maternal care, perinatal clinical services and social support.

According to it, affordable, accessible and appropriate health-care is critical for preventing and treating low birth weight; pregnancy care should be fully integrated with appropriate care for low birth weight babies.

Therefore, in terms of closing progress gaps and data gaps it said: “First, it is important for governments to examine the causes of LBW, given that they differ by region.

“High-income countries will have a predominance of preterm births among their LBW figures, and these might be driven by maternal obesity, smoking, non-medically-indicated caesarean sections, or older maternal age.

“Social determinants of health and education are therefore likely to be key focus areas in these regions.

“In Africa, preterm birth is also the main driver, with a mix of adolescent pregnancy, maternal infections, and possibly genetic influences.

“In South Asia, however, about half of LBW is related to foetal growth restriction driven by undernutrition among girls, as well as maternal obesity, NCDs, anaemia, and exposure to tobacco smoke and indoor air pollution.’’

The second recommendation by the study is for survival gaps to be closed in by low-income countries as high-income and middle-income countries have made rapid progress in the care of LBW babies, reducing both deaths and disability.

“Thirdly, health professionals and advocacy groups should ignite demand for better birth weight data.

“With more births taking place in facilities, and given the minimal cost implications, weighing every baby at birth and having the data recorded in routine health information systems is not a monumental task.

“Women and families should be empowered to demand a birth weight for their baby and an explanation of the possible cause and implications, should it be below 2500g,’’ the study advised. (NAN)