Low birthweight as an indicator of child health in Greenland—use, knowledge and implications

Abstract

Objectives. The aim of this study was to analyse if low birthweight is a valuable indicator of child health in Greenland. Study design. A case study focusing on "low birthweight as an indicator in Greenland" with 3 units and 5 subunits of analyses. Methods. Literature reviews, interviews with health care professionals and an analysis of the National Birth Register. Results. Low birthweight was a well-known and yearly surveyed indicator, but not used by clinicians or by policymakers. Research was sparse, but the major risk factor observed was smoking. The rate of low birthweight in 1997-2005 was on average 5.0%. Of the low birthweight cases, 67.0% infants were born prematurely but only 44.8% of these births had a low birthweight. The known risk factors for a low birthweight in Greenland included abnormal delivery, low Apgar score at 5 minutes, female gender, multiple birth, being a single mother and less than complete prenatal care by a midwife. For preterm birth, associations were found with a not normal delivery, perinatal mortality, low Apgar score at 5 minutes, multiple birth, single mothers, mothers born in Greenland, young mothers, mothers living in a village and in nulliparae. Conclusions. Low birthweight is as valuable an indicator of child health at the national level in Greenland as it is in other developed countries. If interventions are to be aimed at known, quantitatively important, modifiable determinants of low birthweight, the results suggest that cigarette smoking and antenatal care are the most important to address (Int J Circumpolar Health 2007; 66(3):215-225).

Performance indicators for maternity care in a circumpolar context: a scoping review

“…Two articles were from Greenland, including a review of available child health indicators (22) and a critique on the use of low birth weight as MCH indicator in Greenland (23). Four articles were from Australia and focused specifically on maternal health indicators in the Australian Aboriginal and Torres Strait Islander populations (24–26).…”

Core Indicators of Children’s Health and Well-Being at the Municipal Level in Greenland

“…Although today, both some of the old and the new diseases seem to be more prevalent in villages and in remote areas. This pattern has been found in rates of suicides, smoking, child mortality, low birth weight, dental health, tuberculosis, and obesity (Aaen-Larsen and Bjerregaard 2003; Office of the Chief Medical Officer in Greenland 2006a;Petersen and Christensen 2006;Niclasen 2007;.…”

“…The first is whether these indicators are associated with the same risk and protective factors and can be interpreted the same way as in other developed countries. So far, low birth weight has been evaluated in an in-depth validation study as the only indicator (Niclasen 2007). The study found that the quantitatively most important risk factors were the same as in other developed countries, although special risk factors exist in the Arctic.…”

“…Low birth weight: Low birth weight is an important, globally used indicator. The overall rate of low birth weight (5.5%) is equivalent to rates in the other Nordic countries (Niclasen 2007). Tobacco exposure in utero: A very high number (57.5%) of children were exposed to smoking in utero.…”

“…The rate of recommended prenatal care is six examinations by a midwife (or nursing staff) and two by a doctor before 37 weeks of gestation. Less than the recommended care is related to preterm births and low birth weights (Niclasen 2007).…”