National, regional, and worldwide estimates of low birthweight in 2015, with trends from 2000: a systematic analysis

Abstract

Summary Background Low birthweight (LBW) of less than 2500 g is an important marker of maternal and fetal health, predicting mortality, stunting, and adult-onset chronic conditions. Global nutrition targets set at the World Health Assembly in 2012 include an ambitious 30% reduction in LBW prevalence between 2012 and 2025. Estimates to track progress towards this target are lacking; with this analysis, we aim to assist in setting a baseline against which to assess progress towards the achievement of the World Health Assembly targets. Methods We sought to identify all available LBW input data for livebirths for the years 2000–16. We considered population-based national or nationally representative datasets for inclusion if they contained information on birthweight or LBW prevalence for livebirths. A new method for survey adjustment was developed and used. For 57 countries with higher quality time-series data, we smoothed country-reported trends in birthweight data by use of B-spline regression. For all other countries, we estimated LBW prevalence and trends by use of a restricted maximum likelihood approach with country-level random effects. Uncertainty ranges were obtained through bootstrapping. Results were summed at the regional and worldwide level. Findings We collated 1447 country-years of birthweight data (281 million births) for 148 countries of 195 UN member states (47 countries had no data meeting inclusion criteria). The estimated worldwide LBW prevalence in 2015 was 14·6% (uncertainty range [UR] 12·4–17·1) compared with 17·5% (14·1–21·3) in 2000 (average annual reduction rate [AARR] 1·23%). In 2015, an estimated 20·5 million (UR 17·4–24·0 million) livebirths were LBW, 91% from low-and-middle income countries, mainly southern Asia (48%) and sub-Saharan Africa (24%). Interpretation Although these estimates suggest some progress in reducing LBW between 2000 and 2015, achieving the 2·74% AARR required between 2012 and 2025 to meet the global nutrition target will require more than doubling progress, involving both improved measurement and programme investments to address the causes of LBW throughout the lifecycle. Funding Bill & Melinda Gates Foundation, The Children's Investment Fund Foundation, United Nations Children's Fund (UNICEF), and WHO.

Foetal and childhood exposure to famine and the risks of cardiometabolic conditions in adulthood: A systematic review and meta‐analysis of observational studies

“…Indeed, epidemiological evidence has linked low birth weight, marker indicative of foetal undernutrition, to susceptibility to type 2 diabetes mellitus (T2DM), metabolic syndrome, hypertension, and coronary heart disease later in life. In addition to maternal and foetal nutritional status, low birthweight could also be an indicator of other prenatal factors, such as maternal age, obstetric complications, chronic maternal conditions, maternal body composition, smoking, pollution, and drug use . Famine periods can be seen as natural experiments that can provide unique insights into the influence of early‐life undernutrition on the development of cardiometabolic conditions during adulthood that go beyond early body size.…”

Spatial distribution and factors associated with low birth weight in Ethiopia using data from Ethiopian demographic and health survey 2016: spatial and multilevel analysis

“…Among these nearly half (48%) of LBW, births occurred in southern Asia. In sub-Saharan Africa, the number of LBW live births was estimated to have increased from 4·4 million in 2000 to 5·0 million in 2015 (11).…”

Benefits of supplementation with multiple micronutrients in pregnancy

“…Inadequate maternal nutrition can result in infants having low birth weight (LBW, defined as birth weight of <2500 g), which is caused by preterm birth, fetal malnutrition, or both together. It is estimated that in 2015, 14.6% of births globally were LBW totaling 20.5 million births, mainly in South Asia and sub‐Saharan Africa . Babies with LBW, both those who are preterm or have fetal malnutrition, assessed as being born small for gestational age (SGA), as well as babies who are SGA and not LBW, have an elevated risk of death in infancy .…”

“…It is estimated that in 2015, 14.6% of births globally were LBW totaling 20.5 million births, mainly in South Asia and sub-Saharan Africa. 1 Babies with LBW, both those who are preterm or have fetal malnutrition, assessed as being born small for gestational age (SGA), as well as babies who are SGA and not LBW, have an elevated risk of death in infancy. 2 In addition, these babies have an elevated risk of stunting of linear growth and development in childhood and of adultonset chronic diseases.…”