Contribution of low birth weight to childhood undernutrition in India: evidence from the national family health survey 2019–2021

Abstract

Background Infants born with low birth weight (LBW), i.e. less than 2500g, is considered an important factor of malnutrition in Asia. In India, research related to this issue is still neglected and limited. Evidence exists that a large number of child deaths occur in India due to maternal and child malnutrition-related complications. Moreover, it has been found that the cost of malnutrition in India results in a significant reduction of the country's Gross Domestic Product (GDP). Thus, in this current context, this study aims to explore the contribution of low birth weight to childhood undernutrition in India. Methods The study used data from the 5th round of the National Family Health Survey (NFHS-5), a large-scale survey conducted in India. The survey collected information from 176,843 mothers and 232,920 children. The study used the last birth information (last children born 5 years preceding the survey) due to the detailed availability of maternal care information. Univariate and bivariate analyses were conducted to determine the percentage distribution of outcome variables. Multivariate logistic regression was employed to examine the association between LBW and undernutrition (stunting, wasting, and underweight). The study also used the Fairlie decomposition analysis to estimate the contribution of LBW to undernutrition among Indian children. Results The results show that childhood undernutrition was higher in states like Uttar Pradesh, Bihar, Jharkhand, Gujarat, and Maharashtra. The results of the logistic regression analysis show that infants born with low birth weight were more likely to be stunted (OR = 1.46; 95% CI: 1.41–1.50), wasted (OR = 1.33; 95% CI: 1.27–1.37), and underweight (OR = 1.76; 95% CI: 1.70–1.82) in their childhood compared to infants born without low birth weight. The findings from the decomposition analysis explained that approximately 14.8% of the difference in stunting, 10.4% in wasting, and 9.6% in underweight among children born with low birth weight after controlling for the individuals' selected characteristics. Conclusion The findings suggest that LBW has a significant contribution to malnutrition. The study suggests that policymakers should prioritize strengthening maternal and child healthcare schemes, particularly focusing on antenatal and postnatal care, as well as kangaroo mother care at the grassroots level to reduce the burden of LBW and undernourished children.

Influence of Sociodemographic Factors on Stunting, Wasting, and Underweight Among Children Under Two Years of Age Born During the COVID-19 Pandemic in Central India: A Cross-Sectional Study

“…This result is similar to the findings of previous research [33]. In our study, wasting was significantly linked to gestational age at birth of children which resonates with published evidence that has highlighted the effect of preterm birth and low birth weight on child growth and development [21,39]. Considering the heavy burden of childhood undernutrition in India, the identification of factors contributing to its persistence is important and the findings generated by our study would enrich the evidence base and provide direction for future intervention studies.…”

“…In our study, we found that approximately 51 (34.7%) of the studied children were stunted. Our findings are in line with the NFHS-5 (2019-2021), which reports that 32.77% and 32.55% of children in MP and all over India have stunting, respectively [21]. Stunting is reported to be the result of chronic inadequate maternal and child nutrition that can occur secondary to multiple factors ranging from socioeconomic status influenced by the parent's education/occupation to the child's medical history affected by recurrent infections, hospitalizations, or chronic diseases that lead to poor intake, absorption, and utilization of foods [27].…”

“…Our findings show that 22 (14.9%) of the studied children had wasting while 42 (28.6%) were found to be underweight. Our results are lower when compared to the NFHS-5 reports of wasting and underweight for children born in MP (19.59% and 32.39%) and the Indian average of 19.18% and 30.84% [ 21 ]. Such differences at the sub-national level are expected particularly for wasting, which is an indicator of acute malnutrition owing to the multitude of differences across communities [ 30 ].…”

“…As per the National Family Health Survey 2019-2021 (NFHS-5), MP recorded a neonatal mortality rate (NMR) of 29.0, infant mortality rate (IMR) of 41.3, and under-five mortality rate (UFMR) of 49.2, much higher than the Indian averages of 24.9, 35.2 and 41.9, respectively. Similarly, the percentage of children born in MP who had stunting, wasting, and were underweight (i.e., those with weight-for-age less than two SD) was 32.77%, 19.59%, and 32.39%, respectively, higher than the Indian average of 32.55%, 19.18%, 30.84%, respectively [ 21 ]. Of the 50 districts in MP, Vidisha has poor maternal and child health indicators [ 22 ].…”

Risk factors associated with underweight in children aged one to two years: a longitudinal study

“…The association between LBW and weight gain observed in this study is consistent with the findings of the Aboagye studies in sub-Saharan Africa (OR = 1.82) [ 21 ], Arup Jana in India (OR = 1.76) [ 22 ], Khan in Pakistan (OR = 1.67) [ 13 ], and Asmare in The Gambia [ 23 ]. This association may be because LBW children are prone to infections such as diarrhea, prolonged hospitalization, inability to breastfeed, and loss of appetite, leading to poor physical growth and development [ 24 ].…”