Regional trends in birth weight in low- and middle-income countries 2013–2018

Abstract

Background Birth weight (BW) is a strong predictor of neonatal outcomes. The purpose of this study was to compare BWs between global regions (south Asia, sub-Saharan Africa, Central America) prospectively and to determine if trends exist in BW over time using the population-based maternal and newborn registry (MNHR) of the Global Network for Women'sand Children's Health Research (Global Network). Methods The MNHR is a prospective observational population-based registryof six research sites participating in the Global Network (2013–2018), within five low- and middle-income countries (Kenya, Zambia, India, Pakistan, and Guatemala) in threeglobal regions (sub-Saharan Af rica, south Asia, Central America). The birth weights were obtained for all infants born during the study period. This was done either by abstracting from the infants' health facility records or from direct measurement by the registry staff for infants born at home. After controlling for demographic characteristics, mixed-effect regression models were utilized to examine regional differences in birth weights over time. Results The overall BW meanswere higher for the African sites (Zambia and Kenya), 3186 g (SD 463 g) in 2013 and 3149 g (SD 449 g) in 2018, ascompared to Asian sites (Belagavi and Nagpur, India and Pakistan), 2717 g (SD450 g) in 2013 and 2713 g (SD 452 g) in 2018. The Central American site (Guatemala) had a mean BW intermediate between the African and south Asian sites, 2928 g (SD 452) in 2013, and 2874 g (SD 448) in 2018. The low birth weight (LBW) incidence was highest in the south Asian sites (India and Pakistan) and lowest in the African sites (Kenya and Zambia). The size of regional differences varied somewhat over time with slight decreases in the gap in birth weights between the African and Asian sites and slight increases in the gap between the African and Central American sites. Conclusions Overall, BWmeans by global region did not change significantly over the 5-year study period. From 2013 to 2018, infants enrolled at the African sites demonstrated the highest BW means overall across the entire study period, particularly as compared to Asian sites. The incidence of LBW was highest in the Asian sites (India and Pakistan) compared to the African and Central American sites. Trial registration The study is registered at clinicaltrials.gov. ClinicalTrial.gov Trial Registration: NCT01073475.

Population History and Genome Wide Association Studies of Birth Weight in a Native High Altitude Ladakhi Population

“…We showed that the Ladakhi are more closely related to Tibeto-Burman speaking populations than to the Indo-Aryan groups of South Asia, providing clear evidence that Tibeto-Burman expansion occurred in North East India crossing the Himalayan range [34]. Individuals in Leh are born at a significantly higher birth weight than expected, based on existing literature for average birth weights in India at 2.8-3kg [36,37] and seen from previous [20] studies.…”

2.5 Million Annual Deaths—Are Neonates in Low- and Middle-Income Countries Too Small to Be Seen? A Bottom-Up Overview on Neonatal Morbi-Mortality

“…LBW neonates are at higher risk of mortality, stunting, poor neurodevelopment, and adult-onset diseases [ 20 , 87 , 91 ]. More than 20 million neonates are born LBW every year, and about 70% of global neonatal mortality is within this weight group, again, mainly in LMIC [ 96 , 97 ]. In 2015, three-quarters of the world’s LBW neonates were born in South Asia (47%) and sub-Saharan Africa (25%) [ 94 ].…”

Mixed-methods, descriptive and observational cohort study examining feeding and growth patterns among low birthweight infants in India, Malawi and Tanzania: the LIFE study protocol

“…The LIFE study will fill critical data gaps in the care and nutrition of LBW infants in LMICs; although limited, most of the existing research in this area is concentrated in high-income countries 18. Overall, evidence is lacking on feeding, care and health of LBW infants born with birth weights of 1.5 to <2.5 kg; however, these moderately LBW infants represent the majority (>90%) of global LBW births compared with very LBW infants (<1.5 kg) 2 17 18 44–46. We will aim to establish the foundational knowledge required to design, test and implement the most effective and feasible infant feeding strategies to prevent and address growth faltering among LBW infants in low-resource settings.…”