Mortality Risk among Term and Preterm Small for Gestational Age Infants

Globally, 15% of infants are low birthweight (LBW; <2,500 g) each year. Most LBW infants are either preterm (<37 weeks gestation) and/or growth restricted in utero. These etiologies of LBW have different prevalence, risk factors, health and survival consequences, and are attenuated by different interventions. Birthweight has generally been easier to measure than gestational age in low-resource settings. This is now changing rapidly with access to antenatal care and ultrasound and allows providers, researchers and public health practitioners the opportunity to identify infants born too soon or too small, and to better target interventions to reduce mortality and morbidity associated with these conditions. Understanding the mortality patterns and burden of preterm or small for gestational age (SGA) is important for designing programs to prevent these outcomes and improve survival of these infants. We present here estimates of the increased mortality risk, timing of mortality, and attributable mortality burden associated with these conditions. Such data provide estimates of the potential for proven maternal interventions to reduce SGA burden and its associated mortality, as well as identify infants who would most benefit from clinical and public health interventions to improve their survival and health.