Determinants of very low birth weight in India: The National Family Health Survey - 4
Liss Scaria1, Biju Soman1, Babu George2
1AMCHSS, Sree Chitra Thirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, 695011, India.
Insights
Maternal factors like anemia and lack of antenatal care increase very low birth weight (VLBW) risk in India. Socioeconomic status and maternal education are linked to low birth weight (LBW) in disadvantaged communities.
Area of Science:
- Public Health
- Neonatal Medicine
- Epidemiology
Background:
- Low birth weight (LBW) and very low birth weight (VLBW) are critical indicators of neonatal health, associated with increased risks of complications and long-term developmental issues.
- Identifying the determinants of VLBW and LBW in India is crucial for targeted public health interventions.
Purpose of the Study:
- To analyze the socio-demographic and maternal health determinants of very low birth weight (VLBW) in India.
- To compare these determinants with those associated with low birth weight (LBW) using National Family Health Survey-4 data.
Main Methods:
- Utilized data from 147,762 infant-mother pairs from the National Family Health Survey-4 (NFHS-4).
- Employed multiple logistic regression models to identify independent predictors for VLBW (birth weight <1500g) and LBW (birth weight 1500-2499g).
Main Results:
- VLBW affected 1.2% and LBW 15.8% of infants. Key VLBW predictors included female sex, young maternal age (13-19 years), maternal anemia, inadequate antenatal care, short maternal height (<150cm), and multiple pregnancies.
- LBW determinants, in addition to VLBW factors, included lower maternal education levels, belonging to scheduled tribes, and being from the poorest wealth quintiles.
Conclusions:
- Improving antenatal care access, maternal health, and nutritional status are vital for reducing VLBW incidence.
- Further research into the social determinants of LBW is necessary to address its high prevalence among disadvantaged populations in India.
Abstract:
Background Low birth weight (LBW) is susceptible to neonatal complications, chronic medical conditions, and neurodevelopmental disabilities. We aim to describe the determinants of very low birth weight (VLBW) in India and compare it with the determinants of LBW based on the National Family Health Survey - 4 (NHFS-4) Methods Data from the NFHS-4 on birthweight and other socio-demographic characteristics for the youngest child born in the family during the five years preceding the survey were used. Data of 147,762 infant-mother pairs were included. Multiple logistic regression models were employed to delineate the independent predictors of VLBW (birth weight<1500 g) or LBW (birth weight: 1500-2499 g). Results Of the 147,762 children included in the study, VLBW and LBW were observed in 1.2% and 15.8% of children, respectively. The odds of VLBW were higher in female children (aOR: 1.36, 95% CI: 1.15-1.60), among mothers aged 13-19 years (aOR: 1.58, 95% CI: 1.22-2.07), mothers with severe or moderate anaemia (aOR: 1.61, 95% CI: 1.34-1.94), mothers without recommended antenatal care (aOR: 1.47, 95% CI: 1.31-1.90), maternal height less than 150 cm (aOR: 1.54, 95% CI: 1.29-1.85) and among mothers with multiple pregnancy (aOR: 21.34, 95% CI: 14.70-30.96) in comparison to their corresponding counterparts. In addition to the variables associated with VLBW, educational status of mothers (no education; aOR: 1.08, 95% CI: 1.02-1.15 and primary education; aOR: 1.16, 95% CI: 1.08-1.25), caste of the children (scheduled tribe; aOR: 1.13, 95% CI: 1.03-1.24), and wealthiness of the family (poorest wealth quintiles; aOR: 1.11, 95% CI: 1.03-1.19) were associated with LBW. Conclusions Interventions targeting improvements in antenatal care access, maternal health, and nutritional status may reduce the number of VLBW infants. Social determinants of LBW require further detailed study to understand the high propensity of low birth-weight phenotypes in the disadvantaged communities in India.
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