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The relative contribution of prematurity and fetal growth retardation to low birth weight in developing and developed
Insights
Low birth weight (LBW) causes differ globally. In developing nations, LBW is linked to intrauterine growth retardation, while developed countries see LBW primarily from preterm births. Environmental factors likely explain these trends.
Area of Science:
- Neonatal Health
- Global Public Health
- Perinatal Epidemiology
Background:
- Low birth weight (LBW) is a critical indicator of neonatal health outcomes.
- LBW encompasses both preterm infants (less than 37 weeks' gestation) and those with intrauterine growth retardation (IUGR).
- Understanding the distinct contributors to LBW is crucial for targeted public health interventions.
Purpose of the Study:
- To investigate the relative contributions of prematurity and IUGR-LBW to overall LBW incidence across diverse global regions.
- To identify differing patterns of LBW etiology between developed and developing countries.
- To explore potential correlations between LBW components and socioeconomic factors.
Main Methods:
- Comparative analysis of LBW infant data (birth weight, gestational age) from 11 developed regions and 25 developing areas.
- Statistical correlation analysis to assess relationships between total LBW incidence, prematurity, and IUGR-LBW rates.
- Examination of incidence rates in relation to predefined thresholds (e.g., 10% LBW incidence).
Main Results:
- Developing countries showed a strong positive correlation between total LBW and IUGR-LBW (r=0.95), with prematurity not significantly associated.
- Developed countries exhibited opposite trends, where LBW increase was not primarily driven by IUGR-LBW.
- When LBW incidence exceeds 10%, it is mainly due to IUGR-LBW; below 10%, prematurity is the dominant LBW component.
Conclusions:
- The etiological drivers of low birth weight significantly differ between developed and developing regions.
- In developing nations, increased LBW is largely attributable to intrauterine growth retardation, potentially linked to environmental and socioeconomic factors.
- In developed nations, prematurity plays a more prominent role in LBW, especially when overall incidence is lower.
Abstract:
The relative proportions of prematurity (less than or equal to 2,500 gm less than 37 weeks' gestation) and intrauterine growth retardation-low birth weight (IUGR-LBW) (less than or equal to 2,500 gm, greater than or equal 37 weeks' gestation) among total LBW infants were studied in 11 regions in the developed world and 25 developing areas where known gestational ages and birth weights were reported. In developing countries a straight correlation was observed between total LBW incidence and IUGR-LBW incidence rates (r = 0.95; b = 0.98; p less than 0.001); in contrast, prematurity was not significantly associated with total LBW incidence. Data from the developed population showed results exactly opposite to those described for developing areas. Therefore, when the incidence of LBW is higher than 10%, it is almost exclusively due to the increase in IUGR-LBW infants, while prematurity remains almost unchanged (5% to 7%). When LBW incidence is less than 10% (mean=6%), preterm infants represent the major component of LBW. Environmental factors susceptible to changing socioeconomic conditions may be responsible for the observed differences.