Abstract
ObjectiveTo investigate the effect of birth weight on infant mortality, illness and care seeking in rural Ghana.MethodsUsing randomized controlled trial data, we compared infants weighing 2.00–2.49, 1.50–1.99 and < 1.50 kg with non-low-birth-weight infants. We generated adjusted mortality hazard ratios (aHR), adjusted illness rate ratios (aRR) and adjusted odds ratios (aOR) for health-facility admissions and absence of care seeking for four time periods: infancy, the neonatal period, early infancy and late infancy – represented by ages of 0–364, 0–27, 28–182 and 183–364 days, respectively.FindingsAmong 22 906 infants, compared with non-low-birth-weight infants: (i) infants weighing 2.00–2.49, 1.50–1.99 and < 1.50 kg were about two (aHR: 2.13; 95% confidence interval, CI: 1.76–2.59), eight (aHR: 8.21; 95% CI: 6.26–10.76) and 25 (aHR: 25.38; 95% CI: 18.36–35.10) times more likely to die in infancy, respectively; (ii) those born weighing < 1.50 kg were about 48 (aHR: 48.45; 95% CI: 32.81–71.55) and eight (aHR: 8.42; 95% CI: 3.09–22.92) times more likely to die in the neonatal period and late infancy, respectively; (iii) those born weighing 1.50–1.99 kg (aRR: 1.57; 95% CI: 1.27–1.95) or < 1.50 kg (aRR: 1.58; 95% CI: 1.13–2.21) had higher neonatal illness rates; and (iv) for those born weighing 1.50–1.99 kg, care was less likely to be sought in the neonatal period (aOR: 3.30; 95% CI: 1.98–5.48) and early infancy (aOR : 1.74; 95% CI: 1.26–2.39).ConclusionFor low-birth-weight infants in Ghana, strategies to minimize mortality and improve care seeking are needed.
Highlights
14% of infants in low-income countries weigh less than 2.5 kg at birth – many are born preterm.[1]
Our secondary objectives were: (i) to assess, among sick infants, the association between birth weight and care seeking and health-facility admissions; (ii) to examine how the effects of birth weight on infant illness and mortality varied between the neonatal period, early infancy and late infancy: and (iii) to investigate whether any effect of birth weight on mortality varied by distance to the nearest health facility and/or socioeconomic status
Low-birthweight infants – especially those born weighing less than 1.50 kg – have substantively higher mortality rates
Summary
14% of infants in low-income countries weigh less than 2.5 kg at birth – many are born preterm.[1]. We used data from a neonatal vitamin A supplementation (Neovita) trial to investigate birth weight as a risk factor for illness and mortality in infancy. Our primary objective was to determine the extent to which low-birth-weight infants were at increased risk of mortality and illness in the first year of life. Our secondary objectives were: (i) to assess, among sick infants, the association between birth weight and care seeking and health-facility admissions; (ii) to examine how the effects of birth weight on infant illness and mortality varied between the neonatal period, early infancy and late infancy: and (iii) to investigate whether any effect of birth weight on mortality varied by distance to the nearest health facility and/or socioeconomic status
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