Abstract
Estimates of trends in birth weight may be useful in evaluating population health. We aimed to determine whether temporal changes in birth weight have occurred amongst 2.3 million neonates born in Guangzhou, China, during 2001–2015 and investigate the socioeconomic determinants of any changes. Trends in mean birth weight and annualized changes with the associated 95% confidence intervals (CIs) in the incidence of small for gestational age (SGA) and large for gestational age (LGA), defined as birth weight <10th or >90th centile respectively for gestational age and sex, were examined using linear and Poisson regression models. We found that mean birth weight declined by 1.07 grams/year from 2001 to 2015. After adjustment for gestational length, the decline in birth weight was attenuated (0.37 grams/year). The incidence of both SGA and LGA significantly decreased during the study period (annual decrease of 1.6% [95% CI, 1.5% to 1.7%] for SGA, 1.6% [95% CI, 1.5% to 1.8%] for LGA). We found a narrowing of disparities in SGA and LGA incidence across different maternal educational levels and residence location. Our results demonstrate that there has been an increase in the proportion of neonates born in the healthy birth weight range in Guangzhou.
Highlights
China has made remarkable progress in improving maternal and child health and reducing maternal mortality, from 64 in 1996 to 22 per 100,000 in 2014 and infant mortality, from 36 in 1996 to 9 per 1000 live births in 20141
Previous studies have shown that small for gestational age (SGA) babies had increased risk of respiratory complications, hypoglycemia and necrotizing enterocolitis during perinatal period, neurological impairment in childhood and cardiovascular disease and type 2 diabetes mellitus in adulthood[5], while large for gestational age (LGA) is associated with increased risk of birth trauma, cesarean section and postpartum hemorrhage as well as obesity, metabolic syndrome and type 2 diabetes mellitus in adulthood[3, 6]
In one of the most developed cities in China, we found mean birth weight declined by 1.07 grams/year from 2001 to 2015
Summary
China has made remarkable progress in improving maternal and child health and reducing maternal mortality, from 64 in 1996 to 22 per 100,000 in 2014 and infant mortality, from 36 in 1996 to 9 per 1000 live births in 20141. Over the past two decades, a comprehensive healthcare system has been implemented, providing near universal health coverage to all citizens The success of this system is reflected in the decline in maternal mortality rate, which at 7 per 100,000 in 2014, is far lower than the national average[2]. SGA or LGA have been defined as weight at birth below the 10th or above the 90th centiles when compared to a birth weight reference[7] These references were based on the distribution of the weights of all babies born in a specific population, rather than describing healthy or physiological growth[7]. We previously demonstrated in Guangzhou that babies born in 2012, when compared to 20028, had lower mean birth weight with reduced incidence of SGA and LGA. We aimed to examine trends in mean birth weight and incidence of SGA and LGA among 2.3 million singleton births during 2001–2015 and whether these trends reflected changes in maternal characteristics including indicators of changing socio-economic status
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