Abstract
BackgroundLow birth weight (LBW) newborns present different health outcomes when classified in different birth weight strata. This study evaluated the relationship of birth weight with Infant mortality (IM) through the influence of biological, social, and health care factors in a time series.MethodsRetrospective cohort study with data collected from Information Systems (Live Births and Mortality). The mortality trends were performed for each birth weight stratum: extremely low, < 1000 g; very low, 1000–1499 g; low, 1500–2499 g; insufficient, 2500–2999 g; adequate, 3000–3900 g; and macrosomia, > 4000 g. Chi-square tests analyzed IM rates. Sequential Poisson regression analyzed the impact of the determinant factors.ResultsA total of 277,982 newborns were included in the study and 2088 died before their first year. There was a tendency for a decrease in mortality in all strata of weight. With the exception of macrosomics, all other strata had a higher risk for IM when compared with adequate birth weight. Extremely LBW newborns presented higher risk for mortality when born in a public hospital. A higher percentage of infant deaths were associated with lower maternal age and lower schooling for all strata. Prenatal care with less than three visits demonstrated a risk for IM in low, insufficient, and adequate birth weight strata. The cesarean section was a protective factor for IM in Extremely and Very LBW strata and it was a risk factor in adequate birth weight stratum.ConclusionsLBW had a greater association with IM, especially those children of younger mothers and those born in public hospitals.
Highlights
Low birth weight (LBW) newborns present different health outcomes when classified in different birth weight strata
Newborns are classified as “macrosomic,” a term used for newborns weighing more than 4000 g; “adequate birth weight” (ABW), which refers to the birth weight of 3000–3999 g; “inadequate or insufficient birth weight” (IBW), indicating the range between 2500 and 2999 g; and “low birth weight” (LBW), if the weight is less than 2500 g
Birth weight was categorized into strata, based on the World HealthOrganization (WHO) definitions with the following denominations: extremely low birth weight (ELBW), 500–999 g; very low birth weight (VLBW), 1000–1499 g; low birth weight (LBW), 1500–2499 g; insufficient birth weight (IBW), 2500–2999 g; adequate weight (ABW), 3000–3999 g; and macrosomic (MACR), 4000 g or more [1]
Summary
Low birth weight (LBW) newborns present different health outcomes when classified in different birth weight strata. Organization (WHO) [1] defines birth weight as the first measurement obtained from the newborn and that defines the classification of weight strata. According to this measure, newborns are classified as “macrosomic,” a term used for newborns weighing more than 4000 g; “adequate birth weight” (ABW), which refers to the birth weight of 3000–3999 g; “inadequate or insufficient birth weight” (IBW), indicating the range between 2500 and 2999 g; and “low birth weight” (LBW), if the weight is less than 2500 g. Besides the gestational age and sex of the newborn, has a close relationship with infant mortality and its components (neonatal mortality—NM and postnatal mortality—PNM). The lower the birth weight and the gestational age, the greater the chance of death in the first year of life [2]
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