Abstract
ObjectiveUsing data compiled by the SALURBAL project (Urban Health in Latin America; ‘Salud Urbana en América Latina’) we quantified variability in low birth weight (LBW) across cities in Latin America, and evaluated the associations of socio-economic characteristics at various levels (maternal, sub-city and city) with the prevalence of LBW.MethodsThe sample included 8 countries, 360 cities, 1321 administrative areas within cities (sub-city units) and birth registers of more than 4.5 million births for the year 2014. We linked maternal education from birth registers to data on socioeconomic characteristics of sub-cities and cities using the closest available national population census in each country. We applied linear and Poisson random-intercept multilevel models for aggregated data.ResultsThe median prevalence of city LBW by country ranged from a high of 13% in Guatemala to a low of 5% in Peru (median across all cities was 7.8%). Most of the LBW variability across sub-cities was between countries, but there were also significant proportions between cities within a country, and within cities. Low maternal education was associated with higher prevalence of LBW (Prevalence rate ratios (PRR) for less than primary vs. completed secondary or more 1.12 95% CI 1.10, 1.13) in the fully adjusted model. In contrast, higher sub-city education and a better city social environment index were independently associated with higher LBW prevalence after adjustment for maternal education and age, city population size and city gross domestic product (PRR 1.04 95% CI 1.03, 1.04 per SD higher sub-city education and PRR 1.02 95% CI 1.00, 1.04 per SD higher SEI). Larger city size was associated with a higher prevalence of LBW (PRR 1.06; 95% CI 1.01, 1.12).ConclusionOur findings highlight the presence of heterogeneity in the distribution of LBW and the importance of maternal education, local and broader social environments in shaping LBW in urban settings of Latin America. Implementing context-sensitive interventions guided to improve women’s education is recommended to tackle LBW in the region.
Highlights
Low birth weight (LBW) newborns (< 2500 g at birth) have higher risks of adverse health outcomes during childhood and adult life [1, 2], including increased risk of non-communicable disease as well as neurological and cognitive disorders [3,4,5]
Previous studies suggested that mothers with low educational level [15] and those living in more disadvantaged neighborhoods are more likely to give birth to a LBW newborn [16]
Data sources and sample Data was compiled by the SALURBAL project, an interdisciplinary, multinational and collaborative initiative focused on characterizing the drivers of urban health and urban health inequalities across cities of the region [34]
Summary
Low birth weight (LBW) newborns (< 2500 g at birth) have higher risks of adverse health outcomes during childhood and adult life [1, 2], including increased risk of non-communicable disease as well as neurological and cognitive disorders [3,4,5]. Around 15– 20% (20 million infants, approximately) of all births are LBW, and almost 95% of them are born in low- and middle-income countries (LMICs) [6]. In Latin America LBW prevalence is low (around 8.7 in year 2015) compared to other developing regions [7], its rate of reduction has stagnated over the last 2 decades. Previous studies suggested that mothers with low educational level [15] and those living in more disadvantaged neighborhoods are more likely to give birth to a LBW newborn [16]. Other work has found that within a country LBW rates are higher in areas with higher per capita income compared to those with lower per capita income [17]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
