Patterns Of Low Birth Weight Research Articles

Morbidity and Treatment-Seeking Pattern among Low Birth Weight Infants: A Community-based Cohort Study from Puducherry.

To compare the morbidity and treatment-seeking pattern of low birth weight (LBW) and normal birth weight (NBW) infants during the first six months. A prospective cohort study was conducted in the service areas of eight urban primary health centers of Puducherry from October 2019 to July 2021. Details of LBW and sex-matched NBW infants were obtained from the birth registers of selected PHCs. Data were collected using a structured interview schedule on completion of the first, third, and sixth months at their homes. For comparison, Mid-p exact test was used for incidence rates, t-test/Mann-Whitney for continuous variables and the Chi-square/Fisher's exact test for the categorical variables. Ninety-four pairs of LBWS and NBW infants were recruited. The incidence of morbidity during the first six months among LBW and NBW infants was 37.5 and 33.3 episodes per 100 child months, respectively (P value 0.118). Though the incidence of all-cause morbidity was similar, skin infections were significantly higher among LBW (3.10 vs 1.21 per 100 child months, P = 0.04). The incidence of all-cause morbidity was high in LBW infants with poor weight gain. Birth weight was associated with all-cause morbidity during the first three months. However, this association varied in age points and infants' weight gain.

Patterns of low birth weight in greater Mexico City: A Bayesian spatio-temporal analysis

There is strong evidence that low birth weight (LBW) has a negative impact on infants' health. Children with LBW are more vulnerable to having disabilities. There are many studies on LBW, but only a small proportion has examined local geographical patterns in LBW and its determinants. LBW is a particular health concern in Mexico. The study aims to: (i) model the change in the LBW risk at the municipality level in Greater Mexico City, identifying municipalities with highest and lowest LBW risk; and (ii) explore the role of some socioeconomic and demographic risk factors in explaining LBW variations. We propose a Bayesian spatio-temporal analysis to control for space-time patterning of the data and for maternal age and prenatal care, both found to be important LBW determinants. Most of the high-risk municipalities are in the south-west and west of Greater Mexico City; and although for many of these municipalities the trend is stable, some present an increasing LBW risk over time. The results also identify those with medium-risk and with an increasing trend. These findings can support decision-makers in geographical targeting efforts to address spatial health inequalities, they may also facilitate a more proactive and cost-efficient approach to reduce LBW risk.

Early origins of socioeconomic inequalities in chronic inflammation: Evaluating the contributions of low birth weight and short breastfeeding.

The United States is characterized by persistent and widening social inequities in a wide range of adult health outcomes. A life course approach challenges us to consider if, and how, these inequities trace back to early life conditions, and chronic inflammation represents a potentially important mechanism through which early environments may have lasting effects on health in adulthood. Low birth weight (LBW) and shorter durations of breastfeeding both predict increased inflammation in adulthood, which is associated with increased risk for cardiovascular disease, metabolic syndrome, and all-cause mortality. Using data from a large representative sample of young adults in the US (National Longitudinal Study of Adolescent to Adult Health (Add Health)), we document the socioeconomic status (SES) gradient in chronic inflammation, as indicated by concentrations of C-reactive protein (CRP). Using a nested set of structural equation models and marginal standardization techniques, we investigate the extent to which this gradient is explained by patterns of LBW and breastfeeding in infancy. Findings reveal a particularly important role for breastfeeding duration: Based on model predictive margins, increasing breastfeeding duration to three or more months corresponds to a flattening of the SES gradient by 80%, and 83% when LBW is eliminated. This study expands current understandings of the consequential role of developmental environments for population health and for addressing health inequities in future generations.

Neonatal, infant, and childhood growth following metformin versus insulin treatment for gestational diabetes: A systematic review and meta-analysis

Background Metformin is increasingly offered as an acceptable and economic alternative to insulin for treatment of gestational diabetes mellitus (GDM) in many countries. However, the impact of maternal metformin treatment on the trajectory of fetal, infant, and childhood growth is unknown. Methods and findings PubMed, Ovid Embase, Medline, Web of Science, ClinicalTrials.gov, and the Cochrane database were systematically searched (from database inception to 26 February 2019). Outcomes of GDM-affected pregnancies randomised to treatment with metformin versus insulin were included (randomised controlled trials and prospective randomised controlled studies) from cohorts including European, American, Asian, Australian, and African women. Studies including pregnant women with pre-existing diabetes or non-diabetic women were excluded, as were trials comparing metformin treatment with oral glucose-lowering agents other than insulin. Two reviewers independently assessed articles for eligibility and risk of bias, and conflicts were resolved by a third reviewer. Outcome measures were parameters of fetal, infant, and childhood growth, including weight, height, BMI, and body composition. In total, 28 studies (n = 3,976 participants) met eligibility criteria and were included in the meta-analysis. No studies reported fetal growth parameters; 19 studies (n = 3,723 neonates) reported measures of neonatal growth. Neonates born to metformin-treated mothers had lower birth weights (mean difference −107.7 g, 95% CI −182.3 to −32.7, I2 = 83%, p = 0.005) and lower ponderal indices (mean difference −0.13 kg/m3, 95% CI −0.26 to 0.00, I2 = 0%, p = 0.04) than neonates of insulin-treated mothers. The odds of macrosomia (odds ratio [OR] 0.59, 95% CI 0.46 to 0.77, p < 0.001) and large for gestational age (OR 0.78, 95% CI 0.62 to 0.99, p = 0.04) were lower following maternal treatment with metformin compared to insulin. There was no difference in neonatal height or incidence of small for gestational age between groups. Two studies (n = 411 infants) reported measures of infant growth (18–24 months of age). In contrast to the neonatal phase, metformin-exposed infants were significantly heavier than those in the insulin-exposed group (mean difference 440 g, 95% CI 50 to 830, I2 = 4%, p = 0.03). Three studies (n = 520 children) reported mid-childhood growth parameters (5–9 years). In mid-childhood, BMI was significantly higher (mean difference 0.78 kg/m2, 95% CI 0.23 to 1.33, I2 = 7%, p = 0.005) following metformin exposure than following insulin exposure, although the difference in absolute weights between the groups was not significantly different (p = 0.09). Limited evidence (1 study with data treated as 2 cohorts) suggested that adiposity indices (abdominal [p = 0.02] and visceral [p = 0.03] fat volumes) may be higher in children born to metformin-treated compared to insulin-treated mothers. Study limitations include heterogeneity in metformin dosing, heterogeneity in diagnostic criteria for GDM, and the scarcity of reporting of childhood outcomes. Conclusions Following intrauterine exposure to metformin for treatment of maternal GDM, neonates are significantly smaller than neonates whose mothers were treated with insulin during pregnancy. Despite lower average birth weight, metformin-exposed children appear to experience accelerated postnatal growth, resulting in heavier infants and higher BMI by mid-childhood compared to children whose mothers were treated with insulin. Such patterns of low birth weight and postnatal catch-up growth have been reported to be associated with adverse long-term cardio-metabolic outcomes. This suggests a need for further studies examining longitudinal perinatal and childhood outcomes following intrauterine metformin exposure. This review protocol was registered with PROSPERO under registration number CRD42018117503.

Catch-up Growth of Low Birth Weight Infants: A Study Among the Infants Born in the Backward Areas of Howrah

<i>Background:</i> Babies having low birth weight are comparatively more susceptible to infection and are unable to grow to their full potential of physical and mental development. This often lead to high infant morbidity and mortality. Hence, it becomes important to identify the low birth weight infants and offer them adequate care. This study was carried in the District of Howrah. This study was conductedmong 732 LBW survivors and 314 NBW controls from birth to nine months of age. Their growth trends (weight, length, head and chest circumferences) were followed and compared. <i>Objectives:</i> The physical growth pattern of low birth weight and normal birth weight babies under study were compared, relative influence of certain variables on the catch up growth of LBW infants were to be determined and the catch up growth in terms of increments in Height, Length, Weight, Head and Chest Circumferences were analyzed. <i>Results:</i> The catch-up growth among the LBW infants in almost all the anthropometric measurements were of lower values as compared to their NBW counterparts. However the increments in growth were seen to be higher in different months of age for different measurements. The catch-up growth was contributed by gestational age, birth weight, birth length, birth head and chest circumferences. Regarding catch-up growth, length, head circumference and chest circumference were the parameters to start up early as in the 1^st month in case of chest circumference followed by length and head circumference in the 2^nd month of age. Weight was quite late as much as 4^th month. LBW babies were much closer to their NBW counterparts in the 6^th month in all the parameters under this study.

Asian/White differences in the relationship of maternal age to low birth weight: Analysis of the PRAMS Survey, 2004–2011

This study aimed to examine (a) maternal age patterns of low birth weight (LBW; birth weight < 2,500 g) for non-Hispanic (N-H) Asian and N-H White women, and (b) Asian–White gaps in LBW risk by maternal age and their mechanisms. Logistic regression analyses were performed on the Pregnancy Risk Assessment Monitoring System data of N-H Asian and N-H White women who delivered their first singleton birth without birth defects in 13 states between 2004 and 2011. Age- and race/ethnicity-specific LBW risk was estimated, unadjusted and adjusted for maternal risk factors (e.g., marital status, maternal education, pregnancy intention, stress, maternal morbidities, smoking, and prenatal care) and their interactions with maternal age or race/ethnicity. The interaction between maternal age and race/ethnicity was statistically significant (p < .0001) with covariates and interactions held constant. N-H Asian women showed a reverse W-shaped maternal-age pattern of LBW with the highest risk in their late 30s (OR = 1.56, 95% CI [1.26, 1.94]) whereas N-H White women experienced a maternal age-related increase in LBW. N-H Asian women were more likely to deliver LBW infant than their N-H White counterparts between their late 20s and late 30s, with the greatest racial/ethnic gap in their late 20s (OR = 4.19, 95% CI [3.33, 5.29]). Preventive strategies should be developed targeting N-H Asian women aged 25 to 39 years to reduce the Asian–White disparities in LBW. Considering the known maternal risk factors failed to explain such disparities, future research is warranted to explore other risk factors unique to this at-risk population.

The maternal age related patterns of infant low birth weight rates among non-Latino Whites and African-Americans: the effect of maternal birth weight and neighborhood income.

To determine the age related patterns of low birth weight (<2,500g, LBW) and small for gestational age (weight <10th percentile for gestational age, SGA) among former LBW and non-LBW White and African-American mothers. We performed stratified analyses on an Illinois transgenerational dataset of non-Latina White (n=31,616) and African-American (n=38,964) infants born in Chicago or Suburban Cook County (1989-1991) and their mothers (1956-1976) with appended US census income information. In both races, LBW and SGA rates were unrelated to age among former LBW 14-35year old mothers. LBW and SGA rates decreased with advancing age only among former non-LBW White mothers (p<0.0001). Former non-LBW 30-35year old White women (n=11,096) had an infant LBW rate of only 4.3% compared to 6.8% for their teen counterparts (n=1,383), RR (95% CI)=0.6 (0.5, 0.8). In contrast, a weathering pattern of rising LBW and SGA rates with advancing age occurred only among former non-LBW African-American mothers (p<0.0001). Former non-LBW 30-35year old African-American mothers (N=4,807) had a LBW rate of 15.0% compared to 10.8% for their teen counterparts (N=8,627), RR (95% CI)=1.4 (1.3, 1.5). The same trend occurred among the subgroup of African-American mothers with an early-life and adulthood residence in impoverished neighborhoods. Maternal low birth weight does not contribute to the disparate maternal age related patterns of adverse birth outcome between the races. Moreover, it is not associated with a weathering a pattern of rising rates of LBW with advancing age among African-American mothers with a lifelong residence in impoverished neighborhoods.

Evaluation of growth and development pattern in normal, low and very low birth weight neonates at 18 months of age.

Introduction:Growth and development monitoring could lead to general judgment about children's health. With advances in NICUs establishment, the survival rate of very low birth weight (VLBW) neonates has increased in many countries including Iran. Because of the lack of studies about growth and development pattern of low birth weight (LBW) and VLBW neonates in Iran, the present study aimed to compare growth and development of normal, low and very low birth weight neonates at 18 months of age.Materials and Methods:In a cross- sectional descriptive study, 214 children with age 18 months were enrolled (90 LBW, 90 LBW and 34 VLBW) and their growth and development were assessed. Data gathering tool was a researcher made questionnaire including anthropometrics measures and developmental key points. Data analyzed by descriptive (mean and SD) and inferential (ANOVA) tests using SPSS version 15.Results:There were significant differences in the mean of anthropometric indexes between three groups. Majority of subjects in three groups had normal weight growth trend. Mean scores of gross motor and fine motor development indexes had significant association with birth weight. Meanwhile, there was no significant association between mean scores of social/cognitive and also language developmental aspects and birth weight.Conclusion:Findings revealed that in LBW and VLBW children, growth indexes at the age of 18 months are so far from those of NBW neonates. Further nationwide prospective studies, with a longer period of time is needed to estimate when Iranian LBW children reach at the levels of NBW ones.

Pattern of Maternal Complications and Low Birth Weight: Associated Risk Factors among Highly Endogamous Women.

Objective. The objective of the study was to examine the pattern of low birth weight LBW, maternal complications, and its related factors among Arab women in Qatar. Design. This is a prospective hospital-based study. Setting. The study was carried out in Women's Hospital, Doha. Subjects and Methods. Pregnant women in their third trimester were identified in the log book of Women's Hospital and recruited into the study during first week of January 2010 to July 2011. Only 1674 (out of 2238) Arab women (74.7%) consented to participate in this study. Data on clinical and biochemistry parameters were retrieved from medical records. Follow-up data on neonatal outcome was obtained from labor room register. Results. The incidence of LBW (<2500 g) was 6.7% among Arab women during 2010 in Qatar. Distribution of gestational diabetes mellitus (GDM), antepartum hemorrhage (APH), maternal anemia, premature rupture of membrane (PROM), maternal occupation, parity, sheesha smoking, and parental consanguinity were significantly different (P < 0.05) between mothers of LBW and normal birth weight NBW (≥2500 g) babies. Multivariable logistic regression analysis revealed that previous LBW, consanguinity, parity, smoking shesha, GDM, APH, anemia, PROM, maternal occupation, and housing condition were significantly associated with LBW adjusting for gestational age. Conclusion. Maternal complications such as GDM, APH, anemia, PROM, and smoking shesha during pregnancy are significantly increasing the risk of LBW outcome. Screening and prompt treatment for maternal complications and health education for smoking cessation during routine antenatal visits will help in substantial reduction of LBW outcome.

Exploring Weathering: the Relation of Age to Low Birth Weight Among First Generation and Established United States-Born Mexican–American Women

To determine the age-related patterns of low birth weight, preterm birth, and intrauterine growth retardation among first generation and established US-born Mexican-American mothers. We performed stratified analyses on an Illinois transgenerational dataset of Mexican-American infants (1989-1991) and their mothers (1956-1976) with appended U.S. census income information. In Cook County, Illinois established (second or higher generation) US-born Mexican-American women (N = 2,006) had a low birth weight (<2,500 g) rate of 6.2% compared to 4.8% for first generation US-born Mexican-American women (N = 1,450), RR = 1.3 (1.0-1.6). In both subgroups, low birth weight, preterm, and intrauterine growth retarded components rates did not increase with advancing maternal age. First generation 30-35 year old US-born Mexican-American women (N = 159) had a low birth weight rate of 3.1% compared to 4.2% for their teen counterparts (N = 386), RR = 0.8 (0.3-2.0). Established 30-35 year old US-born Mexican-American women (N = 330) had a low birth weight rate of 4.9% compared to 7.4% for their teen counterparts (N = 459), RR = 0.7 (0.4-1.2). There was no evidence of weathering among US-born Mexican-American mothers with a lifelong residence in lower income neighborhoods, with a general downward trend in low birth weight rates with increasing age until age 30-35. Rates of low birth weight, preterm birth, and intrauterine growth retardation do not increase with advancing age among first generation and established US-born 15-35 year old Mexican-American women. This trend persists among both generations of women with a lifelong residence in lower income neighborhoods.

Intermitent presumptive treatment of malaria to prevent low birth weight in newborns in a cohort of pregnant women from a malaria endemic area

To determine and describe the patterns of low birth weight in newborns of a cohort of mothers given intermittent presumptive treatment (IPT) for malaria prevention in a malaria endemic area of Kenya. A longitudinal prospective cohort study. Got Agulu Health Centre in Usigu Division, Bondo District, Nyanza Province. Pregnant women of all parities attending antenatal care services. Only women who gave informed consent for themselves and their newborns after birth were eligible to participate in the study. Parity was highly predictive of birth weight in the study subjects. Primigravidae and secondigravidae had a significantly lower mean birth weight (2952g) than women of higher gravidity (3214g) p-value <0.0001. Regardless of IPT administration, women who became positive for malaria infection at any point during pregnancy delivered 73.7% of the LBW infants. There was no significant difference in mean birth weights between primigravidae and multigravidae who had parasitaemia at baseline and at delivery (means 2906g and 3062g respectively, p=0.11). However, there was a significant difference between the parasitaemia negative primigravidae and multigravidae at baseline and at delivery (means 2952g and 3204g respectively, p=0.006). Infection with helminths did not have an effect on birth weight. Overall, low birth weight was observed in 9% of the newborns and was most commonly found in primigravidae and secondigravidae (14.8% and 13.1% respectively). Although many factors have been known to play a role in the causation of low birth weight (LBW <2500g), parity status and malaria infection in malaria endemic areas still play a major role regardless of IPT administration.

Changes in the spatial pattern of low birth weight in a southern California county: the role of individual and neighborhood level factors

Individual-level maternal risk factors have been able to explain only a small proportion of low birth weight (LBW) births in the US to date and neighborhood-level factors have not been recognized as important predictors of reproductive outcomes. At the US/Mexico border, tremendous demographic changes have taken place between 1980 and 1990. Whether high population growth, economic pressures, and community instability have affected reproductive health in this region is not known. We used spatial epidemiologic methods to investigate the importance of changes in neighborhood and individual-level risk factors in predicting changes in two measures of adverse reproductive health: term and preterm LBW. Using approximately 16,000 births in 1980 and 24,000 births in 1990, we produced a continuous surface of LBW change ( Z scores for difference in proportions) for southern San Diego County, CA, and identified statistically significant “hot spots” of elevated risk. Using a geographic information system, data from the 1980 and 1990 US Census were smoothed to link neighborhood-level variables with individual-level data from the 1980 and 1990 California birth certificates. Multivariate regression models were developed to identify individual- and neighborhood-level variables of 1980–1990 changes which were predictive of Z scores of LBW change. Results of conditional autoregressive models were used to assess effects of spatial autocorrelation. The continuous surface of LBW identified areas with statistically significant increases (17 areas for term LBW and 14 areas for preterm LBW). While individual- and neighborhood-level variables explained about an equal amount of variance in term LBW, only neighborhood-level variables were significant predictors of preterm LBW. While changes in maternal race/ethnicity composition and a measure of stability were related to term LBW, measures of affluence were related to preterm LBW. This study highlights the importance of socioeconomic and demographic changes in a woman's neighborhood on reproductive health.

Growth pattern of low birth weight babies in the first year of life.

The growth pattern of low birth weight (LBW) babies was studied prospectively in our hospital from September 1995 to august 1996. Every baby <1.5 kg birth weight (B.Wt), every 2nd baby between 1.5 to 2 kg, every 6th baby between 2 to 2.5 kg and 120 term appropriate for gestation (AGA) babies ( as controls) were included in the study. Severe birth asphyxia, multiple gestation, major malformations or severe birth trauma formed exclusion criteria. Weight, length and head circumference were measured in all babies at birth and at 2 monthly intervals till 1 year of age. All babies completing 1 year follow-up were included for final analysis. Growth distance curves were constructed separately for each parameter for the six categories based on birth weight (Groups I-VI) and on gestational age (Divisions A-F). Comparison was made between the LBW babies and the controls for growth pattern among the babies who completed 1 year follow up (total of 220 babies). The growth pattern for weight and length showed good catch up growth in babies >1.25 kg B.Wt. and >30 weeks gestation, reaching almost the same level as controls by 1 year of age. Babies with B.Wt <1.25 kg and <30 weeks gestation showed late and poor catch up growth, with considerable lag persisting at 1 year of age. Head circumference increased rapidly in all babies, with maximal growth rate initially followed by a steady decline. All babies showed catch up growth, although those <1.25 kg and <30 weeks gestation still lagged behind even at 1 year. It was seen that the smallest and least mature babies had late and poor catch up growth. Recognition of the factors influencing catch up growth and adequate measures to improve growth (like attention to feeding practices) may improve the overall outcome of these babies.

Effect of gestational age misclassification on the pattern of low birthweight in Aborigines

Are most births of Aboriginal babies with low birthweight preterm or full term? There is no consensus because of the difficulty in obtaining valid measurements of gestational age. In Queensland, between 1988 and 1992, there were 519 births of Aboriginal babies with low birthweight in excess of the number expected if aborigines had the same risk of low birthweight as whites. Most of these were preterm (males 76 per cent, females 65 per cent). Sensitivity analyses were used to investigate whether this result was robust to gestational age misclassification. Implausibly large misclassification proportions were required to make preterm low birthweight an insignificant contributor to the low birthweight excess in Aborigines. Therefore, efforts to reduce the number of preterm births should be given high priority. Unfortunately, significant reductions in the number of preterm births will not be achieved by reducing the prevalence of traditional risk factors for full-term low birthweight (for example, maternal smoking, teenage pregnancy). More work is needed to identify potentially modifiable risk factors for preterm birth.

SPASTIC QUADRIPLEGIA IN WESTERN AUSTRALIA. II: PEDIGRESS AND FAMILY PATTERNS OF BIRTHWEIGHT AND GESTATIONAL AGE

Pedigrees were obtained for all 74 index children and for three controls for each case. Recurrence of similar spastic quadriplegic phenotypes occurred in two families. A karyotype of 46,XY,dup(13)(q14q34), resulting in a partial trisomy 13, was found in another case. Rates of miscarriages and stillbirths plus neonatal deaths were higher among siblings of index cases than in siblings of birth-year controls, but were similar to siblings of birthweight controls. Average birthweights and gestational ages were lower in index cases than in birth-year controls. Children with spastic quadriplegia had significantly lower birthweights and gestational ages than their siblings. However, they also tended to come from families with a pattern of low birthweight and preterm delivery. The differences between families remained after controlling for factors affecting birthweight.

Geographic patterns of low birth weight in Hawaii

This study examines areal variations in low birth weight, using the census tract as the unit of analysis. Reports from the 1980 U.S. census were used to develop summary indicators of environmental and socio-economic conditions, including poverty, employment, education and crowding, for 155 census tracts in the state of Hawaii. Maternal socio-demographic, prenatal care utilization, and medical risk indicators and low birth weight percentages for resident, single live births were extracted from the Hawaii 1979–1987 vital record live birth files and aggregated by census tract. Multiple regression analysis was used to develop a model that predicted 61% of the variation among census tracts in the percentage of low birth weight. Patterns of low birth weight were primarily associated with ethnic patterns of maternal residence and single marital status. There was no association between inadequate prenatal care and low birth weight at the census tract level.

The changing pattern of low birth weight in the United States--1970 to 1980

The changing pattern of low birth weight in the United States--1970 to 1980

The Changing Pattern of Low Birth Weight in the United States 1970 to 1980

Analysis of US Natality Statistics using a bivariate (birth weight-gestational age) approach shows that trends among term-low-birth-weight infants (less than or equal to 2,500 g; greater than or equal to 37 weeks, term low birth weight) and preterm-low-birth-weight infants (less than or equal to 2,500 g; less than 37 weeks, preterm low birth weight) have different patterns over time and by race. Between 1970 and 1980 the incidence of preterm low birth weight for all races declined 7.1%, while the term-low-birth-weight incidence declined almost three times as much (20.9%). The incidence of preterm low birth weight among white infants, during the same period, declined 9.0% with the black preterm-low-birth-weight rate declining by 5.8%. The term-low-birth-weight incidence, however, was 24.6% lower among whites and 14.9% lower among black term-low-birth-weight infants for the same period. The reduction in the overall low-birth-weight incidence for both populations is principally caused by reduction in the incidence of term-low-birth-weight infants. Term- and preterm-low-birth-weight infants reflect different etiologic insults and require different intervention strategies for prevention.

Effect of gestational age misclassification on the pattern of low birthweight in Aborigines

Effect of gestational age misclassification on the pattern of low birthweight in Aborigines

Patterns of low birth weight in West Jerusalem with special reference to maternal origin.

The importance of low birth weight for survival and development and its relationships to gestation period, parity, maternal age, race, social class, nutrition, height and physique, smoking, and many other factors are the subject of continuing research, the goal being prevention of death and damage in early life (Butler and Alberman, 1969; Shapiro, Schlesinger, and Nesbitt, 1968; Abramovicz and Kass, 1966; Rantakallio, 1969).