An infant who is born with a weight of less than 2,500 grams or 2.5 kilos is considered a Low Birth Weight (LBW) Infant. As of 2015, around 14.6 % of babies born globally suffer from low birth weight. In the Philippines, the rate is 20.1 %, which is higher relative to the average global data according to the UNICEF-WHO Low birthweight estimates of 2019.

What are their health risks in future life?

In early childhood, LBW infants are more likely not able to survive in their first month of life, have stunted growth and lower IQ which may affect their school performance [2]. They also have 1.5 times risk of infectious diseases during infancy and childhood. In terms of long-term health risks, female LBW infants have 4 times greater chance of developing Hypertension in adulthood. A 2020 review and meta-analysis has shown the association of LBW with the development of Metabolic syndrome, Cardiovascular diseases and Type 2 Diabetes Mellitus in adulthood.

Why do LBW infants have greater risk of disease in later life?

There is a concept called Fetal programming where unfavorable environments such as malnutrition during pregnancy leads to permanent changes in the child’s genes that will impact their health in adulthood. For example, when mothers are underweight or not gaining enough weight during pregnancy, the developing fetus will activate their “thrifty genes” that will allow them to maximize their little nutrient supply for the development of vital organs such as the brain and heart at the expense of other organs. These genes also allow them to quickly store fat when there is nutrient excess because this is the protective mechanism of their body against starvation.

As a consequence, when LBW infants are exposed to excessive food during their childhood, they quickly store them as fat as compared to other children - making them at risk for developing childhood obesity and early Type 2 Diabetes Mellitus. These conditions together with an unhealthy lifestyle becomes their entry point for developing hypertension and other non-communicable diseases during their adulthood.

What are the factors associated with having a LBW infant?

Maternal malnutrition such as underweight mothers or inadequate weight gain during pregnancy contributes to the slow growth of the fetus leading to low birth weight. A recent study also showed that maternal anemia is a risk factor for low birth weight infants that is why iron supplementation is essential during pregnancy.

What can we do?

These are some of the evidence-based prevention and interventions that we can do to prevent having a LBW infant and to lessen future health risks of LBW infants:
● Regular prenatal check-up, micronutrient supplementation and adequate weight gain during pregnancy to ensure that the fetus is growing well.
● Exclusive breastfeeding for 0 - 6 months and continuous breastfeeding with proper complementary food from 6 months to 2 years old. Studies have shown that breastfeeding has reduced infant mortality and improved the infant’s defense against infection in their early years.
● Complete immunization from infancy to childhood. Immunization provides additional protection against infection especially for LBW infants who have an increased risk for communicable diseases.
● Prevent excessive weight gain to prevent childhood obesity through a healthy diet and regular physical activity.

/AET

References:

Philippine Statistics Authority. (n.d.). Low Birthweight. Philippine Statistics Authority. Retrieved from https://psa.gov.ph/content/low-birthweight-2

UNICEF (2019). Low Birthweight. UNICEF Data: Monitoring the situation of children and women. Retrieved from https://data.unicef.org/topic/nutrition/low-birthweight/

Anjorin, S. S., & Ojeifo, S. B. (2017). The Risk of Infectious Diseases Associated with Birth-weight: a Systematic Review and Meta-analysis. International Journal of Scientific & Engineering Research, 8(5), 1671-1679.

De Mendonça, E. L. S. S., de Lima Macêna, M., Bueno, N. B., de Oliveira, A. C. M., & Mello, C. S. (2020). Premature birth, low birth weight, small for gestational age and chronic non-communicable diseases in adult life: A systematic review with meta-analysis. Early Human Development, 105154.

Law, C. M. (2002). Significance of birth weight for the future. BMJ Journals. ADC Fetal and Neonatal Edition. Retrieved from https://fn.bmj.com/content/86/1/F7

Figueiredo, A., Gomes-Filho, I. S., Silva, R. B., Pereira, P., Mata, F., Lyrio, A. O., Souza, E. S., Cruz, S. S., & Pereira, M. G. (2018). Maternal Anemia and Low Birth Weight: A Systematic Review and Meta-Analysis. Nutrients, 10(5), 601. https://doi.org/10.3390/nu10050601