Taking weight at birth is very important and it dictates the physician what measurement to be taken soon after birth to reduce the morbidity and mortality of neonate.
At least 22.6% of babies are born with low birth weight (below 2.5 Kg) in Bangladesh, according to a national survey. The report of National Low Birth Weight Survey Bangladesh 2015 showed that the rate of intrauterine growth restriction (IUGR), was 72.9% because of high rate of adolescent pregnancy.
The rate of caesarean section also alarmingly rose to 35.5%, according to the survey, conducted by National Nutrition Services under the Institute of Public Health Nutrition. The major causes of low birth weight (LBW) are premature birth, poor nutritional status of mother and inadequate nutritional intake during pregnancy, and intrauterine growth restriction, according to the World Health Organisation.
Well, before discussing LBW, we need to know how many newborns are being weighed at birth in our country? Data is not available but worldwide 48% newborn are not being weighed at birth. Definitely percentage in Bangladesh will not be less then that.
Weight of the baby is related to many factors, but gestational age (duration of pregnancy) is one of the most important ones. Less duration of pregnancy results in less weight of the newborn. Maternal nutrition during pregnancy, number of pregnancy, mother's age, parity, mother's disease like hypertension, heart diseases, chronic kidney diseases etc. are important causes of LBW. A diabetic mother gives birth to a large baby. Newborn weight less then 2,500 grams means LBW, less then 1,500 grams means very LBW, less then 1,000 grams very very LBW and weight less then 750 grams means incredible LBW.
Normal duration pregnancy is 37 weeks to 42 weeks, less then 37 weeks means premature birth, and more then 42 weeks means post mature baby. Management depends on duration of pregnancy and birth weight. If duration of pregnancy is more then 34 weeks and birth weight is around 2.5 Kg, the outcome is good; but if the duration of pregnancy is less 34 weeks and weight is around 1,500 grams, the outcome is guarded. These babies need special care in special unit under experienced paediatrician or neonatologist. It is expensive as well. If LBW babies cannot suck well, they require tube feeding of expressed breast milk. Important causes of mortality of LBW newborns are sepsis, birth asphyxia, metabolic problems, neonatal jaundice etc.
So all LBW newborns should be born in hospitals where reasonable facilities and manpower are available. If we can reduce LBW, our newborn death will be reduced; on the other hand infant mortality will be reduced. Maternal education, periodic antenatal check up and social awareness are needed to reduce LBW and newborn death.
The author is a Professor of Paediatrics at Community Based Medical College, Mymensingh.