The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA and the AMA suggest that you consult your physician. This page may be reproduced noncommercially by physicians and other health care professionals to share with patients. Any other reproduction is subject to AMA approval. To purchase bulk reprints, call 718/946-7424. remature or preterm infants (infants who are born before the 37 week of pregnancy) and lowbirth-weight infants (infants born at a lower than normal weight—less than 5 pounds, 8 ounces) are at higher risk for a number of medical complications than infants carried to full term and born at a normal weight. One way to reduce the chances of having a baby who may be born preterm or at a lower than normal weight is to take good care of yourself during your pregnancy. Proper prenatal care, which includes regularly scheduled visits to your doctor and proper nutrition, will give your baby a better chance for a healthy start to life. An article in the October 25, 2000, issue of JAMA discusses the effectiveness of a program that provides comprehensive follow-up care (more extensive than routine follow-up care) to high-risk infants. The infants were considered at high risk because they had a very low weight at birth (less than 3 pounds, 5 ounces) and needed a mechanical ventilator within 48 hours after their birth. The authors found that the group receiving comprehensive follow-up care had fewer lifethreatening illnesses, fewer hospital admissions, fewer intensive care admissions, and fewer days in the intensive care unit than the group receiving routine follow-up care.

High-Risk Infants

Background: Low birth weight (LBW) has been defined as a birth weight of <2.5 kilogram regardless of gestational age. In India, every 3rd born child is of LBW. LBW is associated with increased neonatal mortality and morbidity, compromised growth and cognitive development.Methods: This is a retrospective cohort study using previously collected data from January 2015 to December 2015.Results: Out of 1238 live births, 485 (39.17%) were LBW. 456(94.01%) were LBW weighing >1500 grams (LBW), 22(4.53%) were VLBW, and 07(1.44%) were ELBW. 361(74.43%) were LBW2 (birth weight ≥2000 - <2500 grams), 95(19.58%) were LBW1 (birth weight ≥1500 - <2000 grams). 289(59.58%) of LBW neonates were full term. SNCU admission is significantly higher in LBW neonates (25.8% vs 9.61%). Morbidities were higher in LBW neonates compared to normal birth weight neonates. Difference was more significant in incidence of sepsis (3.72% vs 0.83%), RDS (2.19% vs 0%), TTN (5.48% vs 2.36%), hypoglycemia (1.31% vs 0%), feed intolerance (1.09% vs 0%) and risk of major congenital malformation (1.97% vs 0.27%). Need for respiratory support was 4.82% in LBW vs 2.36% in normal birth weight neonates. Morbidities were significantly higher in VLBW and ELBW neonates. Immediate poor outcome was in 3.92% in LBW neonates, while it was 0.56% in normal weight neonates. Poor immediate outcome was 1.11% in LBW2, 2.10% in LBW1, 10% in VLBW1, 41.66% IN VLBW2, and 100% in ELBW.Conclusions: LBW neonates are at higher risk of morbidities and mortalities. The major determinant for mortality in LBW babies is the birth weight. The best option to prevent LBW is by improving maternal health. Improvement of perinatal and neonatal services   in government sector and public private partnership model of free neonatal care can help to achieve the INAP goal of NMR <10 by 2030. 

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Morbidity profile and immediate outcome of low birth weight neonates in a rural tertiary care hospital of Gujarat, India

Pregnancy is a critical period for shaping the health of both mother and her baby. Domestic violence during pregnancy is documented as a significant public health issue linked with adverse health outcomes for the newborn, such as low birth weight and preterm birth. The prevalence of violence experienced by pregnant women ranges from 0.9 to 20.1% in different societies. Violence during pregnancy accounts for approximately 15% of all gender-based violence cases in Nepal. The estimated incidence of low birth weight is 16% globally, 19% in the least developed and developing countries, and 7% in developed countries. The prevalence of low birth weight, mainly an outcome of maternal undernutrition, is relatively high in Nepal, ranging from 14 to 43%, and it is a major public health concern. Birth weight is a major predictor of infant growth and survival, and it is linked with early mortality and morbidity. It is documented that women who experienced any type of abuse—physical, sexual, or emotional—during pregnancy are more prone to give birth to a baby with lower birth weight than non-abused women. Domestic violence during pregnancy interferes with the nutritional status of women, leading to suboptimal baby weight gain. The adverse consequences of violence during pregnancy on birth outcomes are well documented.

Domestic Violence During Pregnancy and Its Effects on Birth Weight: Perspective from Nepal

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Clinical Profile of Low Birth Weight Neonates Admitted in NICU: A Hospital Based Study

Low birth weight (LBW) remains an important cause of newborn morbidity and mortality. A hospital based prospective and descriptive study was conducted at Paediatric wards, Nursery, Neonatal intensive unit (NICU) and Post natal ward during period of June to October 2010 to note the clinico-epidemiological profile of Low Birth Weight (LBW) newborns. Incidence of the LBW babies in our hospital was 14.45%; more than four fifth (82.2%) baby's mothers were primigravida. Eighty two percent mothers had unbooked pregnancies. Twenty and half percent LBW babies were twins. The mean duration of hospital stay of the subject was 7.4 (± 5.5) days. The mean birth weight of LBW babies was 1648 (± 344) grams. Clinical sepsis, non physiological jaundice and hypoglycaemia were the three most common complications of LBW babies. Antibiotics, oxygen and phototherapy were the three commonest modes of therapy. Majority of children (82.0%) improved and were discharged. Birth weight and gestational age were significantly different between survivors and babies who expired. Primigravida and lesser antenatal visits were important risk factors for Low birth weight babies. Birth weight, gestational age, apnoea and mechanical ventilation were the predictors of outcome.

Niraula

Papers

Clinico-epidemiological study of low birth weight newborns in the Eastern part of Nepal