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Definition:
Low birth weight has been defined by the
WHO as weight at birth of less than 2,500
grams (5.5 pounds).
This is based on epidemiological
observations that infants weighing less than
2,500 g are approximately 20 times more
likely to die than heavier babies.
Definitions:
Very LBW is less than 1,500 g .
Extremely LBW is less than 1,000 g .
The incidence of LBW:
is defined as the percentage of live births
that weigh less than 2,500 g out of the total
of live births during the same time period.
incidence rate therefore is=
Overview:
More common in developing than developed
countries.
The goal of reducing LBW incidence by at least
one third between 2000 and 2010 is one of the
major goals in A World Fit for Children,.
Forms an important contribution to the Millennium
Development Goal (MDG) for reducing child
mortality.
Overview:
More than 20 million infants worldwide,
representing 15.5% of all births, are born
LBW, 95.6 % in developing countries.
LBW is closely associated with: foetal and
neonatal mortality and morbidity, inhibited
growth and cognitive development, and
chronic diseases later in life.
Risk factors for LBW:
Mother's Malnutrition
Heavy work load
High blood pressure
Infection and diseases
Unregulated fertility.
Causes and consequences of LBW
) Preterm babies:
There are babies born too early before 37
weeks of gestation, their intrauterine growth
may be normal, that is their, weigh, length and
development may be within normal tomtits for
the duration of gestation.
Given good neonatal care, these babies can
catch up growth and by 2 to 3 years of age will
be of normal size and performance.
Approximately 2 thirds of all babies of LBW
in developed countries are estimated to be
preterm the causation of preterm babies is
multifactoral. There include multiple births,
hard physical works hypertensive disorders
of pregnancy. But it is often preventable by
such measures as good prenatal screening
and care.
Small for dates (SFD):
These babies are result of intrauterine fetal
growth.
The factors associated with intra uterine
growth retardation are multiple and
interrelated to mother, placenta or to
foetus.
Factors affecting birth weight:
The maternal factors:
Include malnutrition.
Anaemia.
Heavy physical work-during pregnancy.
Hypertension.
Malaria.
Toxaemia.
Smoking.
The maternal factors:
:
Low economic status.
Short maternal stature.
Young age.
High parity.
Dose birth spacing.
Low education status.
Factors related to placenta:
Placental insufficiency.
Placental abnormalities.
The foetal causes:
Foetal abnormality.
Intra uterine infections.
Chromosomal abnormalities.
Multiple gestation.
SFD babies has a high risk of dying not
only during the neonatal period but during
their infancy, thus significantly raising the
rate of infant and prenatal mortality.
Most of them become victims of protein
energy mal nutrition and infection.
Importance:
LBW is one of the most serious challenges
in maternal and child health indevelped and
developing countries.
Its public health significance may be
ascribed, to numerous factors:
Ecological zone
Farm size
Use of extension services
Food prices
Population response to food shortages
Nutritional status indicators:
Phenomenon Indicator
maternal nutrition birth weight
Infant and preschool % of breastfed babies.
Child nutrition Mortality rates.
Height for age
Weight for height.
School child nutrition Height for age
Weight for height at school
admission
Clinical signs.
Assessment of nutritional status;
Clinical examination.
Anthropometry.
Biochemical evaluation.
Functional assessment.
Assessment of dietary intake.
Vital and health statistics.
Ecological studies.
Assessment of nutritional status;
Clinical examination.
Anthropometry.
Biochemical evaluation.
Functional assessment.
Assessment of dietary intake.
Vital and health statistics.
Ecological studies.
1- Clinical examination:
WHO classification of clinical signs:
1- not related to nutrition e.g alopecia
2- that need further investigation e.g corneal
vascularisation.
3- known to be of value e.g angular stomatitis
Drawbacks of clinical signs
1- malnutrition cannot be quantified.
2- many deficiencies lack clinical signs.
3- lack of specificity.
2- anthropometry
1- height
2- weight.
3- skinfold thickness.
4- arm circumference
Additional in children
5- head circumference
6- Chest circumference.
3- laboratory and biochemical
assessment:
Lab.
Hb%,stools and urine
Biochemical applied to measure:
1- nutrient concentration e.g serum iron.
2- metabolites in urine e.g urinary iodine.
3- enzymes e.g ribofavin deficiency.
Disadvantages:
Time-consuming, expensive ,cannot be applied on
large scale ,and reveal only current status.
4- Functional indicators
Structural integrity.
Host defense.
Homeostasis.
Reproduction.
Nerve function
Work capacity.
5- Assessment of dietary intake
Weighment of raw foods
Weighment of cooked foods.
Oral questionnaire method.
6- Vital statistics
Morbidity data
Mortality data
7- Assessment of ecological factors
food balance sheet.
Socioeconomic factors.
Health and educational services.
Conditioning influences.