Very low and extremely low birth weight

Abstract

DOI: 10.1016/j.rcpe.2016.02.002

Background

Birthweight is one of the biggest predictors of infant mortality, and is associated with high levels of morbidity. In developing countries, infants with very low birth weight (less than 1,500g) have 200 times more risk of mortality compared with babies of the appropriate weight. Very low and extremely low birthweight (less than 1,000g) leaves sequelae in children, and causes disruptions in their families.

Objectives

A narrative review is presented on very low and extremely low birthweight, taking into account topics such as definitions, associated factors, morbidity, mortality, and prevention of these outcomes.

Methodology

An exhaustive search was conducted in literature databases of Medline, Lilacs, and Google Scholar with MeSH terms: “infant”, “very low birthweight”; “extremely low birthweight”; “risk factors”; “morbidity”; “mortality”, and “prevention”; and in Spanish: “recién nacido de muy bajo peso”, “recién nacido con peso al nacer extremadamente bajo”, “factores de riesgo”, “morbilidad”, “mortalidad” y “prevención”. Articles published in the last ten years up to 31 January 2016, were included

Results

Although infants with very low birth weight account for 1 to 1.5% of total births, they contribute significantly to neonatal mortality (50% to 70%) and child mortality (25% to 40%) in the Southern Cone in South America. The associated factors found depend on where they were studied. In developed countries, associations were found with: hypertensive vascular disease, history of previous abortion, and previous stillbirth. In developing countries it was found to be significantly associated with lack of prenatal care, with an OR of 3.8 (3.0-5.0); pre-eclampsia, OR 7.3 (5.1 to 10.6); bleeding, OR 7.5 (5.0 to 11.1), and preterm labour, with an OR of 15.9 (12.1 to 21.0). The complications that arise can be short or long-term: hypothermia, hypoglycaemia, asphyxia, respiratory distress, fluid and electrolyte imbalances, hyperbilirubinaemia, infection, neurological and sensory problems, and even cardiovascular disease in adulthood.

Conclusions

More preventive strategies are required in Colombia to avoid such outcomes. This is observed in the DANE statistics that show that the proportion of low birthweight has not decreased since 2008, and is currently at 9.1%.