Determinants of Low Birth Weight

Abstract

Objective: To determine the incidence of LBW in study population, with particular reference to cause and mode of prevention thereof, in order to improve the existing practices. Study design: Prospective study. Place and duration of study: Department of Obs & Gynae Unit III, Sir Ganga Ram Hospital, Lahore from January 2002 to December, 2002. Patients and methods: All those mothers who gave birth to babies weighing less than 2.5kg during this duration were included in the study population. On admission, detailed history was taken from the patients. Detailed general physical examination, thorough systemic examination and an abdominal examination was performed in accordance with a preset format. Fetal growth was monitored by maternal weight gain and serial measurements of symphysio-fundal height. Ultrasonography was performed to rule out fetal anomalies and serial scan to monitor fetal growth. Other investigations like Blood group and Rh-factor, Blood C/E, Blood sugar level, Liver function tests, Renal function tests, Ultrasonography and Cardiotocography, were carried out to determine any contributing factor. If patient presented with preterm labor, attempts were made to tocolyse. If labor could not be stopped, the babies were delivered and handed over to peadiatrician. Elective induction of labor was performed in case of the babies with congenital anomalies incompatible with life. Labor was either induced or spontaneous, route of delivery was either vaginal or by cesarean section and was elective or emergent. Babies were examined for signs of prematurity, growth restriction or congenital anomalies. Their APGAR score and weight were recorded. The babies were handed over to peadiatrician and were subsequently followed up in the nursery. Results: Out of 3315 deliveries, 135 babies were LBW (4.08%). Major determinants of LBW were found to be Pre-term labor, PROM and IUGR. No cause for LBW was found in 8.88% of cases, however, 91% of LBW babies had verifiable causes. Other causes of LBW babies were either constitutional or intra-uterine death or congenital abnormalities. Conclusion: While yielding some interesting findings in regard to the nexus between poverty and LBW, the study clearly demonstrate the importance of high quality obstetric and peadiatric input at all stages of fetal development.