The contribution of low birth weight to infant mortality and childhood morbidity

Abstract

Low birth weight (LBW) is a major determinant of infant mortality and morbidity. In the past two decades, the infant mortality rate in the United States has declined sharply, primarily due to a decrease in neonatal mortality. This decline has been accompanied by only moderate decreases in the proportion of LBW infants. The increased survival of LBW infants, especially those with very low birth weight, has been attributed to more intensive hospital-based care, including neonatal intensive care. While the cost-effectiveness of neonatal intensive care has been demonstrated, concerns remain about the long-term costs and potential adverse effects of such care. Although LBW infants remain at increased risk of postneonatal mortality and morbidity, the magnitude of these risks is substantially smaller than that of neonatal death. The full range of morbidity experienced by infants with LBW is still being defined, and outcomes among the smallest infants (those weighing 1000 g or less) are unknown. The increased survival of LBW infants has not been associated with an increase in the number with handicapping conditions, suggesting that the gains achieved in the neonatal period have not been offset by increased morbidity later in life. However, concerns remain about the future requirements for special medical and educational services and about the stress on families of LBW infants. Continuation of the current decline in neonatal mortality and reduction of the mortality differentials between high- and low-risk groups require the identification and more effective implementation of strategies for the prevention of LBW. – AI-generated abstract