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Cited by 1,242Global Maternal and Child HealthMaternal and Neonatal HealthcareBirth, Development, and Health

National, regional, and worldwide estimates of low birthweight in 2015, with trends from 2000: a systematic analysis

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Blencowe, Hannah, Krasevec, Julia, de Onis, Mercedes, Black, Robert E, An, Xiaoyi, Stevens, Gretchen A, Borghi, Elaine, Hayashi, Chika +6 more·2019·The Lancet Global Health
DOI 10.1016/s2214-109x(18)30565-5PMC PMC6560046
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Abstract

BACKGROUND: Low birthweight (LBW) of less than 2500 g is an important marker of maternal and fetal health, predicting mortality, stunting, and adult-onset chronic conditions. Global nutrition targets set at the World Health Assembly in 2012 include an ambitious 30% reduction in LBW prevalence between 2012 and 2025. Estimates to track progress towards this target are lacking; with this analysis, we aim to assist in setting a baseline against which to assess progress towards the achievement of the World Health Assembly targets. METHODS: We sought to identify all available LBW input data for livebirths for the years 2000-16. We considered population-based national or nationally representative datasets for inclusion if they contained information on birthweight or LBW prevalence for livebirths. A new method for survey adjustment was developed and used. For 57 countries with higher quality time-series data, we smoothed country-reported trends in birthweight data by use of B-spline regression. For all other countries, we estimated LBW prevalence and trends by use of a restricted maximum likelihood approach with country-level random effects. Uncertainty ranges were obtained through bootstrapping. Results were summed at the regional and worldwide level. FINDINGS: We collated 1447 country-years of birthweight data (281 million births) for 148 countries of 195 UN member states (47 countries had no data meeting inclusion criteria). The estimated worldwide LBW prevalence in 2015 was 14·6% (uncertainty range [UR] 12·4-17·1) compared with 17·5% (14·1-21·3) in 2000 (average annual reduction rate [AARR] 1·23%). In 2015, an estimated 20·5 million (UR 17·4-24·0 million) livebirths were LBW, 91% from low-and-middle income countries, mainly southern Asia (48%) and sub-Saharan Africa (24%). INTERPRETATION: Although these estimates suggest some progress in reducing LBW between 2000 and 2015, achieving the 2·74% AARR required between 2012 and 2025 to meet the global nutrition target will require more than doubling progress, involving both improved measurement and programme investments to address the causes of LBW throughout the lifecycle. FUNDING: Bill & Melinda Gates Foundation, The Children's Investment Fund Foundation, United Nations Children's Fund (UNICEF), and WHO.

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  • 91% of LBW infants are born in low- and middle-income countries and the majority are moderately LBW (1500-<2500g).

    “Although 91% of LBW infants are born in low- and middle-income countries (LMIC) and the majority are moderately LBW (MLBW) (1500-<2500g) [4–6]; research is predominantly from high-income countries and focuses on very LBW (<1500g) or preterm infants [7].”

    From Facility-based care for moderately low birthweight infants in India, Malawi, and Tanzania (2023) · cites this paper as [4]

    The Introduction reports that 91% of low-birthweight livebirths in 2015 were in low- and middle-income countries. The passages found do not report what proportion weighed 1500–<2500 g, so they do not establish that the majority were moderately low birthweight. Page numbers were not available in our copy. (LLM, conf=0.86)

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Authors
Blencowe, H., Krasevec, J., de Onis, M., Black, R. E., An, X., Stevens, G. A., Borghi, E., Hayashi, C., Estevez, D., Cegolon, L., Shiekh, S., Ponce Hardy, V., Lawn, J. E., & Cousens, S.
Affiliations
  • London School of Hygiene & Tropical Medicine (GB)
  • United Nations Children's Fund (US)
  • Johns Hopkins University (US)
  • World Health Organization (CH)
  • IRCCS Materno Infantile Burlo Garofolo (IT)
Corresponding author
Blencowe, Hannah
ORCID
Venue
The Lancet Global Health
Publisher
Elsevier BV
Published
2019-07
Volume
7
Issue
7
Pages
e849-e860
ISSN
2214-109X (ISSN-L)
DOI
10.1016/s2214-109x(18)30565-5
PMC
PMC6560046
OpenAlex
W2945316679
Cited by
1,242
References
4
Citations by year
2026: 106 · 2025: 122 · 2024: 178 · 2023: 214 · 2022: 155 · 2021: 220 · 2020: 204 · 2019: 16
FWCI
154.67
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet Global Health (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • ArTS Archivio della ricerca di Trieste (University of Trieste https://www.units.it/) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Bill and Melinda Gates Foundation
  • Johns Hopkins Bloomberg School of Public Health
  • Children's Investment Fund Foundation
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
Keywords
low birth weight, global estimates, birth weight trends, low- and middle-income countries, maternal and child health, restricted maximum likelihood, B-spline regression, sub-Saharan Africa, South Asia, stunting, global burden of disease, neonatal mortality
MeSH terms
Health Surveys, Humans, Infant, Low Birth Weight, Nutrition Disorders, Regression Analysis, Global Health, Prevalence, Likelihood Functions, Databases, Factual

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