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Show Low Birth Weight in Utah By Nan Streeter, M.S., R.N. Abstract: Although infant mortality rates have declined, low birth weight rates (birth weight less than 2500 grams or 5 1/2 pounds) have gradually increased. Utah has seen an increasing trend in low birth weight percentages from 5.4% in 1986 to 6.6% in 1997. Low birth weight is an important risk factor for infant and child morbidity and infant mortality, and is associated with increased health care costs and special educational needs. The increase in low birth weight rates has probably been a result of developments in medical technology, leading to improved survival for low birth weight infants that previously would have been classified as fetal deaths. The majority of low birth weight infants are preterm (67%). Low birth weight in Utah is associated with maternal age (younger and older mothers); racial and ethnic groups (Black and white Hispanic mothers); low household income; low educational attainment; low pre-pregnancy weight for height; multiple gestation pregnancies; short interpregnancy spacing; smoking; history of previous low birth weight infant; and lack of or inadequate prenatal care. Until an effective intervention for prevention of preterm labor is developed, a reduction in low birth weight births is unlikely. Introduction Although infant mortality rates have significantly declined in recent years, the rate of low birth weight infants has gradually increased. Advances in medical technology, both during pregnancy as well as after birth, have made significant contributions to reducing infant mortality, but with a resultant shift to live births that are low birth weight In 1989, the fetal death rate was 6.4 per 1,000 live births compared to an all time low rate of 4.9 per 1,000 live births in 1997. The decreasing fetal death rates have been associated with a concurrent increase in births of infants of 500 grams or less, increasing from a rate of 0.76 per 1,000 live births in 1989 to 1.44 per 1,000 live births in 1997 (Bureau of Vital Records, 1999a). Since low birth weight is largely due to prematurity (birth before 37 completed weeks of gestation), reduction in low birth weight births will not be realistic until effective interventions for preterm labor are developed. Low birth weight is defined as the birth of an infant weighing less than 2500 grams or 51/2 pounds. Nationally, low birth weight deliveries have increased from 6.8% of live births in 1986 to 7.5% in 1997 (National Center for Health Statistics, 1990), moving away from the national Healthy People 2000 Objective of 5%. Utah has seen a similar trend in low birth weight births, increasing from 5.4% in 1986 to 6.6% in 1997 (Bureau of Vital Records, 1998). Although the reasons for this trend are not entirely clear, it is concerning as low birth weight is an important risk factor for infant and child morbidity, including long-term disability, and infant mortality. The risk of infant mortality is directly related to birth weight and is dramatically increased for the very low birth weight infants as illustrated in Figure 1 (Bureau of Vital Records, 1999c). 250 -l 228.5 200 - ortal ? 150 - ant M (15 a. 100 - 50 - 19.9 3.4 im i iiiiiiii ii him-n <1500 grams 1500 to 2499 grams 2500 grams or > Birthweight in Grams Figure 1: Infant Mortality Rate per 1,000 Live Births by Birth Weight Categories, 1989-1997, Utah 40 |
