Socio-Biological Determinants of Low Birth Weight: A Community based study from rural field practice area of Medical College, Kolkata, West Bengal (India)

Birth weight is the single most important criteria for determining the neonatal and infant survival. Low Birth Weight is the result of complex interplay of various social and reproductive health factors. A cross-sectional community based retrospective study was carried out in rural West Bengal among 540 birth episodes. Proportion of low birth weight infants were found significantly more among mothers elderly & teenaged, less educated, addicted to tobacco, Multipara and primipara, received less antenatal care, female infants, delivered at home, short stature, anaemic and had obstetric complications. Focused attention to reduce low birth weight babies, community specific strategies such as improving awareness of the community and utilization of existing maternal health services is essential. th World Health Assembly in 1981 included LBW as one of the global indicators for monitoring health of the community. Birth weight is a reliable and sensitive indicator for predicting the immediate and long term outcome of a newborn. The low birth weight new borns are four times more likely to die from common childhood diseases in the first year of life, than their normal counterpart. The public health significance of low birth weight may be ascribed to numerous factors, its high incidence, increased risk of perinatal and infant mortality, morbidity and disabilities, its association with mental retardation, the very high cost of specialized institutional care and intensive care units, and its association with socio-economic underdevelopment. There is also emerging evidence that low birth weight neonates are more prone to diabetes mellitus, hypertension and coronary artery disease in later life. Worldwide, the magnitude of LBW problem (defined as infants weighing less than 2500 gm. at birth) varies widely from country to country, from 4.5% in most developed countries to almost 50% in some of the least developed countries. It is estimated that worldwide 15.5% of all Live births per year are Low Birth Weight and more than 95% LBW infants are born in developing countries,72% in Asia with striking regional variations - 27% in Southern Asia,6% in Eastern Asia except Thailand (36%). In India the proportion of baby weighing less than 2.5kg is higher in rural areas (28%) than in urban areas (21%). Birth weight is determined by the complex interplay of numerous factors like genetic, reproductive, obstetric, social and environmental. But the etiology of low birth weight is maximally related to maternal factors like early marriage with teenage pregnancies, frequent & too many pregnancies, maternal malnutrition, anemia and infections. Poor health and education of female children along with low status and empowerment of women in the society are the important contributory factors. The natural history of low birth weight babies usually begins with the girl"s childhood malnutrition. A girl, who is malnourished during early childhood and puberty becomes a short stature women and delivers small baby. The best opportunity of breaking this cycle of "deprivation" is improving the nutritional status of children and adolescents, with greater equity, supported by care for the mothers. In spite of huge advances in the medical science of pregnancy and delivery, the proportion of LBW births has changed little in the world during the past 30 years due to failure to tackle the root causes like too early, too close, too many pregnancies, too little food, too much work, lack of antenatal care including iron-folic acid supplementation etc; are still unsatisfactory. 1-13 Both community and institution based studies are needed to find out the lacunae of occurrence of low birth weight babies, so that effective strategies which are relevant to the local conditions can be adopted for