Preventing Low Birthweight
The Annie E. Casey Foundation
July 2009
Summary
Issue Overview
Despite decades of research and prevention efforts, low birthweight (less than 2,500 grams, or 5lbs., 8 ozs.) remains a major public health challenge. Preterm birth (before 37 weeks of gestation) is by far the most common reason for low birthweight (LBW). Since 1990, the U.S. low-birthweight rate has increased by 19 percent, and the preterm birth rate has risen by 21 percent. There are persistent disparities for different racial and ethnic groups.
Promising Strategies
Five strategies are essential for any plan aimed at preventing low birthweight.
- Expand access to medical and dental services, taking a lifespan approach to health care. Access to adequate health care before, during, and after childbirth is crucial. A lifespan approach is important because women who have chronic health problems, such as obesity, type-2 diabetes, and cardiovascular disease, are more likely to have LBW babies. More research is needed to better address specific risk factors.
- Focus intensively on smoking prevention and cessation. Cigarette smoking during pregnancy is the single most important known cause of low birthweight. Smoking prevention and cessation efforts are therefore crucial to reducing the LBW rate.
- Ensure that pregnant women get adequate nutrition. An infant’s birthweight is connected to the mother’s pre-pregnancy weight as well as her weight gain during pregnancy. A lifespan approach to nutrition makes sense, because when a poorly nourished woman becomes pregnant, even intensive interventions may not be enough to reduce her odds of having a LBW baby.
- Address social and demographic risk factors. A key to prevention is understanding and addressing social and demographic risk factors that affect birth outcomes, especially LBW births to African American women in some highly segregated inner-city communities. Poverty alone cannot explain the high rate of LBW births in these areas. Researchers point to other factors, including stress associated with isolation from mainstream society, environmental risks, substandard housing, increased risk of infection, decreased availability of high quality medical care, the generally poorer quality of food and the higher prices of groceries.
- Support and publicize research on the causes of LBW. Despite decades of research, scientists do not understand all of the reasons that babies are born too early or too small. A better understanding of LBW—including its high prevalence in certain inner-city neighborhoods—remains an urgent priority. The need for additional research is crucial, but should not keep policymakers from publicizing today’s best understandings and spreading best practices.
To read the whole indicator brief go to Preventing Low Birthweight