Low-birthweight rates higher among Bangladeshi neonates measured during active birth surveillance compared to national survey data

Rolf D.W. Klemm, Rebecca D. Merrill, Lee Wu, Abu Ahmed Shamim, Hasmot Ali, Alain Labrique, Parul Christian, Keith P. West

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Birth size is an important gauge of fetal and neonatal health. Birth size measurements were collected within 72h of life for 16290 live born, singleton infants in rural Bangladesh from 2004 to 2007. Gestational age was calculated based on the date of last menstrual period. Newborns were classified as small-for-gestational age (SGA) based on a birthweight below the 10th percentile for gestational age, using three sets of US reference data. Birth size distributions were explored based on raw values as well as after z-score standardisation in reference to World Health Organization (WHO) 2006 growth standards. Mean (SD) birthweight (g), length (cm) and head circumference (cm) measurements, completed within [median (25th, 75th percentile)] 15 (8, 23) h of life, were 2433 (425), 46.4 (2.4) and 32.4 (1.6), respectively. Twenty-twopercent were born preterm. Over one-half (55.3%) of infants were born low birthweight; 46.6%, 37.0% and 33.6% had a weight, length and head circumference below -2 z-scores of the WHO growth standard at birth; and 70.9%, 72.2% and 59.8% were SGA for weight based on Alexander etal., Oken etal. and Olsen etal. references, respectively. Infants in this typical rural Bangladesh setting were commonly born small, reflecting a high burden of fetal growth restriction and preterm birth. Our findings, produced by active birth surveillance, suggest that low birthweight is far more common than suggested by cross-sectional survey estimates. Interventions that improve fetal growth during pregnancy may have the largest impact on reducing SGA rates.

Original languageEnglish (US)
Pages (from-to)583-594
Number of pages12
JournalMaternal and Child Nutrition
Issue number4
StatePublished - Oct 1 2015


  • Birth
  • Growth
  • Intrauterine growth restriction
  • Preterm birth
  • Small-for-gestational age
  • Weight

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology
  • Nutrition and Dietetics
  • Public Health, Environmental and Occupational Health


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