Low birth-weight

The health and nutritional status of the mother greatly influences the growth and development of the baby during pregnancy and infancy. Birth weight is an indicator of both fetal growth and maternal well-being.¹ If the mother is under-nourished, of poor health, or too young, there is a greater chance of pregnancy or labour-related complications, including the baby being born with a low birth weight.² Mothers may also be unaware of the effects of substance abuse on their unborn child. Infants born with low birth weight are at risk of a number of health conditions. These infants may not be able to gain sufficient weight, and may suffer long-term health problems such as developmental delay and other disabilities.³ With an estimated perinatal mortality rate⁴ of 38 per 1,000 births in South Africa⁵, neonatal deaths and illness are critical public health concerns. The prevention of low birth weight has been identified as one of the main gaps that should be addressed to reduce deaths and illness in infants.⁶  

 

In 2006, South Africa had a low birth-weight rate based on the District Health Information System (DHIS) and the Perinatal Problem Identification Programme (PPIP) of 9%⁷ and 15.5%⁸, respectively. This means that about one out of every ten babies born alive weighed less than 2,500g. However, as a large proportion of births – and therefore birth weights – are not documented, the exact figures are likely to be underestimated. Sometimes mothers are not told the weight of their babies at birth, or babies are not weighed at birth.

The Northern Cape province had the highest rate of low birth-weight babies (24%) followed by the Western Cape (17%), and Free State (14%). These rates are higher than the national average. Six of South Africa’s nine provinces have low birth-weight rates equal to or higher than the national average. However, data from the District Health Information System should be interpreted with caution as data collection, and therefore data quality problems, exist.⁹ For this indicator, some data for the North West province are implausible¹⁰, and the very small proportion of low birth weight infants reported for the Gauteng province is questionable.
 

These figures raise serious concerns about the health status of infants, their chances of survival and their quality of life, particularly in provinces with a high incidence of low birth weight. They also indicate that many pregnant women may be undernourished or of poor health, which may result from high levels of poverty among women of child-bearing age. Efforts to reduce the proportion of babies born with low birth weight should focus on improved access to antenatal care, health promotion in pregnant women, adequate nutrition during the antenatal period, and improvements in perinatal care.¹¹