Low birth weight
[1] Infants born with LBW have added health risks which require close management, often in a neonatal intensive care unit (NICU).
[citation needed] In general, risk factors in the mother that may contribute to low birth weight include young ages, multiple pregnancies, previous LBW infants, poor nutrition, heart disease or hypertension, untreated celiac disease, substance use disorder, excessive alcohol use, and insufficient prenatal care.
[8][9] More recently, passive maternal smoking has been examined for possible effects on birth weight, and has been shown to increase risk of LBW by 16%.
[11] Particulate matter, a component of ambient air pollution, is associated with increased risk of low birth weight.
[14] Particulate matter exposure can cause inflammation, oxidative stress, endocrine disruption, and impaired oxygen transport access to the placenta, all of which are mechanisms for heightening the risk of low birth weight.
[15] To reduce exposure to particulate matter, pregnant women can monitor the US Environmental Protection Agency's air quality index and take personal precautionary measures such as reducing outdoor activity on low quality days, avoiding high-traffic roads/intersections, and/or wearing personal protective equipment (i.e., facial mask of industrial design).
[18] It has been revealed that adverse reproductive effects (e.g., risk for LBW) were correlated with maternal exposure to CO emissions in Eastern Europe and North America.
[21] Exposure of pregnant women to airplane noise was found to be associated with low birth weight via adverse effects on fetal growth.
[27] However, fluid overloading is not benign; it is associated with increased risk of congestive heart failure, necrotizing enterocolitis, and mortality.
[27] Potassium must also be monitored carefully, as immature aldosterone sensitivity and sodium-potassium pumping increases risk for hyperkalemia and cardiac arrhythmias.
If present, it is important to evaluate whether the PDA is causing increased circulatory volume, thus posing risk for heart failure.
[27] As their gastrointestinal systems are typically unready for enteral feeds at the time of birth, VLBW infants require initial parenteral infusion of fluids, macronutrients, vitamins, and micronutrients.
[28] Formula is associated with greater linear growth and weight gain than donor breast milk in LBW infants.
[28] One Cochrane review showed administration of erythropoietin (EPO) decreases later need for blood transfusions, and also is associated with protection against necrotizing enterocolitis and intraventricular hemorrhage.
[32] LBW is closely associated with fetal and perinatal mortality and morbidity, inhibited growth and cognitive development, and chronic diseases later in life.
On an individual basis, LBW is an important predictor of newborn health and survival and is associated with higher risk of infant and childhood mortality.
[33] Low birth weight constitutes as sixty to eighty percent of the infant mortality rate in developing countries.
[43] The WHO has set a goal of reducing worldwide prevalence of LBW by 30% through public health interventions including improved prenatal care and women's education.
