National and Regional Estimates of Term and Preterm Babies Born Small for Gestational Age in 138 Low-Income and Middle-Income Countries in 2010

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Lee, Anne C. C.; Katz, Joanne; Blencowe, Hannah; Cousens, Simon N.; Kozuki, Naoko; Vogel, Joshua P.; Adair, Linda S.; Baqui, Abdullah H.; Bhutta, Zulfiqar A.; & Caulfield, Laura E., et al. (2013). National and Regional Estimates of Term and Preterm Babies Born Small for Gestational Age in 138 Low-Income and Middle-Income Countries in 2010. Lancet Global Health, 1(1), e26-36. PMCID: PMC4221634

Abstract

BACKGROUND: National estimates for the numbers of babies born small for gestational age and the comorbidity with preterm birth are unavailable. We aimed to estimate the prevalence of term and preterm babies born small for gestational age (term-SGA and preterm-SGA), and the relation to low birthweight (<2500 g), in 138 countries of low and middle income in 2010.
METHODS: Small for gestational age was defined as lower than the 10th centile for fetal growth from the 1991 US national reference population. Data from 22 birth cohort studies (14 low-income and middle-income countries) and from the WHO Global Survey on Maternal and Perinatal Health (23 countries) were used to model the prevalence of term-SGA births. Prevalence of preterm-SGA infants was calculated from meta-analyses.
FINDINGS: In 2010, an estimated 32.4 million infants were born small for gestational age in low-income and middle-income countries (27% of livebirths), of whom 10.6 million infants were born at term and low birthweight. The prevalence of term-SGA babies ranged from 5.3% of livebirths in east Asia to 41.5% in south Asia, and the prevalence of preterm-SGA infants ranged from 1.2% in north Africa to 3.0% in southeast Asia. Of 18 million low-birthweight babies, 59% were term-SGA and 41% were preterm-SGA. Two-thirds of small-for-gestational-age infants were born in Asia (17.4 million in south Asia). Preterm-SGA babies totalled 2.8 million births in low-income and middle-income countries. Most small-for-gestational-age infants were born in India, Pakistan, Nigeria, and Bangladesh.
INTERPRETATION: The burden of small-for-gestational-age births is very high in countries of low and middle income and is concentrated in south Asia. Implementation of effective interventions for babies born too small or too soon is an urgent priority to increase survival and reduce disability, stunting, and non-communicable diseases.

URL

http://dx.doi.org/10.1016/S2214-109X(13)70006-8

Reference Type

Journal Article

Year Published

2013

Journal Title

Lancet Global Health

Author(s)

Lee, Anne C. C.
Katz, Joanne
Blencowe, Hannah
Cousens, Simon N.
Kozuki, Naoko
Vogel, Joshua P.
Adair, Linda S.
Baqui, Abdullah H.
Bhutta, Zulfiqar A.
Caulfield, Laura E.
Christian, Parul
Clarke, Sian E.
Ezzati, Majid
Fawzi, Wafaie W.
Gonzalez, Rogelio
Huybregts, Lieven
Kariuki, Simon
Kolsteren, Patrick
Lusingu, John
Marchant, Tanya
Merialdi, Mario
Mongkolchati, Aroonsri
Mullany, Luke C.
Ndirangu, James
Newell, Marie-Louise
Nien, Jyh Kae
Osrin, David
Roberfroid, Dominique
Rosen, Heather E.
Sania, Ayesha
Silveira, Mariangela F.
Tielsch, James M.
Vaidya, Anjana
Willey, Barbara A.
Lawn, Joy E.
Black, Robert E., for the CHERG SGA-Preterm Birth Working Group

PMCID

PMC4221634

ORCiD

Adair - 0000-0002-3670-8073