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. 2022 Oct;18(4):e13396.
doi: 10.1111/mcn.13396. Epub 2022 Jul 12.

Newborn weight change and predictors of underweight in the neonatal period in Guinea-Bissau, Nepal, Pakistan and Uganda

Valerie J Flaherman  1 , Amy S Ginsburg  2 , Victoria Nankabirwa  3 , Augusto Braima da Sa  4 , Alvaro Medel-Herrero  1 , Eric Schaefer  5 , Srijana Dongol  6 , Akina Shrestha  6 , Imran Nisar  7 , Muddassir Altaf  7 , Khushboo Liaquat  7 , Benazir Baloch  7 , Najeeb Rahman  7 , Yasir Shafiq  7 , Shabina Ariff  7 , Fyezah Jehan  7 , Susan B Roberts  8
Affiliations

Newborn weight change and predictors of underweight in the neonatal period in Guinea-Bissau, Nepal, Pakistan and Uganda

Valerie J Flaherman et al. Matern Child Nutr. 2022 Oct.

Abstract

In low- and middle-income countries (LMIC), growth impairment is common; however, the trajectory of growth over the course of the first month has not been well characterised. To describe newborn growth trajectory and predictors of growth impairment, we assessed growth frequently over the first 30 days among infants born ≥2000 g in Guinea-Bissau, Nepal, Pakistan and Uganda. In this cohort of 741 infants, the mean birth weight was 3036 ± 424 g. For 721 (98%) infants, weight loss occurred for a median of 2 days (interquartile range, 1-4) following birth until weight nadir was reached 5.9 ± 4.3% below birth weight. At 30 days of age, the mean weight was 3934 ± 592 g. The prevalence of being underweight at 30 days ranged from 5% in Uganda to 31% in Pakistan. Of those underweight at 30 days of age, 56 (59%) had not been low birth weight (LBW), and 48 (50%) had reached weight nadir subsequent to 4 days of age. Male sex (relative risk [RR] 2.73 [1.58, 3.57]), LBW (RR 6.41 [4.67, 8.81]), maternal primiparity (1.74 [1.20, 2.51]) and reaching weight nadir subsequent to 4 days of age (RR 5.03 [3.46, 7.31]) were highly predictive of being underweight at 30 days of age. In this LMIC cohort, country of birth, male sex, LBW and maternal primiparity increased the risk of impaired growth, as did the modifiable factor of delayed initiation of growth. Interventions tailored to infants with modifiable risk factors could reduce the burden of growth impairment in LMIC.

Keywords: growth; low- and middle-income countries; newborn; underweight.

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Conflict of interest statement

All authors disclose support from the Bill & Melinda Gates Foundation which funded this research. Dr. Roberts also discloses funding from Danone, S.A., for unrelated work.

Figures

Figure 1
Figure 1
Infant weight over the first 30 days by country of birth depicted as the 10th, 25th, 50th (median), 75th and 90th percentiles of weight at each time point
See this image and copyright information in PMC

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