Levels and patterns of intrauterine growth retardation in developing countries

Abstract

The aim of this paper is to quantify the magnitude and describe the geographical distribution of intrauterine growth retardation (IUGR) in developing countries. We estimate that at least 13.7 million infants are born every year at term with low birth weight (LBW), representing 11% of all newborns in developing countries. This rate is approximately 6 times higher than in developed countries. LBW, defined as < 2500 g, affects 16.4% of all newborns, or about 20.5 million infants each year. IUGR defined as birth weight below the 10th percentile of the birth-weight-for-gestational-age reference curve, represents 23.8%, or approximately 30 million newborns per year. Overall, nearly 75% of all affected newborns are born in Asia--mainly in South-central Asia--20% in Africa, and about 5% in Latin America. Although some of these are healthy, small infants who merely represent the lower tail of a fetal growth distribution, in most developing countries a large proportion of newborns suffer from some degree of intrauterine growth retardation. These data demonstrate that many developing countries currently exceed the internationally recommended IUGR (> 20%) and LBW (> 15%) cut-off levels for triggering public health action, and that population-wide interventions aimed at preventing fetal growth retardation are urgently required.

PIP: Intrauterine growth retardation (IUGR) is defined as being born with a birth weight under the 10th percentile of the birth-weight-for-gestational-age reference curve. It is a status which applies to approximately 30 million newborns annually. of whom almost 75% are in Asia, mainly in South-central Asia, 20% in Africa, and 5% in Latin America. A large proportion of newborns in most developing countries suffer some degree of IUGR. This paper quantifies the magnitude and describes the geographical distribution of IUGR in developing countries. At least an estimated 13.7 million infants are born annually at term with low birth weight (LBW), 11% of all newborns in developing countries. This rate is approximately 6 times higher than that experienced in developed countries. LBW, being born under 2500 g, affects 16.4% of all newborn infants, or approximately 20.5 million infants annually. Many developing countries currently exceed the internationally recommended IUGR and LBW cut-off levels for triggering public health action. As such, population-wide interventions designed to prevent fetal growth retardation are urgently needed. The data presented in this paper on LBW were obtained from an updated version of the World Health Organization database on LBW compiled by the Maternal Health and Safe Motherhood Program. The database contains data published from 1980 onward.