TY - JOUR
T1 - National, regional, and worldwide estimates of low birthweight in 2015, with trends from 2000
T2 - a systematic analysis
AU - Blencowe, Hannah
AU - Krasevec, Julia
AU - de Onis, Mercedes
AU - Black, Robert E.
AU - An, Xiaoyi
AU - Stevens, Gretchen A.
AU - Borghi, Elaine
AU - Hayashi, Chika
AU - Estevez, Diana
AU - Cegolon, Luca
AU - Shiekh, Suhail
AU - Ponce Hardy, Victoria
AU - Lawn, Joy E.
AU - Cousens, Simon
N1 - Funding Information:
This work was funded through the Bill & Melinda Gates Foundation via a grant to the Johns Hopkins Bloomberg School of Public Health (Maternal and Child Epidemiology Estimation) and via UNICEF (Strengthening Data for Accountability in the Areas of Child Survival, Health and Nutrition grant). Also funded by the Children's Investment Fund Foundation as part of a grant to the London School of Hygiene & Tropical Medicine for Every Newborn measurement improvement. WHO and UNICEF also provided resources. WHO and UNICEF participated in the analyses. We thank the China Low Birthweight Epidemiology Analysis group from the China Health Information and Statistics Center of National Health Commission: Zhang Yao Guang, Deputy Division Director. We are deeply grateful to UNICEF and WHO regional and country offices for their support during the country consultation process and to all Member States who provided updated birthweight data and validated their country LBW estimates. Special thanks to Brazil, Ecuador, Jamaica, Macedonia, and the Philippines, for their valuable feedback on the methodology. We acknowledge Nona Reuter from UNICEF for production of the maps and figures and Ivana Bjelic and Yadigar Coskun from UNICEF for support with analysis of the survey data.
Publisher Copyright:
© 2019 UNICEF and World Health Organization. Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
PY - 2019/7
Y1 - 2019/7
N2 - Background: Low birthweight (LBW) of less than 2500 g is an important marker of maternal and fetal health, predicting mortality, stunting, and adult-onset chronic conditions. Global nutrition targets set at the World Health Assembly in 2012 include an ambitious 30% reduction in LBW prevalence between 2012 and 2025. Estimates to track progress towards this target are lacking; with this analysis, we aim to assist in setting a baseline against which to assess progress towards the achievement of the World Health Assembly targets. Methods: We sought to identify all available LBW input data for livebirths for the years 2000–16. We considered population-based national or nationally representative datasets for inclusion if they contained information on birthweight or LBW prevalence for livebirths. A new method for survey adjustment was developed and used. For 57 countries with higher quality time-series data, we smoothed country-reported trends in birthweight data by use of B-spline regression. For all other countries, we estimated LBW prevalence and trends by use of a restricted maximum likelihood approach with country-level random effects. Uncertainty ranges were obtained through bootstrapping. Results were summed at the regional and worldwide level. Findings: We collated 1447 country-years of birthweight data (281 million births) for 148 countries of 195 UN member states (47 countries had no data meeting inclusion criteria). The estimated worldwide LBW prevalence in 2015 was 14·6% (uncertainty range [UR] 12·4–17·1) compared with 17·5% (14·1–21·3) in 2000 (average annual reduction rate [AARR] 1·23%). In 2015, an estimated 20·5 million (UR 17·4–24·0 million) livebirths were LBW, 91% from low-and-middle income countries, mainly southern Asia (48%) and sub-Saharan Africa (24%). Interpretation: Although these estimates suggest some progress in reducing LBW between 2000 and 2015, achieving the 2·74% AARR required between 2012 and 2025 to meet the global nutrition target will require more than doubling progress, involving both improved measurement and programme investments to address the causes of LBW throughout the lifecycle. Funding: Bill & Melinda Gates Foundation, The Children's Investment Fund Foundation, United Nations Children's Fund (UNICEF), and WHO.
AB - Background: Low birthweight (LBW) of less than 2500 g is an important marker of maternal and fetal health, predicting mortality, stunting, and adult-onset chronic conditions. Global nutrition targets set at the World Health Assembly in 2012 include an ambitious 30% reduction in LBW prevalence between 2012 and 2025. Estimates to track progress towards this target are lacking; with this analysis, we aim to assist in setting a baseline against which to assess progress towards the achievement of the World Health Assembly targets. Methods: We sought to identify all available LBW input data for livebirths for the years 2000–16. We considered population-based national or nationally representative datasets for inclusion if they contained information on birthweight or LBW prevalence for livebirths. A new method for survey adjustment was developed and used. For 57 countries with higher quality time-series data, we smoothed country-reported trends in birthweight data by use of B-spline regression. For all other countries, we estimated LBW prevalence and trends by use of a restricted maximum likelihood approach with country-level random effects. Uncertainty ranges were obtained through bootstrapping. Results were summed at the regional and worldwide level. Findings: We collated 1447 country-years of birthweight data (281 million births) for 148 countries of 195 UN member states (47 countries had no data meeting inclusion criteria). The estimated worldwide LBW prevalence in 2015 was 14·6% (uncertainty range [UR] 12·4–17·1) compared with 17·5% (14·1–21·3) in 2000 (average annual reduction rate [AARR] 1·23%). In 2015, an estimated 20·5 million (UR 17·4–24·0 million) livebirths were LBW, 91% from low-and-middle income countries, mainly southern Asia (48%) and sub-Saharan Africa (24%). Interpretation: Although these estimates suggest some progress in reducing LBW between 2000 and 2015, achieving the 2·74% AARR required between 2012 and 2025 to meet the global nutrition target will require more than doubling progress, involving both improved measurement and programme investments to address the causes of LBW throughout the lifecycle. Funding: Bill & Melinda Gates Foundation, The Children's Investment Fund Foundation, United Nations Children's Fund (UNICEF), and WHO.
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U2 - 10.1016/S2214-109X(18)30565-5
DO - 10.1016/S2214-109X(18)30565-5
M3 - Article
C2 - 31103470
AN - SCOPUS:85065186770
VL - 7
SP - e849-e860
JO - The Lancet Global Health
JF - The Lancet Global Health
SN - 2214-109X
IS - 7
ER -