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Giving birth to a child of low birth weight

Notes from Guinea-Bissau

Maternal mortality (MM) is a leading cause of death among women of reproductive age. It is one of the eight Millennium Development Goals to improve maternal health. However, the knowledge on how to prevent MM is limited. Many of the most affected low-income countries do not have good health statistics and only few risk factors have been identified.

In Guinea-Bissau, the Bandim Health Project followed more than 5000 mothers giving birth to a healthy child at the National Hospital of Guinea-Bissau. We found that mothers of low birth weight (LBW) infants had a frightening high risk of MM; 19 of 1616 mothers of healthy LBW infants died within the first 90 days after the delivery, resulting in a mortality rate of 48/1000 person-years of risk. Mortality from delivery to 90 days postpartum was more than 10 times higher among mothers of LBW infants compared with mothers of normal birth weight (NBW) infants (Figure). This difference between mothers of LBW and mothers of NBW infants was particular apparent after the first week postpartum because mothers of LBW infants continued to have a high mortality rate during the 90 days. The mortality among mothers of LBW infants was particularly high among mothers who delivered during the late rainy and early dry season.

Hence, in Guinea-Bissau a LBW delivery was a predictor of a higher risk of subsequent maternal mortality. Furthermore, season of delivery was a significant risk factor for mortality amongst mothers of LBW infants.

In low-income countries the consequences of a maternal death are widespread for families and the society. It is well-known that motherless children have a significantly higher mortality, hence preventing a maternal death often also implies saving her offspring's life. To single out the mothers at highest risk would help concentrate the sparse resources on those most in need. Experiences from other countries support that high incidence of MM can be reversed in foreseeable future with concerted efforts. Methods to define risk groups must be simple and straight forward to be functional in low-income countries. Based on our results, a LBW delivery is a serious symptom that should lead to increased awareness and to programmes for monitoring and improving the health of the mother.

Christine Stabell Benn and Peter Aaby

Figure. Cumulative mortality among mothers of LBW infants and mothers of NBW infants

The figure demonstrates that mothers of low birth weight infants are much more likely to die during the first 3 months after the delivery than mothers of normal birth weight infants.

Read more:The Bandim Health Project: www.bandim.org

United Nation's Development Goals: http://www.un.org/millenniumgoals/

A photo from the maternity ward at the National Hospital in Guinea-Bissau. Very often two mothers and their babies have to share the same bed.