Low birth weight mortality rates across country spike in 15 years

In the last 15 years, deaths among infants in India due to low birth weight have increased. The increase in low birth weight deaths has been noticed in poorer states and rural areas of Madhya Pradesh, Uttar Pradesh, Rajasthan, Bihar, Punjab, and Haryana.

The Million Death Study (MDS) commissioned by Registrar General of India notes, prematurity or low birth weight mortality rates rose in rural areas (from 13·2 per 1000 live births in 2000 to 17·0 per 1000 live births in 2015) and in poorer states (from 11·3 per 1000 live births in 2000 to 17·8 per 1000 live births in 2015), while in richer states and urban areas it declined, resulting in an average increase in deaths from 12 per 1000 live births in 2000 to 14 per 1000 live births in 2015.

The study calls to attention increasing number of child deaths due to low birth weight. The figures become relevant in the light of the recent spate of infant deaths that have occurred in Gorakhpur and later in Farrukhabad in Uttar Pradesh. Following which there were deaths of 52 children in Jharkhand in a month. 38 of them who were in the Neo-natal ICU, had low birth weight and thus acutely malnourished.

There is a possibility of a child being vulnerable to infections and dying due to being born pre-term are more. The development is disturbing because these children who were studied in MDS were born to mothers who had completed their full -term of pregnancy.

MDS was conducted in 1.3 million homes in 7,000 randomly selected areas of India, by non-medical surveyors who conduct verbal autopsies for deaths and trained physicians who then analyse the structured autopsies and arrive at the cause of death.

Renowned medical journal, The Lancet, in which the analysis has been published, notes, "The absolute number of neonatal deaths from prematurity or low birth weight rose from 3, 42,000 deaths in 2000 to about 3,70,000 by 2015."

2.9 crore children have died in India between 2000 to 2015. Largest number of children, close to 10 lakh died in rural areas, while 8.5 lakh children died in nine poorer states. Neonatal deaths were 50% of all child deaths in 2000, but this proportion rose to 58% by 2015.
 
With declines in other causes in neonates, prematurity or low birth weights are a rising proportion of a shrinking total, it says. Nearly 60% of deaths among children younger than 5 years in India in 2015 were among neonates, which is in the first month of life.

While India has reduced its child mortality (under five years) by 62% from 125 children per 1000 live births in 1990, to 47 per 1000 live births in 2015, it has not met the Millennium Development Goal of a 66% decrease. Now the Sustainable Development Goals (SDGs) need India to achieve child mortality figures of 25 per 1000 live births by 2030.  60 lakh children, younger than five years of age die globally every year and India carries one fifth of the burden – which is 12 lakh Indian children die before reaching the fifth birthday.

“To meet the 2030 Sustainable Development Goals for child mortality, India will need to maintain the current trajectory of 1–59-month mortality and accelerate declines in neonatal mortality (to >5% annually) from 2015 onwards. Continued progress in reduction of child mortality due to pneumonia, diarrhoea, malaria, and measles at 1–59 months is feasible. Additional attention to low birth weight is required,” notes The Lancet.

Low birth weight in a child is strongly linked to anaemia or low haemoglobin levels in mother, non-provision of adequate medical care and nutrition care during pregnancy and use of oral tobacco.
In contrast, among other things, in urban areas, injuries are killing as many children in 1 – 59 months as diarrhoea, the analysis notes. “Deaths from injuries rose from the sixth rank to third rank. 17000 (25%) of 69000 injury deaths in 2015 were due to falls and about 14000 (20%) were due to drowning,” it says.