Low birth weight
Encyclopedia
Low birth weight is defined as a birth weight
Birth weight
Birth weight is the body weight of a baby at its birth.There have been numerous studies that have attempted, with varying degrees of success, to show links between birth weight and later-life conditions, including diabetes, obesity, tobacco smoking and intelligence.-Determinants:There are...

 of a liveborn infant of less than 2,500 g. regardless of gestational age

Causes

LBW is either the result of preterm birth (that is, a low gestational age
Gestational age
Gestational age relates to the age of an embryo or fetus . There is some ambiguity in how it is defined:*In embryology, gestational age is the time elapsed since conception. This interval is also termed fertilisation age....

 at birth, commonly defined as younger than 37 weeks of gestation) or of the infant being small for gestational age
Small for gestational age
Small for gestational age babies are those who are smaller in size than normal for the baby's sex and gestational age, most commonly defined as a weight below the 10th percentile for the gestational age.-Terminology:...

 (that is, a slow prenatal growth rate), or a combination of both.

In general, risk factors in the mother that may contribute to low birth weight include young ages, multiple pregnancies, previous LBW infants, poor nutrition, heart disease or hypertension
Hypertension
Hypertension or high blood pressure is a cardiac chronic medical condition in which the systemic arterial blood pressure is elevated. What that means is that the heart is having to work harder than it should to pump the blood around the body. Blood pressure involves two measurements, systolic and...

, drug addiction, alcohol abuse, and insufficient prenatal care
Prenatal care
Prenatal care refers to the medical and nursing care recommended for women before and during pregnancy. The aim of good prenatal care is to detect any potential problems early, to prevent them if possible , and to direct the woman to appropriate specialists, hospitals, etc...

. With specific interest to the environmental factors, smoking, lead exposure, and other types of air pollutions.

Preterm birth

Four different pathways have been identified that can result in preterm birth and have considerable evidence: precocious fetal endocrine activation, uterine overdistension, decidual bleeding, and intrauterine inflammation/infection. From a practical point a number of factors have been identified that are associated with preterm birth, however, an association does not establish causality.

Being small for gestational age

Being small for gestational age
Small for gestational age
Small for gestational age babies are those who are smaller in size than normal for the baby's sex and gestational age, most commonly defined as a weight below the 10th percentile for the gestational age.-Terminology:...

 can be constitutional, that is, without an underlying pathological cause, or it can be secondary to intrauterine growth restriction
Intrauterine growth restriction
Intrauterine growth restriction refers to poor growth of a baby while in the mother's womb during pregnancy. The causes can be many, but most often involve poor maternal nutrition or lack of adequate oxygen supply to the fetus....

, which, in turn, can be secondary to many possible factors. For example, babies with congenital anomalies or chromosomal abnormalities are often associated with LBW. Problems with the placenta
Placenta
The placenta is an organ that connects the developing fetus to the uterine wall to allow nutrient uptake, waste elimination, and gas exchange via the mother's blood supply. "True" placentas are a defining characteristic of eutherian or "placental" mammals, but are also found in some snakes and...

 can prevent it from providing adequate oxygen and nutrients to the fetus. Infections during pregnancy that affect the fetus, such as rubella
Rubella
Rubella, commonly known as German measles, is a disease caused by the rubella virus. The name "rubella" is derived from the Latin, meaning little red. Rubella is also known as German measles because the disease was first described by German physicians in the mid-eighteenth century. This disease is...

, cytomegalovirus
Cytomegalovirus
Cytomegalovirus is a viral genus of the viral group known as Herpesviridae or herpesviruses. It is typically abbreviated as CMV: The species that infects humans is commonly known as human CMV or human herpesvirus-5 , and is the most studied of all cytomegaloviruses...

, toxoplasmosis
Toxoplasmosis
Toxoplasmosis is a parasitic disease caused by the protozoan Toxoplasma gondii. The parasite infects most genera of warm-blooded animals, including humans, but the primary host is the felid family. Animals are infected by eating infected meat, by ingestion of feces of a cat that has itself...

, and syphilis
Syphilis
Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The primary route of transmission is through sexual contact; however, it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis...

, may also affect the baby's weight.

Environmental factors

While active maternal tobacco smoking has well established adverse perinatal outcomes such as LBW, that mothers who smoke during pregnancy are twice as likely to give birth to low-birth weight infants. Review on the effects of passive maternal smoking, also called environmental tobacco exposure (ETS), demonstrated that increased risks of infants with LBW were more likely to be expected in ETS-exposed mothers.
Researches have shown that elevated blood lead levels in pregnant women, even those well below 10ug/dL can cause miscarriage
Miscarriage
Miscarriage or spontaneous abortion is the spontaneous end of a pregnancy at a stage where the embryo or fetus is incapable of surviving independently, generally defined in humans at prior to 20 weeks of gestation...

, premature birth
Premature birth
In humans preterm birth refers to the birth of a baby of less than 37 weeks gestational age. The cause for preterm birth is in many situations elusive and unknown; many factors appear to be associated with the development of preterm birth, making the reduction of preterm birth a challenging...

, and LBW in the offspring. With 10ug/dL as the Centers for Disease Control and Prevention's “level of concern”, this cut-off value really needs to arise more attentions and implementations in the future.

The combustion products of solid fuel in developing countries can cause many adverse health issues in people. Because a majority of pregnant women in developing countries, where rate of LBW is high, are heavily exposed to indoor air pollution, increased relative risk translates into substantial population attributable risk of 21% of LBW.

A correlation between maternal exposure to CO and low birth weight has been reported that the effect on birth weight of increased ambient CO was as large as the effect of the mother smoking a pack of cigarettes per day during pregnancy.
It has been revealed that adverse reproductive effects (e.g., risk for LBW) were correlated with maternal exposure to air pollution combustion emissions in Eastern Europe and North America.
Mercury is an known toxic heavy metal that can harm fetal growth and health, and there has been evidence showing that exposure to mercury (via consumption of large oily fish
Oily fish
Oily fish have oil in their tissues and in the belly cavity around the gut. Their fillets contain up to 30 percent oil, although this figure varies both within and between species...

) during pregnancy may be related to higher risks of LBW in the offspring.

It was revealed that, exposure of pregnant women to airplane noise was found to be associated with low birth weight. Aircraft noise exposure caused adverse effects on fetal growth leading to low birth weight and preterm infants..

Effects

LBW is closely associated with fetal and Perinatal mortality
Perinatal mortality
Perinatal mortality , also perinatal death, refers to the death of a fetus or neonate and is the basis to calculate the perinatal mortality rate. Variations in the precise definition of the perinatal mortality exist specifically concerning the issue of inclusion or exclusion of early fetal and...

 and Morbidity, inhibited growth and cognitive development, and chronic diseases later in life. At the population level, the proportion of babies with a LBW is an indicator of a multifaceted public-health problem that includes long-term maternal malnutrition, ill health, hard work and poor health care in pregnancy. On an individual basis, LBW is an important predictor of newborn health and survival and is associated with higher risk of infant and childhood mortality.
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