Perinatal outcomes associated with low birth weight in a historical cohort

A retrospective cohort study in a tertiary maternity hospital. Analysis of the database on 43,499 liveborn infants delivered between 1986 and 2004 with low (n = 6,477) and normal (n = 37,467) birth weight. Outcomes associated with LBW were identified through crude and adjusted risk ratio (RR) and 95%CI with bivariate and multivariate analysis. The main outcomes were: onset of labor, mode of delivery, indication for cesarean section; amniotic fluid, fetal heart rate pattern, Apgar score, somatic gestational age, gender and congenital malformation.LBW infants showed more frequently signs of perinatal compromise such as abnormal amniotic fluid volume (especially olygohydramnios), nonreassuring patterns of fetal heart rate, malformation, lower Apgar scores and lower gestational age at birth. They were associated with a greater risk of labor induction and cesarean delivery, but lower risk of forceps.There was a clear association between LBW and unfavorable perinatal outcomes.Low birth weight (LBW) is a key issue in public health, especially for developing countries. It is a result of preterm delivery or the birth of a growth restricted fetus [1] and represents a major determinant of adverse health outcomes throughout life, from infancy to adulthood. Along with prematurity, it is associated with poorer indicators of child morbidity [2] and mortality [3]. There is even evidence of its association with adverse health conditions later in life, such as coronary disease, stroke, hypertension, type 2 diabetes [4] and recurrence of low birth weight in the offspring [5]. Estimates of LBW rates vary worldwide, from 3.1% to 13.3% [6]. The World Health Organization has established a goal of reducing its incidence by one third in the next decade with the objective of improving child mortality rates [7].In the last decade increases in medically indicated labor induction and cesarean delivery have resulted in rising rates of preterm birth (PTB). In the United States alone this increase