DefinitionVery low birth weight (VLBW) infants are those weighing less than 1,500 grams (3 lbs 5 oz) at birth, regardless of gestational age.
The very low birth weight rate is the number of live born infants who weigh less than 1,500 grams, divided by the total of live births over the same time period.
NumeratorNumber of live born infants weighing under 1,500 grams in the resident population for a specific time period.
DenominatorTotal number of live births in the resident population for a specific time period.
Why Is This Important?Low birth weight is an important factor affecting neonatal mortality, and a significant determinant of postneonatal mortality. The two main reasons a baby may be born with very low birth weight are premature birth (birth before 37 weeks of pregnancy, and often less than 30 weeks) and fetal growth restriction, usually due to
problems with placenta, maternal health, or to birth defects. Clinical problems associated with very low birth weight include: hypothermia, hypoglycemia, hypoxia, respiratory problems, fluid imbalance, hyperbilirubinemia, anemia, and impaired nutrition. ^1^ Compared to infants of a normal weight, low birth weight infants are at increased risk of infection, impaired immune function, delayed motor and social development, learning disabilities, and poor school performance.^2^
1. UCSF Children's Hospital. Intensive Care Nursery House Staff Manual. Very low and extremely low birthweight infants. [https://www.ucsfbenioffchildrens.org/pdf/manuals/20_VLBW_ELBW.pdf]. Published 2004 Accessed November 2, 2018.
2. U.S. Centers for Disease Control and Prevention (CDC). Reproductive and birth outcomes: low birth weight.[https://ephtracking.cdc.gov/showRbLBWGrowthRetardationEnv.action]. Accessed November 2, 2018.
Healthy People Objective: Very low birth weight (VLBW)U.S. Target: 1.4 percent
Other ObjectivesTitle V Maternal and Child Health Services Block Grant to States Program:
National Outcome Measure 4.1 - Percent of low birth weight deliveries
For more information:
How Are We Doing?In 2017, 1.0% of live births for all Alaskans had very low birth weight in Alaska, a level essentially unchanged since 1990. Live born infants enrolled in Medicaid had a higher prevalence of very low birth weight than those not enrolled in Medicaid, 1.3% and 0.6% respectively in 2017.
There are no significant racial or regional differences in Alaska for the most recent data.
How Do We Compare With the U.S.?In 2017, the rate of very low birth weight was 1.4% of births in the United States compared to 1.0% in Alaska.^3^ Alaska has consistently had a lower prevalence of very low birth weight compared to the nation as a whole for the period since 1990. Alaska Native people have a rate of very low birth rate that has been equal to or less than the national rate since 1991.
3. Hamilton BE, Martin JA, Osterman MJK, Driscoll AK, Rossen LM.
Births: Provisional data for 2017. Vital Statistics Rapid Release; no 4.
Hyattsville, MD: National Center for Health Statistics. May 2018.[https://www.cdc.gov/nchs/data/vsrr/report004.pdf]. Accessed on November 1, 2018.
What Is Being Done?Prevention of unintended pregnancy as well as early and continuous prenatal care may improve infant outcomes. According to the U.S. Surgeon General, women who quit smoking before or during pregnancy reduce the risk of preterm delivery and low birth weight (LBW). Furthermore, women who stop smoking by the first trimester have infants with weight and body measurements comparable with those of nonsmokers. Studies suggest that smoking in the third trimester is particularly detrimental to fetal growth.^4^
Alaska is participating in the Collaborative Improvement and Innovation Network (CoIIN) to Reduce Infant Mortality and improve birth outcomes. Through CoIIN, Alaska is using evidence-based practices to focus on factors that may influence the rate of infants born with low birth weight; such as smoking cessation (before, during and/or after pregnancy), substance use cessation, and preconception/interconception health.^5^[[br]]
4. U.S. Department of Health and Human Services. The Health Consequences of Smoking-50 Years of Progress: A Report of the Surgeon General, 2014. [http://www.surgeongeneral.gov/library/reports/50-years-of-progress/]. Published 2014. Accessed November 2, 2018.
5. NICHQ. Collaborative improvement and innovation network to reduce infant mortality. [https://www.nichq.org/project/collaborative-improvement-and-innovation-network-reduce-infant-mortality-infant-mortality]. Accessed November 2, 2018.
Evidence-based PracticesThe Annie E. Casey Foundation has prepared the KIDS COUNT Indicator Brief on Preventing Low Birth Weight.^6^
This KIDS COUNT Indicator Brief describes five strategies that are essential to any plan aimed at reducing the rate of LBW births:
[[br]]Expand access to medical and dental services, taking a lifespan approach to health care
[[br]]Focus intensively on smoking prevention and cessation
[[br]]Ensure that pregnant women get adequate nutrition
[[br]]Address demographic, social, and environmental risk factors
[[br]]Support sustained research on the causes of LBW.
Other rigorously evaluated programs have been shown to be effective for minimizing negative outcomes for low birthweight infants:
[[br]]Nurse-Family Partnership [http://www.childtrends.org/?programs=nurse-family-partnership]
[[br]]Early Intervention Program For Low Birth Weight Infants [http://www.childtrends.org/?programs=early-intervention-program-for-low-birth-weight-infants]
[[br]]Infant Health and Development Program (IHDP) [http://www.childtrends.org/?programs=infant-health-and-development-program-ihdp]
[[br]]Transactional Model of Early Home Intervention [https://www.childtrends.org/?programs=transactional-model-of-early-home-intervention]
6. The Annie E. Casey Foundation. KIDS COUNT Indicator Brief Preventing Low Birth Weight. July 2009. [http://files.eric.ed.gov/fulltext/ED507776.pdf]. Accessed November 2, 2018.