Birth Weight Related Issues –

Emphasis on Low Birth Weight

By
Dr. Disu
Consultant Paediatrician
LASUTH
 BIRTH WEIGHT CLASSIFICATION

• Normal birth weight (NBW) 2,500 – 3,999g

• Low birth weight (LBW) 2,500g
• Very low birth weight less than (VLBW)
1500g
• Extreme low birth weight less than(ELBW)
1000g
 Small For Gestation Age
• SGA describes a baby whose birth weight is
below the 10th percentile for age and sex.
• It may also be defined as birth weight more than
two standard deviations below the mean for age
and sexWeight below 10th centile for gestation
• Roberton(1999) states that 50% of babies that
are SGA there is no known cause. These babies
are proportionally small in all the parameters.
Babies are well & healthy.
 Regulators of fetal growth
Normal fetal growth is dependent on the
-mother,
-placenta and
-fetus
Regulators of fetal growth
• Genetics
• Environmental factors
• Placental function
• Growth factors , hormones etc
 Intrauterine Growth Restriction
• Head appears large in relation to body
• Skin dry, thin layer of subcutaneous fat
• Baby looks anxious
• Neurological assessment usually corresponds
to gestation
• Increased morbidity and mortality when
compared to AGA neonates of same GA.
 Asymmetrical Growth Restriction
• Normally in the third trimester
• Associated with insult such as pregnancy
induced hypertension
• Head circumference & length normal but
weight is low in proportion to those
parameters
• Growth restriction as a result of malnutrition
 Symmetrical Growth Restriction
• Earlier in pregnancy:
• Intrauterine infections
• Substance abuse
• Head circumference is in proportion to weight
& length
Problems of the low birth weight
baby (SGA)
– Hypothermia as a result of low subcutaneous fat
– Increased susceptibility to infection
– Polycythaemia resulting from excessive stimulation of bone
marrow by intrauterine hypoxia
– HIE
– Congenital anomalies Dysmorphology
– Pulmonary haemorrhage
– Persistent pulmonary hypertension
– Meconium aspiration
– Hypoglycaemia/ tissue glycogen
– Polycythemia –due to fetal hypoxia
– Acute tubular necrosis / renal insufficiency
 Causes of Large for Gestational Age
• Constitutionally large infants (large parents)
• Infants of diabetic mothers
• Some post-term infants
• Beckwith-Wiedemann and other syndromes
 Problems of LGAs
• Birth injuries
• Perinatal asphyxia
• Hypoglycaemia
• Hyperbilirunaemia