PREVALENCE, COMPOSITION, DETERMINANTS, AND RISK FACTORS FOR LOW BIRTH WEIGHT
IN SRI LANKA 2023 - 2024
Highlights
Low birth weight (LBW) (defined as weight at birth less than 2500g) remains one of the most important challenges affecting newborn health and survival worldwide. In Sri Lanka, despite notable achievements in maternal and child health, the burden of low birth weight has persisted over the years. To better understand this issue, the Perinatal Society of Sri Lanka, in collaboration with the Family Health Bureau and UNICEF, conducted the first island-wide multicenter study on LBW between 2023 and 2024. Covering 9,130 live births across hospitals representing all nine provinces, the study provides the most comprehensive evidence to date on the prevalence, causes, and determinants of low birth weight in Sri Lanka.
The study revealed that approximately 1 out of 5 live births in the study sites were born with low birth weight, highlighting that the problem remains a significant public health concern. Importantly, the findings demonstrated that low birth weight in Sri Lanka is driven predominantly by babies being born small for gestational age (SGA) rather than by prematurity alone. Nearly two-thirds of LBW babies were identified as SGA, indicating that restricted fetal growth during pregnancy is a major contributor to poor birth outcomes. While pre-term birth remains an important concern, accounting for around one-third of LBW cases, the study underscores the need to place greater emphasis on improving fetal growth and maternal health throughout pregnancy.
The research also identified several modifiable factors that increase the risk of LBW and SGA births. Maternal undernutrition, low pre-pregnancy body mass index, inadequate weight gain during pregnancy, anemia, teenage pregnancy, pregnancy-induced hypertension, and poor socioeconomic conditions were among the key risk factors. These findings highlight the critical role of maternal health and nutrition before and during pregnancy in determining birth outcomes. The study further revealed regional variations in LBW prevalence, suggesting the need for targeted interventions in areas with a higher burden.
Another important finding was that fetal growth continues to increase significantly up to 39–40 weeks of gestation. This suggests that, when medically appropriate, supporting pregnancies to continue to full term may contribute to healthier birth weights and improved newborn outcomes.
Based on these findings, the study calls for a renewed focus on preventing both LBW and SGA births through evidence-based interventions. Strengthening maternal nutrition programs, improving the prevention and management of anemia, reducing teenage pregnancies, ensuring adequate antenatal care, and enhancing the management of pregnancy-related complications are identified as key priorities. The report also recommends the development of national guidelines and targeted strategies for the prevention and management of LBW, preterm birth, and growth-restricted newborns.
The findings of this landmark study provide critical evidence for policymakers, program managers, healthcare providers, and development partners. By addressing the underlying causes of poor fetal growth and strengthening support for women before and during pregnancy, Sri Lanka has an opportunity to significantly reduce the burden of LBW and improve the health, survival, and development of future generations.
