The health and nutritional status of the mother greatly influences the growth and development of the baby during pregnancy and infancy. Birth weight is an indicator of both fetal growth and maternal well-being.
1 If the mother is under-nourished, in poor health, very young or very old, there is a greater chance of pregnancy or labour-related complications, including the baby being born with a low birth weight.
2 Mothers may also be unaware of the effects of substance abuse on their unborn child. Infants born with low birth weight are at risk of a number of health conditions. These infants may not be able to gain sufficient weight, and may suffer long-term health problems such as compromised growth, developmental delays and other disabilities.
3 They are also at greater risk of dying in the first 28 days. With an estimated infant mortality rate
of 30 per 1,000 births in South Africa
4, neonatal deaths and illness are critical public health concerns. The prevention of low birth weight has been identified as one of the main gaps that should be addressed to reduce deaths and illness in infants.
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There has been a steady increase in the share of births that take place in facilities over the past decade. In 2021/22, an estimated 83% of pregnant women delivered in healthcare facilities.
In 2021, South Africa had a low birth-weight rate pf 13.2%. This means that more than one out of every ten babies born alive weighed less than 2,500g. However, as a large proportion of births – and therefore birth weights – are not documented, the exact figures are likely to be underestimated. Sometimes mothers are not told the weight of their babies at birth, or babies are not weighed at birth.
The Northern Cape province had the highest rate of low birth-weight babies (18.2%) followed by the Free State (14.8%), Western Cape (14.4%) nad Eastern Cape (14.3%). These rates are higher than the national average. The loweest rate was in Limpopo (10.6%)
These figures raise serious concerns about the health status of infants, their chances of survival and their quality of life, particularly in provinces with a high incidence of low birth weight. They also indicate that many pregnant women may be undernourished or in poor health, which may result from high levels of poverty among women of child-bearing age. Efforts to reduce the proportion of babies born with low birth weight should focus on improved access to antenatal care, health promotion in pregnant women, adequate nutrition during the antenatal period, and improvements in perinatal care.
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1 Swart R, Sanders D & McLachlan M (2008) Nutrition: A primary health care perspective. In: Barron P & Roma-Reardon J (eds) South African Health Review 2008. Durban: Health Systems Trust.
2 Pattinson RC, Sithembiso V, Hardy B, Moran N & Steyn W (2009) Overview. In: Pattinson RC (ed) Saving babies 2006 – 2007: Sixth perinatal care survey of South Africa. Pretoria: Tshepesa Press.
3 Illingworth RS (1987) The Development of the Infant and Young Child. Normal and Abnormal. London: Churchill Livingstone.
4 2022 mortality rates derived from the same Medical Research Council Rapid Mortality Surveillance project published by the UN Inter-agency Group for Child Mortality Estimation and available at https://childmortality.org/all-cause-mortality/data?refArea=ZAF&indicator=MRY0T4.
5 Mhlanga RE (2008) Maternal, Newborn and Child Health: 30 years on. In: Barron P & Roma-Reardon J (eds) South African Health Review 2008. Durban: Health Systems Trust.
6 Mhlanga RE (2008) Maternal, Newborn and Child Health: 30 years on. In: Barron P & Roma-Reardon J (eds) South African Health Review 2008. Durban: Health Systems Trust.