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Trends in low birth weight across 36 states and union territories in India, 1993-2021

Karlsson, Omar LU ; Kumar, Akhil ; Kim, Rockli and Subramanian, S V (2025) In BMJ Global Health 10(6).
Abstract

INTRODUCTION: Low birth weight is an important measure of the health of pregnant women and newborns. We investigated the prevalence of low birth weights in India over nearly three decades to assess trends and convergence across states.

METHODS: Data came from five waves of the National Family Health Survey (1992-93 to 2019-21). The prevalence of low birth weight was estimated. To explore the sensitivity of our results to missing birth weight data-since the completeness of birth weight information has changed drastically-we also estimated prevalence from multiple imputation models, Heckman selection models, and by reweighting the data so that socioeconomic characteristics of children with birth weight data matched across... (More)

INTRODUCTION: Low birth weight is an important measure of the health of pregnant women and newborns. We investigated the prevalence of low birth weights in India over nearly three decades to assess trends and convergence across states.

METHODS: Data came from five waves of the National Family Health Survey (1992-93 to 2019-21). The prevalence of low birth weight was estimated. To explore the sensitivity of our results to missing birth weight data-since the completeness of birth weight information has changed drastically-we also estimated prevalence from multiple imputation models, Heckman selection models, and by reweighting the data so that socioeconomic characteristics of children with birth weight data matched across surveys.

RESULTS: The overall prevalence of low birth weight in India declined from 26% to 18% during the period. The 2019-21 survey revealed that four states, Uttar Pradesh, Bihar, Maharashtra, and West Bengal accounted for almost half of all low-birth-weight births in India. The Pearson's correlation between the prevalence of low birth weight in 1992-93 and percentage point change across the period was -0.85, suggesting convergence between states, where states with greater prevalence in 1992-93 had faster declines. Convergence was robust across sensitivity specifications.

CONCLUSION: State-level convergence indicates a potential 'catch-up' phenomenon, where states with initially higher prevalence have experienced greater declines. This finding suggested a possible impact of interventions prompted by dire figures in the earliest surveys, yet also stresses the necessity for continued interventions across all states to maintain and further progress. Our analysis, however, warrants a cautious interpretation due to data limitations. However, we observed convergence in the prevalence of low birth weight across states in all sensitivity specifications.

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Please use this url to cite or link to this publication:
author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Humans, India/epidemiology, Infant, Low Birth Weight, Female, Infant, Newborn, Prevalence, Health Surveys, Pregnancy, Male, Adult, Socioeconomic Factors
in
BMJ Global Health
volume
10
issue
6
publisher
BMJ Publishing Group
external identifiers
  • pmid:40523807
ISSN
2059-7908
DOI
10.1136/bmjgh-2024-016732
language
English
LU publication?
yes
additional info
© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group.
id
55aad48e-ec19-463d-bc89-f4e48748eee6
date added to LUP
2025-06-17 17:31:11
date last changed
2025-06-24 08:57:00
@article{55aad48e-ec19-463d-bc89-f4e48748eee6,
  abstract     = {{<p>INTRODUCTION: Low birth weight is an important measure of the health of pregnant women and newborns. We investigated the prevalence of low birth weights in India over nearly three decades to assess trends and convergence across states.</p><p>METHODS: Data came from five waves of the National Family Health Survey (1992-93 to 2019-21). The prevalence of low birth weight was estimated. To explore the sensitivity of our results to missing birth weight data-since the completeness of birth weight information has changed drastically-we also estimated prevalence from multiple imputation models, Heckman selection models, and by reweighting the data so that socioeconomic characteristics of children with birth weight data matched across surveys.</p><p>RESULTS: The overall prevalence of low birth weight in India declined from 26% to 18% during the period. The 2019-21 survey revealed that four states, Uttar Pradesh, Bihar, Maharashtra, and West Bengal accounted for almost half of all low-birth-weight births in India. The Pearson's correlation between the prevalence of low birth weight in 1992-93 and percentage point change across the period was -0.85, suggesting convergence between states, where states with greater prevalence in 1992-93 had faster declines. Convergence was robust across sensitivity specifications.</p><p>CONCLUSION: State-level convergence indicates a potential 'catch-up' phenomenon, where states with initially higher prevalence have experienced greater declines. This finding suggested a possible impact of interventions prompted by dire figures in the earliest surveys, yet also stresses the necessity for continued interventions across all states to maintain and further progress. Our analysis, however, warrants a cautious interpretation due to data limitations. However, we observed convergence in the prevalence of low birth weight across states in all sensitivity specifications.</p>}},
  author       = {{Karlsson, Omar and Kumar, Akhil and Kim, Rockli and Subramanian, S V}},
  issn         = {{2059-7908}},
  keywords     = {{Humans; India/epidemiology; Infant, Low Birth Weight; Female; Infant, Newborn; Prevalence; Health Surveys; Pregnancy; Male; Adult; Socioeconomic Factors}},
  language     = {{eng}},
  month        = {{06}},
  number       = {{6}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{BMJ Global Health}},
  title        = {{Trends in low birth weight across 36 states and union territories in India, 1993-2021}},
  url          = {{http://dx.doi.org/10.1136/bmjgh-2024-016732}},
  doi          = {{10.1136/bmjgh-2024-016732}},
  volume       = {{10}},
  year         = {{2025}},
}