Prematurity and Low Birth Weight

Prematurity refers to birth before 37 completed weeks of pregnancy, and low birth weight refers to a newborn weighing less than 2.5 kilograms. Both increase the risk of complications in the newborn period and require close monitoring and specialised care.

• Small size and low birth weight relative to gestational age
• Difficulty maintaining body temperature
• Difficulty feeding effectively, due to immature sucking and swallowing coordination
• Breathing difficulty, due to immature lungs, particularly in more significantly preterm infants
• Jaundice, which is more common and can be more pronounced in preterm infants
• Increased susceptibility to infection

• Prematurity can result from many causes, including multiple pregnancy (twins or more), infections during pregnancy, pre-eclampsia, placental problems, and, in many cases, no clearly identifiable cause.
• Low birth weight can result from prematurity, restricted growth of the baby within the womb, or a combination of both.
• Risk factors include maternal malnutrition, malaria and other infections during pregnancy, young or advanced maternal age, and closely spaced pregnancies.

• Gestational age is assessed based on the mother's menstrual history, antenatal ultrasound where available, and, after birth, examination of the newborn's physical characteristics.
• Birth weight is measured immediately after birth to identify low birth weight and guide the level of care needed.
• Close monitoring for common complications of prematurity — including breathing difficulty, low blood sugar, temperature instability, and infection — begins immediately after birth.

Keeping the baby warm is a priority, using skin-to-skin contact (kangaroo mother care) wherever possible, which has been shown to significantly improve outcomes for preterm and low birth weight infants.

Support for feeding is essential, including help with breastfeeding, expressed breast milk, or, for very preterm infants, specialised feeding support until sucking and swallowing coordination matures.

Breathing difficulty, low blood sugar, jaundice, and suspected infection are each identified and managed promptly, as preterm infants can deteriorate quickly.

More significantly preterm or unwell infants require care in a facility equipped for specialised newborn care, which may include supplemental oxygen or other supportive treatment.

Ongoing growth and developmental monitoring after discharge helps identify and address any longer-term needs.

• Attend regular antenatal care, which helps identify and manage conditions that increase the risk of preterm birth.
• Ensure adequate maternal nutrition during pregnancy.
• Prevent and promptly treat malaria and other infections during pregnancy.
• Practise kangaroo mother care (skin-to-skin contact) for preterm or low birth weight infants, which supports temperature regulation, feeding, and bonding.
• Attend all recommended newborn follow-up visits to monitor growth and development after birth.