Low‐birthweight rates higher among B angladeshi neonates measured during active birth surveillance compared to national survey data

Birth size is an important gauge of fetal and neonatal health. Birth size measurements were collected within 72 h of life for 16 290 live born, singleton infants in rural B angladesh from 2004 to 2007. Gestational age was calculated based on the date of last menstrual period. Newborns were classified as small‐for‐gestational age ( SGA ) based on a birthweight below the 10th percentile for gestational age, using three sets of US reference data. Birth size distributions were explored based on raw values as well as after z ‐score standardisation in reference to W orld H ealth O rganization ( WHO ) 2006 growth standards. Mean ( SD ) birthweight (g), length (cm) and head circumference (cm) measurements, completed within [median (25th, 75th percentile)] 15 (8, 23) h of life, were 2433 (425), 46.4 (2.4) and 32.4 (1.6), respectively. Twenty‐two per cent were born preterm. Over one‐half (55.3%) of infants were born low birthweight; 46.6%, 37.0% and 33.6% had a weight, length and head circumference below −2 z ‐scores of the WHO growth standard at birth; and 70.9%, 72.2% and 59.8% were SGA for weight based on Alexander et al ., Oken et al . and Olsen et al . references, respectively. Infants in this typical rural B angladesh setting were commonly born small, reflecting a high burden of fetal growth restriction and preterm birth. Our findings, produced by active birth surveillance, suggest that low birthweight is far more common than suggested by cross‐sectional survey estimates. Interventions that improve fetal growth during pregnancy may have the largest impact on reducing SGA rates.