Effects of COVID-19 pandemic on low birth weight in a nationwide study in India.

ABSTRACT

BACKGROUND: Among newborns, those born in India have the highest prevalence of low birth weight (LBW). The COVID-19 pandemic exacerbated the risk factors for LBW. This study examined whether birth outcomes deteriorated during the pandemic period compared to those during the pre-pandemic period. METHODS: This cross-sectional study included nationally representative data on 198,203 infants. Multivariate ordinary least square and logistic regression models with district fixed effects were fitted to compare the birth outcomes in the pandemic period (April 2020-April 2021) and the pre-pandemic period (July 2014-December 2019). Regression models were adjusted for covariates-gender and birth order of the child, mother's age and education, rural residence, religion, caste, and household wealth. RESULTS: The pandemic cohort includes 11,851 infants (5.8%), while the pre-pandemic cohort includes 192,764 infants (94.2%). The LBW prevalence rate is 20% in the pandemic cohort and 17% in the pre-pandemic cohort. The covariate-adjusted model shows significant differences in birth weight (11 grams) and LBW (aOR 1.08; 95% CI 1.03-1.14) between the pandemic and pre-pandemic cohorts. CONCLUSIONS: Our findings show that babies born during the COVID-19 pandemic are more likely to be LBW. The subgroup analyses indicate significant differences by religion but not by maternal education, caste, and wealth group.

Globally, approximately 20 million babies are born with low birth weight (weighing less than 2,500 grams) every year. These babies are at increased risk of physical and cognitive deficits and behavioral abnormalities in their later lives. In this research, we investigate the impact of the COVID-19 pandemic on the prevalence of low birth weight in India. Our findings reveal that babies born between April 2020 and April 2021 faced a higher risk of being born as low birth weight compared to those born before April 2020. This underscores the necessity for targeted policies aimed at mitigating the risk of low birth weight during periods of high COVID-19 infection, especially for vulnerable populations in low and middle-income countries.