US Babies Getting Smaller

US babies are getting smaller. Low birthweight babies are at higher risk for a host of health problems.

Between 1990 and 2005, the birthweight of full-term babies in the U.S. declined nearly two ounces to an average of 7 pounds, 7.54 ounces, according to a study published in the Journal of Obstetrics and Gynaecology.

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Actually since the 1950s, the birth-weight had actually been increasing across the country. Why this reversal now, no one seems to be clear. Besides the babies were also born 2.5 days earlier on average in 2005 than in 1990, the study said.

The study analyzed data on birth weight, maternal and neonatal characteristics, obstetric care and other trends from the National Center for Health Statistics Natality Data Sets, looking at 36,827,828 U.S. babies born at full-term between 1990 and 2005. Birth weight -- a combination of fetal growth and length of gestation -- was recorded in grams. The investigators teased out certain factors, including the mothers' age, race or ethnicity, education level, marital status and tobacco use, as well as the amount of weight the women gained during pregnancy and how early in pregnancy they received prenatal care. They also considered the women's risk of conditions like hypertension and use of obstetric procedures such as induction of labor and cesarean delivery.

The small decrease in weight—based on an analysis of nearly 37 million nonmultiple births from a national database—isn't likely to affect the health of the average baby in the study, according to researchers. But the data showed a 1% increase in the number of the lowest-weight babies and suggested the birth-weight decline didn't stop in 2005.

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In contrast to previous research findings, birth weights plummeted even further in infants born to a subset of women considered to be at low risk for small babies: Mothers who were white, well-educated, married, didn't smoke, received early prenatal care, and delivered vaginally with no complications had babies who weighed an average of 79 grams (2.78 ounces) less at birth during the study period.

The results are "surprising and unexpected," said Emily Oken, an author of the paper and an assistant professor of population medicine at Harvard Medical School. "We do need to keep a close eye on the babies that are the smallest babies to see if the proportion of those is increasing over time, because they may require extra resources and have extra health concerns," she said.

In addition to declines in birth weight, average gestation length among these full-term births also dropped by more than two days. "A logical conclusion might be that trends in obstetric management, such as greater use of cesarean delivery and induction of labor, might account for these decreases in birth weight and gestation length," says Oken. "However, our analysis showed that this was not the case."

While the decline may simply represent a reversal of previous increases in birth weights, it may also be cause for concern: babies born small not only face short-term complications such as increased likelihood of requiring intensive care after birth and even higher risk of death, they may also be at higher risk for chronic diseases in adulthood.

Future research may identify other factors not included in the current data that might contribute to lower birth weight, such as trends in mothers' diets, physical activity, stress, and exposure to environmental toxins. "There's still a lot we don't know about the causes of low birth weight," says Oken. "More research needs to be done."

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This research was supported by grants from the National Institutes of Health.

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