Low birth weight and fetal anaemia as risk factors for infant morbidity in rural Malawi

In sub-Saharan Africa, infant morbidity and mortality rates are excessively high and reductions have not kept pace with expectations. Most available data indicate that diarrhoea, malaria and acute respiratory infections account for the majority of infant deaths.

Low birth weight (LBW) and fetal anaemia (FA) are common in malaria endemic areas. To investigate the incidence of infectious morbidity in infants in rural Malawi in relation to birth weight and fetal anaemia, a cohort of babies was followed for a year on the basis of LBW and FA. A matched group of normal birth weight (NBW), non-anaemic (NFA) new-borns were enrolled as controls. Morbidity episodes were recorded at 4-weekly intervals and at each extra visit made to a health centre with any illness.

The study shows that LBW and FA are not significant risk factors for morbidity incidence in infants, although babies with FA experience their first infection at an earlier age and are more likely to have a persistent morbidity episode. Interventions to reduce infant morbidity need to address risk factors for severity of infectious episodes in order to optimise care for those babies.