Low birthweight in China: evidence from 441 health facilities between 2012 and 2014

Objective: This study aimed to identify new evidence about the burden and risk factors of low birthweight (LBW) in China using national facility-based data.Methods: The association between sociodemographic and obstetric characteristics and LBW was examined using a multilevel model, taking into account the clustering of livebirths within hospitals and multiple gestations per woman.Results: There were 3 915 965 deliveries and 235 247 cases born with LBW, producing a LBW rate of 5.36% in mainland China; 65.34% of all cases of LBW were caused by preterm birth. The LBW rate was particularly high for women who delivered at home, were younger than 14 years of age, were unmarried, were illiterate, had not received antenatal care, had delivered three or more infants and who had multiple gestations. Maternal complications were strongly associated with LBW, but the risk effects of full-term LBW were lower than for of LBW.Conclusions: China's LBW rate was lower than that of many other countries, but due to its large population size, the number of infants born with LBW still contributed significantly to the overall number of LBW births globally. By recognizing populations of the most disadvantaged women, we can identify opportunities for prevention and intervention that target LBW.