Four to five per cent of babies, born to term in Barbados, have a low birth weight and this is of concern to doctors at the Queen Elizabeth Hospital (QEH).
Senior Registrar in the Department of Obstetrics and Gynaecology at the QEH, Dr. Bayo Ogunbiyi noting that “to term” meant between 37 and 40 weeks of a mother’s pregnancy said, this low birth weight of 2.5 kilos (or 5½ lbs) was of concern “because these babies, born at this weight, actually create the possibility for long term problems in terms of learning and chronic diseases.”
Dr. Ogunbiyi said the factors which contributed to this included the mother’s health, teenaged pregnancy, if the mother was over 40 years or if the woman had several babies in the past, usually four or more. “If the mother comes into the pregnancy with a chronic illness such as hypertension and diabetes, which we are seeing in lots of younger mothers now, it can affect the health of the child,” he added.
And, he explained, with teenaged mothers, the reasons were nutritionally–based. “This is not just about the food she is eating but the constituents of her body – because a teenaged mother is still growing, she still needs the iron – for example her own folic acid for her own cells – so if she has a baby inside that is depending on her, as a mother, for everything, it will take the nutrients it needs. If the mother’s store is depleted, the baby will become lacking,” said the Senior Registrar.
For women over 40, it was the ageing process. The medical practitioner said: “The arteries and all the other things needed for the development of the placenta can be compromised, and consequently you have placenta malfunction. When this occurs, you have a baby that is not reaching what is called its growth potential.”
Queried about whether such babies would necessarily develop chronic non-communicable diseases (CNCDs), Dr. Ogunbiyi said: “The emerging evidence now says yes; that’s the case. But this is not inevitable. There are lots of things that can be done either at the pre-pregnancy stage or immediately after birth.”
While pointing out that interventions before pregnancy were limited in scope, he cautioned women who were thinking about becoming pregnant to consider what must be done before. “In an ideal world you want all pregnancies to be planned… the best thing for the woman [to do] is to optimise her weight because if she is obese then she is likely to have a lot of other problems including this one.
“It used to be thought that an obese woman would almost always have a big baby but the converse is actually what we are seeing and this is worldwide in its occurrence; so that is why we are focusing on it.”
Dr. Ogunbiyi explained that the problem with babies of low birth weight was epi-genesis (outside of the genetic inheritance) and he said the stress the baby received within the womb caused certain genetic alterations that affect the way it dealt with nutrition once it was born.
He said: “The baby becomes a hoarder; if you give the baby a certain amount of nutrition it will hoard more than it requires; so there is a period of catch up which leads to excess stress on their various functions, especially the insulin. This then leads to relative insulin resistance and you have an early onset of diabetes; and sometimes this is not detected until later.”
The Senior Registrar recommended a specialist clinic, where these babies would be isolated and kept on iron; and where their nutrition – the way they are fed, the content and the amount of food given – would be specifically tailored to them “to reduce the incidence of low grade inflammation.”
Women with low birth weight babies are also urged to pay attention to their supplement and formula, since they may contain too much protein and carbohydrates; and this is likely to perpetuate the problem. “You need to be very careful how you calculate the calorific requirement of the baby and the amount of protein you need for each age because this can also affect their cognitive function later in life,” said Dr. Ogunbiyi.
Dr. Ogunbiyi is the author of a research paper entitled: “From The Cradle to the Grave: Low Birth Weight As a Predictor of Chronic Non-communicable Disease.” It was presented at the 8th Annual Professor E. R. Walrond symposium, held in July of this year, in the Auditorium of the QEH. (BGIS)