The contribution of very low birth weight deaths to infant mortality.

BACKGROUND Infant mortality remains high in many developing countries in which the contribution of deaths among infants born very low birth weight (VLBW) may be considerable. This contribution has however not been quantified in most such countries. This paper explores a model that can be used in this respect. OBJECTIVE To determine the contribution of very low birth weight infants towards the overall infants deaths in Kenya. DESIGN Prospective cohort study. SETTING Kenyatta National Hospital, Pumwani Maternity Hospital and Kilifi District Hospital. SUBJECTS Very low birth weight infants followed up for a period of one year. RESULTS The neonatal, post-neonatal and infant mortalities for the cohort were 442, 139 and 581/1000 respectively. These were thirteen, three and seven times higher than the national averages respectively. Of the national birth cohort of 1,300,000 during that year, it was estimated that between 15,600 (1.2%) and 24,700 (1.9%) were born VLBW. Given this VLBW infant burden and extrapolating the infant mortality observed in this study to the general population, between 9,064 (8.9%) and 14,351(14.2%) of the 101,400 (78/1000) infants who die during infancy in the country are born VLBW. CONCLUSION The cohort reports very high infant mortality for VLBW infants when compared to the general population. Despite constituting less than 2% of the birth cohort, these infants contribute between 8.9% and 14.2% of all infant deaths.