Low birthweight as an indicator of child health in Greenland - Use, knowledge and implications

Objectives. The aim of this study was to analyse if low birthweight is a valuable indicator of child health in Greenland. Study design. A case study focusing on "low birthweight as an indicator in Greenland" with 3 units and 5 subunits of analyses. Methods. Literature reviews, interviews with health care professionals and an analysis of the National Birth Register. Results. Low birthweight was a well-known and yearly surveyed indicator, but not used by clinicians or by policymakers. Research was sparse, but the major risk factor observed was smoking. The rate of low birthweight in 1997-2005 was on average 5.0%. Of the low birthweight cases, 67.0% infants were born prematurely but only 44.8% of these births had a low birthweight. The known risk factors for a low birthweight in Greenland included abnormal delivery, low Apgar score at 5 minutes, female gender, multiple birth, being a single mother and less than complete prenatal care by a midwife. For preterm birth, associations were found with a not normal delivery, perinatal mortality, low Apgar score at 5 minutes, multiple birth, single mothers, mothers born in Greenland, young mothers, mothers living in a village and in nulliparae. Conclusions. Low birthweight is as valuable an indicator of child health at the national level in Greenland as it is in other developed countries. If interventions are to be aimed at known, quantitatively important, modifiable determinants of low birthweight, the results suggest that cigarette smoking and antenatal care are the most important to address.