# Prevalence of and Risk Factors for Extremely Low Birth Weight Infants in Saudi Arabia: A Four-Year Single-Center Experience

## TL;DR

This study examines the prevalence and risk factors for extremely low birth weight infants in Saudi Arabia over four years, identifying key factors like multiple births and maternal age.

## Contribution

The study provides new insights into specific risk factors for ELBW infants in Saudi Arabia using a four-year single-center dataset.

## Key findings

- The prevalence of ELBW infants was 0.71% over four years at King Abdulaziz Medical City.
- Twin and triplet births were significant risk factors for birth weight less than 750 grams.
- Lower gestational age and prolonged rupture of membranes were linked to birth weights of 750-1000 grams.

## Abstract

Introduction

Globally, extremely low birth weight (ELBW) infants present a distinct challenge for neonatologists, representing a significant portion of the most vulnerable and high-risk cases admitted to the neonatal intensive care units (NICUs). Saudi Arabia has a high prevalence of ELBW, which leads to a significant risk of morbidity and mortality, as many of these extreme preterm infants who are admitted to NICUs may not survive till discharge. This study aimed to evaluate the prevalence of ELBW infants and associated risk factors over a four-year period.

Methods

Two study designs were used in this research: a cross-sectional retrospective design was used for estimating the prevalence rate over four years, and a case-control study with a retrospective chart review for the risk factor correlation. The study was conducted at King Abdulaziz Medical City (KAMC), Riyadh, Kingdom of Saudi Arabia, covering four years, from January 2017 to December 2020. All newborn live infants born at KAMC who weighed 1000 grams or less were included in the study. Infants born outside KAMC and those with fatal anomalies were excluded from the study. The pregnancy notes on the mothers were reviewed blindly, with no knowledge of the newborn's outcome. Statistical data were analyzed using SPSS version 26.

Results

A total of 256 ELBW infants were recorded out of 36,000 live births. The prevalence of ELBW during the study period of four years was 0.71%. Of the ELBW infants, 57.4% had a birth weight between 750 and 1000 grams, while 42.6% weighed less than 750 grams. Lower gestational age and prolonged rupture of membrane (PROM) were associated with a birth weight of 750-1000 g, whereas twin and triplet births were associated with a birth weight of <750 g. Interestingly, there was a positive correlation between birth weight and maternal age, but birth weight was inversely correlated with gestational age.

Conclusion

There was a minimal incidence rate of ELBW during the four-year duration. Significant risk factors for birth weight <750 g were triplets and twins, while lower gestational age and PROM were significant risk factors for birth weight of 750-1000 g. Interventions focusing on improving antenatal care access, maternal health education, and nutritional status may help reduce the prevalence of ELBW in our region.