Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Delivery modes and pregnancy outcomes of low birth weight infants in China



To investigate and analyze the perinatal outcomes of low birth weight (LBW) infants, thereby selecting the appropriate mode and suitable time of delivery to improve the adverse pregnancy outcomes.

Study Design:

A retrospective analysis of 112 441 deliveries (from 39 hospitals of different levels in 14 provinces and autonomous regions in China throughout 2011) were performed in this study to further evaluate the modes of delivery and pregnancy outcomes of LBW infants.


The rate of cesarean section, stillbirth, neonatal asphyxia and mortality of LBW were significantly higher than those of normal birth weight (NBW) infants (odds ratio, 1.24, 56.56, 57.27 and 10.40 times higher, respectively). Stratified analysis showed that adverse events were reduced with the increase in gestational weeks, especially at 34 to 36+6 weeks. However, LBW infants still had higher risks of adverse events as compared with NBW infants. In particular, full-term LBW babies had a 23.81- and 26.06-fold higher risk of stillbirth and neonatal death as compared with term babies with NBW. In addition, the cesarean delivery rate was 1.24-fold higher for LBW babies than for NBW babies. With an increase in gestational age in LBW infants, the rate of cesarean section was also increased. The rates of stillbirth and neonatal mortality of full-term LBW infants who were delivered via cesarean section (0.5% and 1.0%, respectively) were significantly lower than in the vaginal-delivery group (5.2% and 6.9%, respectively).


LBW is one of the causes of perinatal death and other adverse pregnancy outcomes and increases the rate of cesarean section. Individualized analysis according to gestational age and intrauterine fetal condition should be performed to extend the gestational age to at least 34 weeks before delivery, cesarean section is a relatively safe mode of delivery, but cannot completely eliminate complications. The key to improving mother and child outcomes is to strengthen pregnancy care and reduce low birth weight infants and premature birth. LBW is one of the causes of adverse pregnancy outcomes in both premature and full-term infants and increases the rate of cesarean section. Individualized analysis of the mode of delivery should be performed to extend the gestational age to 34 weeks and so improve the survival rate.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others


  1. Kramer MS . The epidemiology of low birth weight. Nestle Nutr Inst Workshop Ser 2013; 74: l–10.

    Google Scholar 

  2. CIass QA, Rickert ME, Lichtenstein P, D’Onofrio BM . Birth weight, physical morbidity, and mortality: a population-based sibling comparison study. Am J Epidemiol 2014; 179 (5): 550–558.

    Article  Google Scholar 

  3. Chen W, Srinivasan SR, Yao L, Li S, Dasmahapatra P, Fernandez C et al. Low birth weight is associated with higher blood pressure variability from childhood to young adulthood: the Bogalusa Heart Study. Am J Epidemiol 2012; 176: 99–105.

    Article  Google Scholar 

  4. Christensen DL, Kapur A, Bygbjerg IC . Physiological adaption to maternal malaria and other adverse exposure: low birth weight, functional capacity, and possible metabolic disease in adult life. Int J Gynaecol Obstet 2011; 115: 16–191.

    Article  Google Scholar 

  5. Cui H, He CH, Miao L, Zhu J, Wang YP, Li Q et al. Trendency analysis of infant mortality rate due to premature birth or low birth weight in China from 1996 to 2013. Clin J Prev Med 2015; 49 (2): 161–165.

    Google Scholar 

  6. Xie X, Gou WL . Obstetrics and Gynecology, 8th edn. People’s Medical Publishing House: Beijing, 2013.

    Google Scholar 

  7. International Association of Diabetes and Pregnancy Study Groups Consensus Panel, Metzger BE, Gabbe SG, Persson B, Buchanan TA, Catalano PA et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care 2010; 33: 676–682.

    Article  Google Scholar 

  8. Lin L, Liu Y, Zhang X, Mi J, Cao L . Sampling survey on Low birth weight in China in 1998. Zhonghua Yu Fang Yi Xue Za Zhi 2002; 36: 149–153.

    PubMed  Google Scholar 

  9. Zou LY, Wang X, Ruan Y, Li GH, Chen Y, Zhang WY . Preterm birth and nonatality in China 2011. Int J Gynecol Obstet 2014; 127: 243–247.

    Article  Google Scholar 

  10. Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE et al. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet 2012; 379: 2151–2161.

    Article  Google Scholar 

  11. Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller AB, Narwal R et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet 2012; 379: 2162–2172.

    Article  Google Scholar 

  12. World Health Organization: The World Health Report 2005. Make Every Mother and Child Count. The Greatest Risks to Life are in its Beginning. WHO: Geneva, Switzerland, 2005, pp 79–81.

  13. World Health Organization: Neonatal and Perinatal Mortality. Country, Regional and Global Estimates. WHO Press: Geneva, Switzerland, 2006.

  14. Rosa D, Darling RD, RNC-NIC.. Risk factors for low birth weight in New York state counties. Policy Polit Nurs Pract 2012; 13: 17–26.

    Article  Google Scholar 

  15. Coutinho PR, Cecatti JG, Surita FG, Costa ML, Morais SS . Perinatal outcomes associated with low birth weight in a historical cohort. Reprod Health 2011; 17: 23–31.

    Google Scholar 

  16. Hannah ME, Hannah WJ, Hewson SA, Hodnett ED, Saigal S, Willan AR, Term Breech Trial Collaborative Group. Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomized multi centre trial. Lancet 2000; 356: 1375–1383.

    Article  CAS  Google Scholar 

  17. Robilio PA, Boe NM, Danielsen B, Gilbert WM . Vaginal vs. cesarean delivery for preterm breech presentation of singleton infants in California: a population-based study. Reprod Med 2007; 52: 473–479.

    Google Scholar 

Download references


The 39 participating hospitals included NanFang Hospital of Southern Medical University (Yanhong Yu), Affiliated Obstetrics and Gynecology Hospital of Fudan University (Xiaotian Li), First Affiliated Hospital of Medical College of Xi’an Jiaotong University (Wenli Gou), West China Second University Hospital (Xinghui Liu), Shengjing Hospital of China Medical University (Caixia Liu), the Second Hospital of Jilin University (Yanhui Zhao), Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School (Yimin Dai), Shandong Provincial Hospital (Xietong Wang), First Hospital of Inner Mongolia Medical College (Muge Qi), Cangzhou Central Hospital (Junfeng Zhang), Beijing Friendship Hospital, Capital Medical University (Li Lin), Maternal and Child Health Hospital of Taiyuan, Shanxi Province (Meihua Zhang), and the First Teaching Hospital of Xinjiang Medical University (Qiying Zhu). This project was supported by the Special Research Fund in Nonprofit Health Care Industry of the People’s Republic of China, granted to Weiyuan Zhang (201002013) and the Research Fund for High-level Talented Individuals of Beijing Health Bureau, granted to Weiyuan Zhang (2009-2-11). We would like to submit our manuscript “Delivery modes and pregnancy outcomes of low birth weight infants in China”. All authors have read and approved the submitted manuscript.

Author information

Authors and Affiliations


Corresponding author

Correspondence to L Fan.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chen, Y., Wu, L., Zhang, W. et al. Delivery modes and pregnancy outcomes of low birth weight infants in China. J Perinatol 36, 41–46 (2016).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:

This article is cited by


Quick links