Spatio-temporal distribution and socioeconomic inequality of low birthweight rate in China from 1992 to 2021 and its predictions to 2030

Abstract

This paper aims to investigate the trend, spatio-temporal distribution, and socioeconomic inequality of the low birthweight rate (LBWR) in China from 1992 to 2021 and to project the LBWR to 2030. We performed a secondary analysis of data from the China Health Statistics Yearbook. LBWR refers to the ratio of the number of infants born with a birth weight less than 2,500 grams to the number of live births in a given year. We used joinpoint regression models to estimate LBWR trends from 1992 to 2021 for the whole country and from 2002 to 2021 for the three regions (eastern, central, and western regions) and each province. The slope index of inequality (SII) and relative index of inequality (RII) were calculated for each year from 2002 to 2021 based on provincial data. LBWR increased from 2.52% (1992) to 3.70% (2021), and the average annual percentage change (AAPC) (95% confidence interval [CI]) was 1.35% (0.22%, 2.49%) in China. The overall LBWR from 2002 to 2021 was greatest in the Eastern region, but LBWR had the fastest increase in the Western region, with an AAPC (95% CI) of 3.15% (2.59%, 3.12%). There were spatio-temporal differences in the LBWR and trends between provinces. The SII and RII increased linearly from -0.15 and 0.94 to 0.53 (B = 0.035%, p < 0.001) and 1.16 (B = 0.011, p < 0.01), respectively, over the past 20 years. The results of the ARIAM model showed that the National LBWR will be increasedfrom 3.70% in 2021 to 5.28% in 2030. The LBWRs in the eastern, central and western regions in 2030 will be 4.93%, 6.02% and 5.82%, respectively. National and local governments must prioritize disadvantaged groups to mitigate the rapid prevalence of LBWR, reduce regional disparities, and improve perinatal and infant health and health equity in China.