The Effect of Child’s Body Size at Birth on Infant and Child Mortality in India

  • Bali RamEmail author
  • Shefali S. Ram
  • Awdhesh Yadav


Low birth weight is one of the strongest predictors of infant mortality, especially in the neonatal period. In this paper, we use data from the 2015–2016 India’s National Family Health Survey to examine the effect of mother’s assessment of child’s body size at birth on four measures of mortality: infant mortality, neonatal mortality, post-neonatal mortality, and child mortality. Using the Cox proportional hazards model, we found that small babies were slightly more than one and a half times and very small babies nearly four times more likely than average or larger size babies to die in the neonatal period. This was true even when potential confounders were held constant. However, the effect of child size on mortality risk became progressively weaker, though highly significant, in the post-neonatal and early childhood periods. We also found that, in spite of significant sex differences in mortality during infancy and early childhood, boys and girls were equally sensitive to the harmful effects of smaller body size at birth on mortality risks.


Low birth weight Child’s size Infant mortality Neonatal mortality Post-neonatal mortality Child mortality 


Le faible poids à la naissance est l’un des prédicteurs les plus importants de la mortalité infantile, en particulier pendant la période néonatale. Dans cet article, nous avons utilisé les données de l’Enquête nationale sur la santé de la famille de 2015-2016 de l’Inde pour examiner l’effet de l’évaluation par la mère de la taille de l’enfant à la naissance sur quatre mesures de mortalité: la mortalité infantile, la mortalité néonatale, la mortalité post-néonatale et la mortalité en bas de 5 ans. En utilisant le modèle à risques proportionnels de Cox, nous avons constaté que les bébés de petite taille et les bébés de très petite taille étaient respectivement un peu plus qu’une fois et demie et près de quatre fois plus susceptibles que les bébés de taille moyenne ou plus grande de décéder au cours de la période néonatale. Ce constat demeurait vrai même lorsque les facteurs potentiels de biais étaient maintenus constants. Cependant, l’effet de la taille de l’enfant sur le risque de mortalité s’affaiblit progressivement, bien que de manière très significative, au cours des périodes post-néonatale et précoce. Nous avons également constaté que, malgré d'importantes différences de mortalité entre les sexes en matière de mortalité pendant la petite enfance, les garçons et les filles étaient également sensibles aux effets néfastes d'une taille plus petite à la naissance sur les risques de mortalité.

Mots clés

faible poids à la naissance taille de l’enfant mortalité infantile mortalité néonatale mortalité post-néonatale mortalité en bas de 5 ans 



We are thankful to two anonymous referees for their helpful comments.


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Authors and Affiliations

  1. 1.Western UniversityLondonCanada
  2. 2.Carleton UniversityOttawaCanada
  3. 3.University of TorontoTorontoCanada
  4. 4.Abt AssociatesNew DelhiIndia

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