Abstract
Low birth weight (LBW), defined as birth weight below 2,500 grams, continues to be a serious public health concern worldwide, particularly in low and middle-income countries. LBW is linked with a range of adverse health consequences for the infants, both short- and long-term(1, 2). Statistics Indonesia reported that LBW rates increased from 11.32% in 2019 to 12.58% in 2022(3), although the actual burden is unknown due to inconsistent prevalence estimates across numerous independent surveys in the country. This systematic review and meta-analysis sought to estimate the prevalence of LBW in Indonesia. Four electronic databases were used to search for the relevant studies (PubMed, Scopus, Web of Science, ScienceDirect) up to August 2024. Findings were reported according to PRISMA guidelines. The meta-analysis used a random-effects model with the restricted maximum likelihood (REML) estimation method. Heterogeneity was examined using the I2 statistic, with a value ≥ 50% indicating substantial heterogeneity. Twenty-six studies published between 1985 and 2023 were eligible to be included, comprising 119,556 livebirths. Meta-analysis revealed an overall pooled prevalence of LBW of 23% (95% CI: 15, 30%; I2: 99.93%), with the study setting identified as a potential source of high heterogeneity. Thus, separate analyses for population-based and hospital-based studies were performed showing LBW prevalence of 13% (95% CI: 8, 18%) and 32% (95% CI: 20, 44%), respectively. Such a difference suggests that the sampling frame and database significantly affect estimates in Indonesia, considering that those who came to the hospital were expected to be in the high-risk pregnancy group. Moreover, birth weight data were more precisely collected through measurement in a hospital survey, compared to those in a population-based survey. Regions also played an important role as each has different population characteristics and health issues that lead to different prevalence. Our study emphasises that LBW prevalence was higher than the official reported estimate in Indonesia, and that it differed between hospital and population surveys.