Prioritizing prenatal care may decrease low birth weight outcomes in The Gambia, Notre Dame research finds
In The Gambia, a small country in West Africa, 1 in 10 newborns have a low birth weight — less than 5.5 pounds — and face daunting challenges. They are more likely to die within a month of birth or in their first year, and they experience higher rates of physical and cognitive impairment and higher risks of developing chronic health issues throughout their lives.
But there is a solution: More prenatal checkups support improved birth outcomes. That is a key finding of a new study co-authored by University of Notre Dame researchers, which provides new causal evidence from The Gambia that can help improve the health of newborns. The study was published in PLOS Global Public Health.
“Newborn health, measured by birth weight, is an important marker that not only reflects an infant's immediate well-being but also predicts future health and development,” said co-author Santosh Kumar Gautam, associate professor of development and global health economics and director of doctoral studies in sustainable development for the University of Notre Dame’s Keough School of Global Affairs. “Our study found that more prenatal checkups produce better birth outcomes, and these findings can inform policies that will prioritize the health of mothers and their newborn children.”
Previous studies in other contexts have shown a causal link between prenatal checkups and improved birth outcomes, Gautam said. Within The Gambia, previous studies had shown an association between checkups and outcomes, but there was limited empirical evidence estimating the causal effects these checkups have on low birth weight. However, in this latest study, Notre Dame researchers moved beyond correlation to demonstrate a causal link, Gautam said.
The study analyzed data on more than 4,400 births from the 2019-20 Gambian Demographic and Health Survey. Researchers found that each prenatal checkup was associated with a small increase in birth weight — about .77 ounces — and a 1.2 percent reduction in low birth weight, Gautam said.
But Gautam stressed that prenatal checkups had a cumulative effect: Mothers who had four or more prenatal checkups were 3.9 percent less likely to have a newborn with low birth weight than mothers who had fewer than four checkups. The average treatment effect for having four or more checkups was a 2.5-ounce increase in birth weight and a 4.7 percent reduction in the incidence of low birth weight. Gautam said these improvements would help to reduce deaths within the first month and the first year after birth.
Prenatal checkups play a vital role in detecting and managing conditions like intrauterine growth restriction, Gautam said, which occurs when a baby does not grow at the expected rate during pregnancy. The interventions delivered during these visits, including iron and folic acid supplementation and ongoing education about healthy behaviors, can target the causes of low fetal growth and ensure babies have a healthy weight at birth, he said.
Gautam co-authored the study with Alasana Suso, a 2024 graduate of the Keough School's Master of Global Affairs program, and Elizabeth Wood, associate professor of the practice and director of the Master of Science in Global Health program within the University's Eck Institute for Global Health.
The research is part of the larger work that the Eck Institute for Global Health does to address the critical healthcare needs of pregnant and postpartum women and their children. Through its Maternal, Newborn and Child Health Initiative, the institute fosters interdisciplinary collaborations and inspires advancements to improve health outcomes around the world. The research is also part of larger work by the Keough School to address issues relating to global poverty and inequality.
Gautam and Wood said future research should examine the comprehensiveness and quality of prenatal checkups to determine which components most effectively support fetal growth and neonatal survival in resource-constrained settings such as The Gambia.
Ultimately, researchers said, this study and new work that builds on it can provide additional evidence that will inform public health policy and improve birth outcomes.
“Our findings are especially valuable for guiding policy in sub-Saharan Africa, as they highlight both the quantity and quality of care as essential for meaningful gains in neonatal health,” Wood said. “These insights underscore the urgent need for sustained investments to ensure mothers have access to comprehensive prenatal checkups so that their children start life on a healthy path.”
Originally published by at keough.nd.edu on June 19.
Contact: Tracy DeStazio, associate director of media relations, 574-631-9958 or tdestazi@nd.edu
Latest International
- On the eve of COP30 in Brazil, Notre Dame convenes faculty in São PauloSince its founding, the University of Notre Dame has sought to address the world’s most pressing challenges through scholarship, partnership and service. Responding to the growing urgency of environmental change requires precisely this kind of collaboration, bringing together universities, researchers and communities to create solutions that are just, sustainable and grounded in shared responsibility for our planet. This November, COP30 will convene in Belem, Brazil. Capitalizing on Notre Dame’s presence in São Paulo, Notre Dame Global and Notre Dame São Paulo will host a conference together with Notre Dame Research and the Notre Dame Deloitte Center for Ethical Leadership (NDDCEL), the week before the international climate summit.
- Catholic Peacebuilding Network releases new report on global mining, using Catholic social teaching lensNotre Dame's Catholic Peacebuilding Network released a new report, Catholic Approaches to Mining: A Framework for Reflection, Planning, and Action, a nearly 50-page report identifying the problems associated with mining — social, economic and environmental among them — and analyzing these issues through Catholic social teaching to provide a path forward for mining-affected communities.
- Notre Dame’s Kellogg Institute partners with Vanderbilt University to launch 2025-26 democracy surveyThe University of Notre Dame’s Kellogg Institute for International Studies and Vanderbilt University’s Center for Global Democracy are partnering to advance one of the world’s leading surveys on attitudes toward democracy. Starting in October, the Center for Global Democracy, with support from the Kellogg Institute, will conduct the 2025-26 round of the AmericasBarometer, which tracks public opinion on democracy in 20 countries across the Americas.
- University of Notre Dame joins the Global Coalition of Ukrainian StudiesThe University of Notre Dame has joined the Global Coalition of Ukrainian Studies after signing a memorandum of cooperation, formalized Sept. 24, at the Ukrainian Institute of America in New York City. Notre Dame joined four other American institutions that were also publicly welcomed to the coalition at this event: Arizona State University, Columbia University, Manor College and the Shevchenko Scientific Society.
- Statement from University President Rev. Robert A. Dowd, C.S.C., on the anniversary of the atomic bombing of HiroshimaToday, on the anniversary of the bombing of Hiroshima, Father Dowd offered remarks at the Elisabeth University of Music as a guest of its president, Yuji Kawano, and Bishop Alexis Mitsuru Shirahama of Hiroshima. Father Dowd focused on the role that universities can play in addressing the current nuclear predicament and the wider challenges of peace in today’s world.
- Vatican honors Martin and Carmel Naughton with papal awardThe late Pope Francis, in one of his last acts, conferred the honour of the Order of Saint Gregory the Great upon Carmel and Martin Naughton, Trustee Emeritus of the University of Notre Dame. The papal honor is in recognition of the Naughtons’ outstanding philanthropy in the areas of education and the arts, particularly in the provision of philanthropic support and scholarships to Catholic education at the University of Notre Dame and Kylemore Abbey, and in their transformative contributions to higher education in Ireland.
