In this article
  • The foetal origins hypothesis and low birth weight 
  • What is low birth weight?
  • Chronic conditions linked to low birth weight
  • Risk factors for having a LBW baby
  • Can low birth weight be prevented? 
  • Can you help prevent health problems in LBW people?
  • Key points to consider
The foetal origins hypothesis and low birth weight 

In the late 1980s, the epidemiologist David Barker suggested that what happens in the womb can have lifelong consequences. His foetal origins hypothesis1 argued that poor nutrition or an unhealthy environment before birth could slow growth and raise the risk of chronic disease in adulthood2. Since then, studies have consistently linked low birth weight (LBW) with a higher chance of developing long-term health problems. This is distinct from babies born prematurely, who face different risks.

What is low birth weight?

Low birth weight means a newborn baby weighs 2,500g/5 pounds 8 ounces or less following 37 weeks of pregnancy.

Chronic conditions linked to low birth weight

Low birth weight is now linked with chronic conditions including2:

Cancer. Analysis of birth weight and paediatric (child and young adolescent) cancer3 reported a link between LBW and a higher risk of hepatic (liver) tumours. However, lower risks of Hodgkin lymphoma and soft tissue sarcomas were observed.

Cardiovascular disease. A large cohort study in Sweden and Denmark in 2023, involving more than 3 million people, showed that children born with LBW or preterm faced a greater risk of heart disease, high blood pressure and stroke as adults4. Family history appeared to play a bigger role for those with LBW than for those born prematurely.

Chronic kidney disease. Growth restriction in the womb can affect kidney development, leading to fewer filtering units (nephrons) in the kidneys. This may contribute to high blood pressure5 and chronic kidney disease6 later in life. A 2023 study of teenagers confirmed that those born very small were more likely to have reduced kidney function and high blood pressure7.

Type-2 diabetes. A Danish study published in 20238 followed nearly 4,600 people for about 19 years, and found that LBW was strongly linked to later development of type 2 diabetes. The risk was independent of genetic risk factors or body mass index.

High blood fats (dyslipidemia). A study published in 20209 showed that women born with LBW tend to have higher cholesterol, more “bad” LDL cholesterol and more triglycerides, all of which raise the risk of heart disease and stroke. Men with LBW, by contrast, are more likely to have lower levels of “good” HDL cholesterol, which helps remove excess cholesterol from the body.

High levels of protein in urine (proteinuria). As noted above, LBW can reduce the number of nephrons in the kidneys. As a result, the remaining filtering units (called glomeruli) filter the blood at a higher rate (hyperfiltration) and become enlarged. Proteinuria may be an early sign of this10.

Risk factors for having a LBW baby

Several factors raise the risk of LBW. A mother’s socioeconomic background – her education, income and work – plays a role11. So can her relationship status, though the evidence is mixed12. Ethnic inequalities are clear in the UK: Black and south Asian women are more likely than white women to have a LBW baby11. Smoking, over-exercising, poor living conditions and domestic abuse also contribute13,14. Other risks include maternal depression, gum disease, anaemia, diabetes, high caffeine intake, alcohol and drug use.

Can low birth weight be prevented?

Some risk factors can be reduced to help lower the chances of having a LBW baby, such as:

  • Better education and living conditions for mothers
  • Good nutrition, including taking folic acid supplements
  • Support for emotional wellness
  • Good oral health and hygiene 
  • Regular moderate exercise in the fresh air 
  • Limiting stress during pregnancy
  • Avoiding harmful toxins, including household chemicals, tobacco smoke and alcohol
Can you help prevent health problems in LBW people?

In 2022, 2.9% of live births in the UK were of LBW – up slightly from 2.6% the year before15. That translates to around 1.75 million people at greater risk of chronic illness.

We cannot change a person’s history of low birth weight, but healthy habits can help reduce future risks. Here’s what research tells us:

  • It is proposed that giving natural substances soon after birth (‘physiological regenerative medicine’) may boost kidney development in babies with LBW16, potentially lowering their risk of kidney or metabolic disease.
  • Good nutrition from infancy helps protect against obesity, metabolic syndrome and heart disease17. 
  • For adults, a healthy lifestyle18 including regular exercise, a healthy diet, and avoiding smoking or heavy drinking remain the best defence against chronic illness – whatever your birthweight.
Key points to consider
  • The evidence suggests a link between LBW and certain types of chronic disease later in life.
  • Risk factors for LBW include low maternal education, poor nutrition, ethnic background, socio-economic status, environmental factors, and possibly marital status.
  • Improving the nutritional education of pregnant women would be beneficial. 
  • Whatever your birthweight, having a healthy lifestyle that includes regular exercise, a healthy diet and no smoking or heavy drinking can help to reduce the risk of chronic disease. 

Reviewed and updated by Mojitola Idowu, September 2025.

References 
  1. Almond D, Currie J. Killing Me Softly: The Fetal Origins Hypothesis. J Econ Perspect. 2011 Summer;25(3):153-172.  https://pmc.ncbi.nlm.nih.gov/articles/PMC4140221/
  2. Bianchi ME, Restrepo JM. Low Birthweight as a Risk Factor for Non-communicable Diseases in Adults. Front Med (Lausanne). 2022 Jan 6;8:793990. https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.793990/full
  3. Hoang TT, Schraw JM, Peckham-Gregory EC, et al. Fetal growth and pediatric cancer: A pan-cancer analysis in 7000 cases and 37 000 controls. Int J Cancer. 2024 Jan 1;154(1):41-52. https://onlinelibrary.wiley.com/doi/abs/10.1002/ijc.34683
  4. Lu D, Yu Y, Ludvigsson JF, et al. Birth Weight, Gestational Age, and Risk of Cardiovascular Disease in Early Adulthood: Influence of Familial Factors. Am J Epidemiol. 2023 Jun 2;192(6):866-877. https://academic.oup.com/aje/article/192/6/866/6969414?login=false
  5. Jebasingh F, Thomas N. Barker Hypothesis and Hypertension. Front Public Health. 2022 Jan 21;9:767545. https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2021.767545/full
  6. Sutherland MR, Black MJ. The impact of intrauterine growth restriction and prematurity on nephron endowment. Nat Rev Nephrol. 2023 Apr;19(4):218-228. https://www.nature.com/articles/s41581-022-00668-8
  7. Brathwaite KE, Levy RV, Sarathy H, et al. Reduced kidney function and hypertension in adolescents with low birth weight, NHANES 1999-2016. Pediatr Nephrol. 2023 Sep;38(9):3071-3082. https://link.springer.com/article/10.1007/s00467-023-05958-2
  8. Wibaek R, Andersen GS, Linneberg A, et al. Low birthweight is associated with a higher incidence of type 2 diabetes over two decades independent of adult BMI and genetic predisposition. Diabetologia. 2023 Sep;66(9):1669-1679. https://link.springer.com/article/10.1007/s00125-023-05937-0
  9. Al Salmi I, Hannawi S. Birthweight and Lipids in Adult Life: Population-Based Cross Sectional Study. Lipids. 2020 Jul;55(4):365-374. doi: 10.1002/lipd.12242. https://pubmed.ncbi.nlm.nih.gov/32372421/
  10. Luyckx VA, Brenner BM. Clinical consequences of developmental programming of low nephron number. Anat Rec (Hoboken). 2020 Oct;303(10):2613-2631. doi: 10.1002/ar.24270. https://pubmed.ncbi.nlm.nih.gov/31587509/
  11. Jardine J, Walker K, Gurol-Urganci I, et al; National Maternity and Perinatal Audit Project Team. Adverse pregnancy outcomes attributable to socioeconomic and ethnic inequalities in England: a national cohort study. Lancet. 2021 Nov 20;398(10314):1905-1912. doi: 10.1016/S0140-6736(21)01595-6. Epub 2021 Nov 1. Erratum in: Lancet. 2021 Nov 20;398(10314):1874. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01595-6/abstract 
  12. Iacono CD, Requena M, Stanek M. Partnership, living arrangements, and low birth weight: evidence from a population-based study on Spanish mothers. BMC Pregnancy Childbirth 2022; 22: 925. https://pubmed.ncbi.nlm.nih.gov/36482353/
  13. Bandyopadhyay A, Jones H, Parker M, et al. Weighting of risk factors for low birth weight: a linked routine data cohort study in Wales, UK. BMJ Open. 2023 Feb 10;13(2):e063836.  https://bmjopen.bmj.com/content/13/2/e063836.long 
  14. Arabzadeh H, Doosti-Irani A, Kamkari S, et al. The maternal factors associated with infant low birth weight: an umbrella review. BMC Pregnancy Childbirth. 2024 Apr 25;24(1):316. https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-024-06487-y 
  15. Office for National Statistics. Birth characteristics in England and Wales 2022. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/livebirths/bulletins/birthcharacteristicsinenglandandwales/2022
  16. Faa G, Fanos V, Manchia M, et al. The fascinating theory of fetal programming of adult diseases: A review of the fundamentals of the Barker hypothesis. J Public Health Res. 2024 Mar 1;13(1):22799036241226817. https://journals.sagepub.com/doi/10.1177/22799036241226817
  17. Gantenbein KV, Kanaka-Gantenbein C. Highlighting the trajectory from intrauterine growth restriction to future obesity. Front Endocrinol (Lausanne). 2022 Nov 11;13:1041718. https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.1041718/full
  18. NHS. Live Well. https://www.nhs.uk/live-well/

 

 

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