Abstract
Objective: We aimed to understand the mortality risks of vulnerable newborns (defined as preterm and/or born weighing smaller or larger compared to a standard population), in low- and middle-income countries (LMICs). Design: Descriptive multi-country, secondary analysis of individual-level study data of babies born since 2000. Setting: Sixteen subnational, population-based studies from nine LMICs in sub-Saharan Africa, Southern and Eastern Asia, and Latin America. Population: Live birth neonates. Methods: We categorically defined five vulnerable newborn types based on size (large- or appropriate- or small-for-gestational age [LGA, AGA, SGA]), and term (T) and preterm (PT): T + LGA, T + SGA, PT + LGA, PT + AGA, and PT + SGA, with T + AGA (reference). A 10-type definition included low birthweight (LBW) and non-LBW, and a four-type definition collapsed AGA/LGA into one category. We performed imputation for missing birthweights in 13 of the studies. Main Outcome Measures: Median and interquartile ranges by study for the prevalence, mortality rates and relative mortality risks for the four, six and ten type classification. Results: There were 238 143 live births with known neonatal status. Four of the six types had higher mortality risk: T + SGA (median relative risk [RR] 2.8, interquartile range [IQR] 2.0–3.2), PT + LGA (median RR 7.3, IQR 2.3–10.4), PT + AGA (median RR 6.0, IQR 4.4–13.2) and PT + SGA (median RR 10.4, IQR 8.6–13.9). T + SGA, PT + LGA and PT + AGA babies who were LBW, had higher risk compared with non-LBW babies. Conclusions: Small and/or preterm babies in LIMCs have a considerably increased mortality risk compared with babies born at term and larger. This classification system may advance the understanding of the social determinants and biomedical risk factors along with improved treatment that is critical for newborn health.
| Original language | English |
|---|---|
| Journal | BJOG: An International Journal of Obstetrics and Gynaecology |
| Number of pages | 12 |
| ISSN | 1470-0328 |
| DOIs | |
| Publication status | E-pub ahead of print - 2024 |
Bibliographical note
Publisher Copyright:© 2023 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.
Keywords
- low-and middle-income countries, obstetrics and gynaecology
- paediatrics: neonatal
- preterm
- small-for-gestational age
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- 10.1111/1471-0528.17518Licence: CC BY
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Neonatal mortality risk of vulnerable newborns : A descriptive analysis of subnational, population-based birth cohorts for 238 143 live births in low- and middle-income settings from 2000 to 2017. / Hazel, Elizabeth A.; Erchick, Daniel J.; Katz, Joanne; Lee, Anne C.C.; Diaz, Michael; Wu, Lee S.F.; West, Keith P.; Shamim, Abu Ahmed; Christian, Parul; Ali, Hasmot; Baqui, Abdullah H.; Saha, Samir K.; Ahmed, Salahuddin; Roy, Arunangshu Dutta; Silveira, Mariângela F.; Buffarini, Romina; Shapiro, Roger; Zash, Rebecca; Kolsteren, Patrick; Lachat, Carl; Huybregts, Lieven; Roberfroid, Dominique; Zhu, Zhonghai; Zeng, Lingxia; Gebreyesus, Seifu H.; Tesfamariam, Kokeb; Adu-Afarwuah, Seth; Dewey, Kathryn G.; Gyaase, Stephaney; Poku-Asante, Kwaku; Boamah Kaali, Ellen; Jack, Darby; Ravilla, Thulasiraj; Tielsch, James; Taneja, Sunita; Chowdhury, Ranadip; Ashorn, Per; Maleta, Kenneth; Ashorn, Ulla; Mangani, Charles; Mullany, Luke C.; Khatry, Subarna K.; Ramokolo, Vundli; Zembe-Mkabile, Wanga; Fawzi, Wafaie W.; Wang, Dongqing; Schmiegelow, Christentze; Minja, Daniel; Msemo, Omari Abdul; Lusingu, John P.A.; Smith, Emily R.; Masanja, Honorati; Mongkolchati, Aroonsri; Keentupthai, Paniya; Kakuru, Abel; Kajubi, Richard; Semrau, Katherine; Hamer, Davidson H.; Manasyan, Albert; Pry, Jake M.; Chasekwa, Bernard; Humphrey, Jean; Black, Robert E.; Klemm, Rolf D.W. (Member of author collaboration); Massie, Allan B. (Member of author collaboration); Mitra, Maithilee (Member of author collaboration); Mehra, Sucheta (Member of author collaboration); Schulze, Kerry J. (Member of author collaboration); Sommer, Alfred (Member of author collaboration); Ullah, Md Barkat (Member of author collaboration); Labrique, Alain B. (Member of author collaboration); Rashid, Mabhubur (Member of author collaboration); Shaikh, Saijuddin (Member of author collaboration); Begum, Nazma (Member of author collaboration); Chowdhury, Nabidul Haque (Member of author collaboration); Islam, Md Shafiqul (Member of author collaboration); Khanam, Rasheda (Member of author collaboration); Mitra, Dipak Kumar (Member of author collaboration); Quaiyum, Abdul (Member of author collaboration); Diseko, Modiegi (Member of author collaboration); Makhema, Joseph (Member of author collaboration); Cheng, Yue (Member of author collaboration); Roro, Meselech (Member of author collaboration); Endris, Bilal Shikur (Member of author collaboration); Arnold, Charles D. (Member of author collaboration); Bahl, Rajiv (Member of author collaboration); Bhandari, Nita (Member of author collaboration); Martines, Jose (Member of author collaboration); Mazumder, Sarmila (Member of author collaboration); Hallamaa, Lotta (Member of author collaboration); Pyykkö, Juha (Member of author collaboration); Urassa, Willy (Member of author collaboration); Deloron, Phillippe (Member of author collaboration); Bygbjerg, Ib Christian (Member of author collaboration); Moeller, Sofie Lykke (Member of author collaboration); Theander, Thor Grundtvig (Member of author collaboration); Muhihi, Alfa (Member of author collaboration); Noor, Ramadhani Abdallah (Member of author collaboration); Kamya, Moses R. (Member of author collaboration); Nakalembe, Miriam (Member of author collaboration); Biemba, Godfrey (Member of author collaboration); Herlihy, Julie M. (Member of author collaboration); Mbewe, Reuben K. (Member of author collaboration); Mweena, Fern (Member of author collaboration); Yeboah-Antwi, Kojo (Member of author collaboration); Prendergast, Andrew (Member of author collaboration); Lawn, Joy E. (Member of author collaboration); Blencowe, Hannah (Member of author collaboration); Ohuma, Eric (Member of author collaboration); Okwaraji, Yemi (Member of author collaboration); Yargawa, Judith (Member of author collaboration); Bradley, Ellen (Member of author collaboration); Idueta, Lorena Suarez (Member of author collaboration).
In: BJOG: An International Journal of Obstetrics and Gynaecology, 2024.Research output: Contribution to journal › Journal article › Research › peer-review
}
TY - JOUR
T1 - Neonatal mortality risk of vulnerable newborns
T2 - A descriptive analysis of subnational, population-based birth cohorts for 238 143 live births in low- and middle-income settings from 2000 to 2017
AU - Hazel, Elizabeth A.
AU - Erchick, Daniel J.
AU - Katz, Joanne
AU - Lee, Anne C.C.
AU - Diaz, Michael
AU - Wu, Lee S.F.
AU - West, Keith P.
AU - Shamim, Abu Ahmed
AU - Christian, Parul
AU - Ali, Hasmot
AU - Baqui, Abdullah H.
AU - Saha, Samir K.
AU - Ahmed, Salahuddin
AU - Roy, Arunangshu Dutta
AU - Silveira, Mariângela F.
AU - Buffarini, Romina
AU - Shapiro, Roger
AU - Zash, Rebecca
AU - Kolsteren, Patrick
AU - Lachat, Carl
AU - Huybregts, Lieven
AU - Roberfroid, Dominique
AU - Zhu, Zhonghai
AU - Zeng, Lingxia
AU - Gebreyesus, Seifu H.
AU - Tesfamariam, Kokeb
AU - Adu-Afarwuah, Seth
AU - Dewey, Kathryn G.
AU - Gyaase, Stephaney
AU - Poku-Asante, Kwaku
AU - Boamah Kaali, Ellen
AU - Jack, Darby
AU - Ravilla, Thulasiraj
AU - Tielsch, James
AU - Taneja, Sunita
AU - Chowdhury, Ranadip
AU - Ashorn, Per
AU - Maleta, Kenneth
AU - Ashorn, Ulla
AU - Mangani, Charles
AU - Mullany, Luke C.
AU - Khatry, Subarna K.
AU - Ramokolo, Vundli
AU - Zembe-Mkabile, Wanga
AU - Fawzi, Wafaie W.
AU - Wang, Dongqing
AU - Schmiegelow, Christentze
AU - Minja, Daniel
AU - Msemo, Omari Abdul
AU - Lusingu, John P.A.
AU - Smith, Emily R.
AU - Masanja, Honorati
AU - Mongkolchati, Aroonsri
AU - Keentupthai, Paniya
AU - Kakuru, Abel
AU - Kajubi, Richard
AU - Semrau, Katherine
AU - Hamer, Davidson H.
AU - Manasyan, Albert
AU - Pry, Jake M.
AU - Chasekwa, Bernard
AU - Humphrey, Jean
AU - Black, Robert E.
A2 - Klemm, Rolf D.W.
A2 - Massie, Allan B.
A2 - Mitra, Maithilee
A2 - Mehra, Sucheta
A2 - Schulze, Kerry J.
A2 - Sommer, Alfred
A2 - Ullah, Md Barkat
A2 - Labrique, Alain B.
A2 - Rashid, Mabhubur
A2 - Shaikh, Saijuddin
A2 - Begum, Nazma
A2 - Chowdhury, Nabidul Haque
A2 - Islam, Md Shafiqul
A2 - Khanam, Rasheda
A2 - Mitra, Dipak Kumar
A2 - Quaiyum, Abdul
A2 - Diseko, Modiegi
A2 - Makhema, Joseph
A2 - Cheng, Yue
A2 - Roro, Meselech
A2 - Endris, Bilal Shikur
A2 - Arnold, Charles D.
A2 - Bahl, Rajiv
A2 - Bhandari, Nita
A2 - Martines, Jose
A2 - Mazumder, Sarmila
A2 - Hallamaa, Lotta
A2 - Pyykkö, Juha
A2 - Urassa, Willy
A2 - Deloron, Phillippe
A2 - Bygbjerg, Ib Christian
A2 - Moeller, Sofie Lykke
A2 - Theander, Thor Grundtvig
A2 - Muhihi, Alfa
A2 - Noor, Ramadhani Abdallah
A2 - Kamya, Moses R.
A2 - Nakalembe, Miriam
A2 - Biemba, Godfrey
A2 - Herlihy, Julie M.
A2 - Mbewe, Reuben K.
A2 - Mweena, Fern
A2 - Yeboah-Antwi, Kojo
A2 - Prendergast, Andrew
A2 - Lawn, Joy E.
A2 - Blencowe, Hannah
A2 - Ohuma, Eric
A2 - Okwaraji, Yemi
A2 - Yargawa, Judith
A2 - Bradley, Ellen
A2 - Idueta, Lorena Suarez
N1 - Publisher Copyright: © 2023 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.
PY - 2024
Y1 - 2024
N2 - Objective: We aimed to understand the mortality risks of vulnerable newborns (defined as preterm and/or born weighing smaller or larger compared to a standard population), in low- and middle-income countries (LMICs). Design: Descriptive multi-country, secondary analysis of individual-level study data of babies born since 2000. Setting: Sixteen subnational, population-based studies from nine LMICs in sub-Saharan Africa, Southern and Eastern Asia, and Latin America. Population: Live birth neonates. Methods: We categorically defined five vulnerable newborn types based on size (large- or appropriate- or small-for-gestational age [LGA, AGA, SGA]), and term (T) and preterm (PT): T + LGA, T + SGA, PT + LGA, PT + AGA, and PT + SGA, with T + AGA (reference). A 10-type definition included low birthweight (LBW) and non-LBW, and a four-type definition collapsed AGA/LGA into one category. We performed imputation for missing birthweights in 13 of the studies. Main Outcome Measures: Median and interquartile ranges by study for the prevalence, mortality rates and relative mortality risks for the four, six and ten type classification. Results: There were 238 143 live births with known neonatal status. Four of the six types had higher mortality risk: T + SGA (median relative risk [RR] 2.8, interquartile range [IQR] 2.0–3.2), PT + LGA (median RR 7.3, IQR 2.3–10.4), PT + AGA (median RR 6.0, IQR 4.4–13.2) and PT + SGA (median RR 10.4, IQR 8.6–13.9). T + SGA, PT + LGA and PT + AGA babies who were LBW, had higher risk compared with non-LBW babies. Conclusions: Small and/or preterm babies in LIMCs have a considerably increased mortality risk compared with babies born at term and larger. This classification system may advance the understanding of the social determinants and biomedical risk factors along with improved treatment that is critical for newborn health.
AB - Objective: We aimed to understand the mortality risks of vulnerable newborns (defined as preterm and/or born weighing smaller or larger compared to a standard population), in low- and middle-income countries (LMICs). Design: Descriptive multi-country, secondary analysis of individual-level study data of babies born since 2000. Setting: Sixteen subnational, population-based studies from nine LMICs in sub-Saharan Africa, Southern and Eastern Asia, and Latin America. Population: Live birth neonates. Methods: We categorically defined five vulnerable newborn types based on size (large- or appropriate- or small-for-gestational age [LGA, AGA, SGA]), and term (T) and preterm (PT): T + LGA, T + SGA, PT + LGA, PT + AGA, and PT + SGA, with T + AGA (reference). A 10-type definition included low birthweight (LBW) and non-LBW, and a four-type definition collapsed AGA/LGA into one category. We performed imputation for missing birthweights in 13 of the studies. Main Outcome Measures: Median and interquartile ranges by study for the prevalence, mortality rates and relative mortality risks for the four, six and ten type classification. Results: There were 238 143 live births with known neonatal status. Four of the six types had higher mortality risk: T + SGA (median relative risk [RR] 2.8, interquartile range [IQR] 2.0–3.2), PT + LGA (median RR 7.3, IQR 2.3–10.4), PT + AGA (median RR 6.0, IQR 4.4–13.2) and PT + SGA (median RR 10.4, IQR 8.6–13.9). T + SGA, PT + LGA and PT + AGA babies who were LBW, had higher risk compared with non-LBW babies. Conclusions: Small and/or preterm babies in LIMCs have a considerably increased mortality risk compared with babies born at term and larger. This classification system may advance the understanding of the social determinants and biomedical risk factors along with improved treatment that is critical for newborn health.
KW - low-and middle-income countries, obstetrics and gynaecology
KW - paediatrics: neonatal
KW - preterm
KW - small-for-gestational age
U2 - 10.1111/1471-0528.17518
DO - 10.1111/1471-0528.17518
M3 - Journal article
C2 - 37156238
AN - SCOPUS:85158148856
JO - British Journal of Obstetrics and Gynaecology, Supplement
JF - British Journal of Obstetrics and Gynaecology, Supplement
SN - 0140-7686
ER -