| Title: |
Neonatal mortality risk for vulnerable newborn types in 15 countries using 125.5 million nationwide birth outcome records, 2000-2020. |
| Authors: |
Suárez-Idueta, L; Blencowe, H; Okwaraji, YB; Yargawa, J; Bradley, E; Gordon, A; Flenady, V; Paixao, ES; Barreto, ML; Lisonkova, S; Wen, Q; Velebil, P; Jírová, J; Horváth-Puhó, E; Sørensen, HT; Sakkeus, L; Abuladze, L; Yunis, KA; Al Bizri, A; Barranco, A; Broeders, L; van Dijk, AE; Alyafei, F; Olukade, TO; Razaz, N; Söderling, J; Smith, LK; Draper, ES; Lowry, E; Rowland, N; Wood, R; Monteath, K; Pereyra, I; Pravia, G; Ohuma, EO; Lawn, JE; National Vulnerable Newborn Mortality Collaborative Group and Vulnerable Newborn Measurement Core Group |
| Publication Year: |
2023 |
| Collection: |
Queen Mary University of London: Queen Mary Research Online (QMRO) |
| Subject Terms: |
neonatal mortality; preterm birth; size for gestational age; vulnerable newborn |
| Description: |
OBJECTIVE: To compare neonatal mortality associated with six novel vulnerable newborn types in 125.5 million live births across 15 countries, 2000-2020. DESIGN: Population-based, multi-country study. SETTING: National data systems in 15 middle- and high-income countries. METHODS: We used individual-level data sets identified for the Vulnerable Newborn Measurement Collaboration. We examined the contribution to neonatal mortality of six newborn types combining gestational age (preterm [PT] versus term [T]) and size-for-gestational age (small [SGA], 90th centile) according to INTERGROWTH-21st newborn standards. Newborn babies with PT or SGA were defined as small and T + LGA was considered as large. We calculated risk ratios (RRs) and population attributable risks (PAR%) for the six newborn types. MAIN OUTCOME MEASURES: Mortality of six newborn types. RESULTS: Of 125.5 million live births analysed, risk ratios were highest among PT + SGA (median 67.2, interquartile range [IQR] 45.6-73.9), PT + AGA (median 34.3, IQR 23.9-37.5) and PT + LGA (median 28.3, IQR 18.4-32.3). At the population level, PT + AGA was the greatest contributor to newborn mortality (median PAR% 53.7, IQR 44.5-54.9). Mortality risk was highest among newborns born before 28 weeks (median RR 279.5, IQR 234.2-388.5) compared with babies born between 37 and 42 completed weeks or with a birthweight less than 1000 g (median RR 282.8, IQR 194.7-342.8) compared with those between 2500 g and 4000 g as a reference group. CONCLUSION: Preterm newborn types were the most vulnerable, and associated with the highest mortality, particularly with co-existence of preterm and SGA. As PT + AGA is more prevalent, it is responsible for the greatest burden of neonatal deaths at population level. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
BJOG; https://qmro.qmul.ac.uk/xmlui/handle/123456789/89622 |
| DOI: |
10.1111/1471-0528.17506 |
| Availability: |
https://qmro.qmul.ac.uk/xmlui/handle/123456789/89622; https://doi.org/10.1111/1471-0528.17506 |
| Rights: |
Attribution 3.0 United States ; http://creativecommons.org/licenses/by/3.0/us/ |
| Accession Number: |
edsbas.2016F2F8 |
| Database: |
BASE |