Sharan, Apoorva; Stuurman, Anke L; Jahagirdar, Shubhashri; Elango, Varalakshmi; Riera-Montes, Margarita; Kashyap, Neeraj Kumar; Biccler, Jorne; Poluru, Ramesh; Arora, Narendra Kumar; Mathai, Mathews; +8 more... Mangtani, Punam; Devlieger, Hugo; Anderson, Steven; Whitaker, Barbee; Wong, Hui-Lee; Moran, Allisyn; Maure, Christine Guillard; WHO Global Vaccine Safety Multi-Country Collaboration sites; (2022) Estimating baseline rates of adverse perinatal and neonatal outcomes using a facility-based surveillance approach: A prospective observational study from the WHO Global Vaccine Safety Multi-Country Collaboration on safety in pregnancy. EClinicalMedicine, 50. 101506-. ISSN 2589-5370 DOI: https://doi.org/10.1016/j.eclinm.2022.101506
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Abstract
BACKGROUND: Most perinatal and neonatal deaths occur in low- and middle-income countries (LMICs), yet, quality data on burden of adverse outcomes of pregnancy is limited in such countries. METHODS: A network of 21 maternity units, across seven countries, undertook surveillance for low birthweight, preterm birth, small for gestational age (SGA), stillbirths, congenital microcephaly, in-hospital neonatal deaths, and neonatal infections in a cohort of over 85,000 births from May 2019 - August 2020. For each outcome, site-specific rates per 1,000 livebirths (or per 1,000 total births for stillbirth) and 95% confidence intervals (CI) were calculated. Descriptive sensitivity analysis was conducted to gain insight regarding underreporting of four outcomes at 16 sites. FINDINGS: Estimated rates varied across countries and sites, ranging between 43·3-329·5 and 21·4-276·6/1000 livebirths for low birthweight and preterm birth respectively and 11·8-81/1,000 livebirths for SGA. No cases of congenital microcephaly were reported by three sites while the highest estimated rate was 13/1,000 livebirths. Neonatal infection and neonatal death rates varied between 1·8-73 and 0-59·9/1000 livebirths respectively while stillbirth rates ranged between 0-57·1/1000 total births across study sites. Results from the sensitivity analysis confirmed the underreporting of congenital microcephaly and SGA in our study. INTERPRETATION: Our study establishes site-specific baseline rates for important adverse perinatal and neonatal outcomes and addresses a critical evidence gap towards improved monitoring of benefits and risks of emerging pregnancy and neonatal interventions. FUNDING: The study was sponsored by the World Health Organization with funding from the Bill and Melinda Gates Foundation.
Item Type | Article |
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Faculty and Department | Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology |
Research Centre | Vaccine Centre |
PubMed ID | 35770255 |
Elements ID | 181083 |
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Filename: Sharon_etal_2022_Estimating-baseline-rates-of-adverse.pdf
Licence: Creative Commons Attribution 3.0 IGO
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