Suárez-Idueta, Lorena; Blencowe, Hannah; Okwaraji, Yemisrach B; Yargawa, Judith; Bradley, Ellen; Gordon, Adrienne; Flenady, Vicki; Paixao, Enny S; Barreto, Mauricio L; Lisonkova, Sarka; +27 more... Wen, Qi; Velebil, Petr; Jírová, Jitka; Horváth-Puhó, Erzsebet; Sørensen, Henrik Toft; Sakkeus, Luule; Abuladze, Liili; Yunis, Khalid A; Al Bizri, Ayah; Barranco, Arturo; Broeders, Lisa; van Dijk, Aimée E; Alyafei, Fawziya; Olukade, Tawa O; Razaz, Neda; Söderling, Jonas; Smith, Lucy K; Draper, Elizabeth S; Lowry, Estelle; Rowland, Neil; Wood, Rachael; Monteath, Kirsten; Pereyra, Isabel; Pravia, Gabriella; Ohuma, Eric O; Lawn, Joy E; National Vulnerable Newborn Mortality Collaborative Group and Vu; (2023) Neonatal mortality risk for vulnerable newborn types in 15 countries using 125.5 million nationwide birth outcome records, 2000-2020. BJOG : an international journal of obstetrics and gynaecology. ISSN 1470-0328 DOI: https://doi.org/10.1111/1471-0528.17506
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Abstract
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], <10th centile, appropriate [AGA], 10th-90th centile or large [LGA], >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.
Item Type | Article |
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Faculty and Department | Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology & International Health (2023-) |
Research Centre | Centre for Maternal, Reproductive and Child Health (MARCH) |
PubMed ID | 37156244 |
Elements ID | 202972 |
Official URL | https://doi.org/10.1111/1471-0528.17506 |
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Filename: Suarez-Idueta-etal-2023-neonatal-morality-risk-for-vulnerable-newborn-types-in-15-countries-using-125.5-million-nationwide-birth-outcome-records-2000-2020.pdf
Licence: Creative Commons: Attribution 4.0
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