Mortality risk in preterm and small-for-gestational-age infants in low-income and middle-income countries: A pooled country analysis

Background Babies with low birthweight (<2500 g) are at increased risk of early mortality. However, low birthweight includes babies born preterm and with fetal growth restriction, and not all these infants have a birthweight less than 2500 g. We estimated the neonatal and infant mortality associa...

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Main Authors: Joanne Katz, Anne C.C. Lee, Naoko Kozuki, Joy E. Lawn, Simon Cousens, Hannah Blencowe, Majid Ezzati, Zulfiqar A. Bhutta, Tanya Marchant, Barbara A. Willey, Linda Adair, Fernando Barros, Abdullah H. Baqui, Parul Christian, Wafaie Fawzi, Rogelio Gonzalez, Jean Humphrey, Lieven Huybregts, Patrick Kolsteren, Aroonsri Mongkolchati, Luke C. Mullany, Richard Ndyomugyenyi, Jyh Kae Nien, David Osrin, Dominique Roberfroid, Ayesha Sania, Christentze Schmiegelow, Mariangela F. Silveira, James Tielsch, Anjana Vaidya, Sithembiso C. Velaphi, Cesar G. Victora, Deborah Watson-Jones, Robert E. Black
Other Authors: Johns Hopkins Bloomberg School of Public Health
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Published: 2018
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Online Access:https://repository.li.mahidol.ac.th/handle/123456789/32301
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spelling th-mahidol.323012018-10-19T12:23:05Z Mortality risk in preterm and small-for-gestational-age infants in low-income and middle-income countries: A pooled country analysis Joanne Katz Anne C.C. Lee Naoko Kozuki Joy E. Lawn Simon Cousens Hannah Blencowe Majid Ezzati Zulfiqar A. Bhutta Tanya Marchant Barbara A. Willey Linda Adair Fernando Barros Abdullah H. Baqui Parul Christian Wafaie Fawzi Rogelio Gonzalez Jean Humphrey Lieven Huybregts Patrick Kolsteren Aroonsri Mongkolchati Luke C. Mullany Richard Ndyomugyenyi Jyh Kae Nien David Osrin Dominique Roberfroid Ayesha Sania Christentze Schmiegelow Mariangela F. Silveira James Tielsch Anjana Vaidya Sithembiso C. Velaphi Cesar G. Victora Deborah Watson-Jones Robert E. Black Johns Hopkins Bloomberg School of Public Health Brigham and Women's Hospital Save the Children USA London School of Hygiene &amp; Tropical Medicine Imperial College London The Aga Khan University The University of North Carolina System Universidade Federal de Pelotas Centro Harvard School of Public Health Pontificia Universidad Catolica de Chile Clinica Santa Maria Zvitambo Universiteit Gent Prins Leopold Instituut voor Tropische Geneeskunde Mahidol University Uganda Ministry of Health Clinica Davila Universidad de los Andes, Santiago UCL Institute of Child Health George Washington University Kobenhavns Universitet Copenhagen University Hospital University of Witwatersrand National Institutes of Medical Research Medicine Background Babies with low birthweight (<2500 g) are at increased risk of early mortality. However, low birthweight includes babies born preterm and with fetal growth restriction, and not all these infants have a birthweight less than 2500 g. We estimated the neonatal and infant mortality associated with these two characteristics in low-income and middle-income countries. Methods For this pooled analysis, we searched all available studies and identified 20 cohorts (providing data for 2015019 livebirths) from Asia, Africa, and Latin America that recorded data for birthweight, gestational age, and vital statistics through 28 days of life. Study dates ranged from 1982 through to 2010. We calculated relative risks (RR) and risk differences (RD) for mortality associated with preterm birth (<32 weeks, 32 weeks to <34 weeks, 34 weeks to <37 weeks), small-for-gestational-age (SGA; babies with birthweight in the lowest third percentile and between the third and tenth percentile of a US reference population), and preterm and SGA combinations. Findings Pooled overall RRs for preterm were 6·82 (95% CI 3·56-13·07) for neonatal mortality and 2·50 (1·48-4·22) for post-neonatal mortality. Pooled RRs for babies who were SGA (with birthweight in the lowest tenth percentile of the reference population) were 1·83 (95% CI 1·34-2·50) for neonatal mortality and 1·90 (1·32-2·73) for post-neonatal mortality. The neonatal mortality risk of babies who were both preterm and SGA was higher than that of babies with either characteristic alone (15·42; 9·11-26·12). Interpretation Many babies in low-income and middle-income countries are SGA. Preterm birth affects a smaller number of neonates than does SGA, but is associated with a higher mortality risk. The mortality risks associated with both characteristics extend beyond the neonatal period. Differentiation of the burden and risk of babies born preterm and SGA rather than with low birthweight could guide prevention and management strategies to speed progress towards Millennium Development Goal 4 - the reduction of child mortality. © 2013 Elsevier Ltd. 2018-10-19T05:23:05Z 2018-10-19T05:23:05Z 2013-06-07 Article The Lancet. Vol.382, No.9890 (2013), 417-425 10.1016/S0140-6736(13)60993-9 1474547X 01406736 2-s2.0-84881183070 https://repository.li.mahidol.ac.th/handle/123456789/32301 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84881183070&origin=inward
institution Mahidol University
building Mahidol University Library
continent Asia
country Thailand
Thailand
content_provider Mahidol University Library
collection Mahidol University Institutional Repository
topic Medicine
spellingShingle Medicine
Joanne Katz
Anne C.C. Lee
Naoko Kozuki
Joy E. Lawn
Simon Cousens
Hannah Blencowe
Majid Ezzati
Zulfiqar A. Bhutta
Tanya Marchant
Barbara A. Willey
Linda Adair
Fernando Barros
Abdullah H. Baqui
Parul Christian
Wafaie Fawzi
Rogelio Gonzalez
Jean Humphrey
Lieven Huybregts
Patrick Kolsteren
Aroonsri Mongkolchati
Luke C. Mullany
Richard Ndyomugyenyi
Jyh Kae Nien
David Osrin
Dominique Roberfroid
Ayesha Sania
Christentze Schmiegelow
Mariangela F. Silveira
James Tielsch
Anjana Vaidya
Sithembiso C. Velaphi
Cesar G. Victora
Deborah Watson-Jones
Robert E. Black
Mortality risk in preterm and small-for-gestational-age infants in low-income and middle-income countries: A pooled country analysis
description Background Babies with low birthweight (<2500 g) are at increased risk of early mortality. However, low birthweight includes babies born preterm and with fetal growth restriction, and not all these infants have a birthweight less than 2500 g. We estimated the neonatal and infant mortality associated with these two characteristics in low-income and middle-income countries. Methods For this pooled analysis, we searched all available studies and identified 20 cohorts (providing data for 2015019 livebirths) from Asia, Africa, and Latin America that recorded data for birthweight, gestational age, and vital statistics through 28 days of life. Study dates ranged from 1982 through to 2010. We calculated relative risks (RR) and risk differences (RD) for mortality associated with preterm birth (<32 weeks, 32 weeks to <34 weeks, 34 weeks to <37 weeks), small-for-gestational-age (SGA; babies with birthweight in the lowest third percentile and between the third and tenth percentile of a US reference population), and preterm and SGA combinations. Findings Pooled overall RRs for preterm were 6·82 (95% CI 3·56-13·07) for neonatal mortality and 2·50 (1·48-4·22) for post-neonatal mortality. Pooled RRs for babies who were SGA (with birthweight in the lowest tenth percentile of the reference population) were 1·83 (95% CI 1·34-2·50) for neonatal mortality and 1·90 (1·32-2·73) for post-neonatal mortality. The neonatal mortality risk of babies who were both preterm and SGA was higher than that of babies with either characteristic alone (15·42; 9·11-26·12). Interpretation Many babies in low-income and middle-income countries are SGA. Preterm birth affects a smaller number of neonates than does SGA, but is associated with a higher mortality risk. The mortality risks associated with both characteristics extend beyond the neonatal period. Differentiation of the burden and risk of babies born preterm and SGA rather than with low birthweight could guide prevention and management strategies to speed progress towards Millennium Development Goal 4 - the reduction of child mortality. © 2013 Elsevier Ltd.
author2 Johns Hopkins Bloomberg School of Public Health
author_facet Johns Hopkins Bloomberg School of Public Health
Joanne Katz
Anne C.C. Lee
Naoko Kozuki
Joy E. Lawn
Simon Cousens
Hannah Blencowe
Majid Ezzati
Zulfiqar A. Bhutta
Tanya Marchant
Barbara A. Willey
Linda Adair
Fernando Barros
Abdullah H. Baqui
Parul Christian
Wafaie Fawzi
Rogelio Gonzalez
Jean Humphrey
Lieven Huybregts
Patrick Kolsteren
Aroonsri Mongkolchati
Luke C. Mullany
Richard Ndyomugyenyi
Jyh Kae Nien
David Osrin
Dominique Roberfroid
Ayesha Sania
Christentze Schmiegelow
Mariangela F. Silveira
James Tielsch
Anjana Vaidya
Sithembiso C. Velaphi
Cesar G. Victora
Deborah Watson-Jones
Robert E. Black
format Article
author Joanne Katz
Anne C.C. Lee
Naoko Kozuki
Joy E. Lawn
Simon Cousens
Hannah Blencowe
Majid Ezzati
Zulfiqar A. Bhutta
Tanya Marchant
Barbara A. Willey
Linda Adair
Fernando Barros
Abdullah H. Baqui
Parul Christian
Wafaie Fawzi
Rogelio Gonzalez
Jean Humphrey
Lieven Huybregts
Patrick Kolsteren
Aroonsri Mongkolchati
Luke C. Mullany
Richard Ndyomugyenyi
Jyh Kae Nien
David Osrin
Dominique Roberfroid
Ayesha Sania
Christentze Schmiegelow
Mariangela F. Silveira
James Tielsch
Anjana Vaidya
Sithembiso C. Velaphi
Cesar G. Victora
Deborah Watson-Jones
Robert E. Black
author_sort Joanne Katz
title Mortality risk in preterm and small-for-gestational-age infants in low-income and middle-income countries: A pooled country analysis
title_short Mortality risk in preterm and small-for-gestational-age infants in low-income and middle-income countries: A pooled country analysis
title_full Mortality risk in preterm and small-for-gestational-age infants in low-income and middle-income countries: A pooled country analysis
title_fullStr Mortality risk in preterm and small-for-gestational-age infants in low-income and middle-income countries: A pooled country analysis
title_full_unstemmed Mortality risk in preterm and small-for-gestational-age infants in low-income and middle-income countries: A pooled country analysis
title_sort mortality risk in preterm and small-for-gestational-age infants in low-income and middle-income countries: a pooled country analysis
publishDate 2018
url https://repository.li.mahidol.ac.th/handle/123456789/32301
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