Stillbirths and neonatal mortality in LMICs: A community-based mother-infant cohort study.

Autor:	Rambliere L; Institut Pasteur, Université Paris Cité, Epidemiology and Modelling of Antibiotic Evasion (EMAE), Paris, France.; Université Paris-Saclay, UVSQ, Inserm, CESP, Anti-infective evasion and pharmacoepidemiology team, Montigny-le-Bretonneux, France., de Lauzanne A; Institut Pasteur du Cambodge, Epidemiology & Public Health Unit, Phnom Penh, Cambodia., Diouf JB; Centre Hospitalier Roi Baudouin Guédiawaye, Dakar, Senegal., Zo AZ; Peadiatric Ward, Centre Hospitalier de Soavinandriana, Antananarivo, Madagascar., Landau M; Institut Pasteur de Madagascar, Unité d'épidémiologie et de recherche clinique, Antananarivo, Madagascar., Herindrainy P; Institut Pasteur de Madagascar, Unité d'épidémiologie et de recherche clinique, Antananarivo, Madagascar., Hivernaud D; Assistance Publique-Hôpitaux de Paris, Hôpital Universitaire Necker-Enfants Malades, Department of Neonatology, Université de Paris, Paris, France., Sarr FD; Institut Pasteur de Dakar, Unité d'épidémiologie des maladies infectieuses, Dakar, Senegal., Sok T; Ministry of Health, Phnom Penh, Cambodia., Vray M; Institut Pasteur de Dakar, Unité d'épidémiologie des maladies infectieuses, Dakar, Senegal., Collard JM; Institut Pasteur de Madagascar, Unité de bactériologie expérimentale, Antananarivo, Madagascar., Borand L; Institut Pasteur du Cambodge, Epidemiology & Public Health Unit, Phnom Penh, Cambodia.; Center for Tuberculosis Research, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Delarocque-Astagneau E; Université Paris-Saclay, UVSQ, Inserm, CESP, Anti-infective evasion and pharmacoepidemiology team, Montigny-le-Bretonneux, France.; APHP, GHU Université Paris-Saclay, Raymond Poincaré Hospital, Epidemiology and Public Health, Garches, France., Guillemot D; Institut Pasteur, Université Paris Cité, Epidemiology and Modelling of Antibiotic Evasion (EMAE), Paris, France.; Université Paris-Saclay, UVSQ, Inserm, CESP, Anti-infective evasion and pharmacoepidemiology team, Montigny-le-Bretonneux, France.; APHP, GHU Université Paris-Saclay, Raymond Poincaré Hospital, Epidemiology and Public Health, Garches, France., Kermorvant-Duchemin E; Institut Pasteur de Madagascar, Unité d'épidémiologie et de recherche clinique, Antananarivo, Madagascar., Huynh BT; Institut Pasteur, Université Paris Cité, Epidemiology and Modelling of Antibiotic Evasion (EMAE), Paris, France.; Université Paris-Saclay, UVSQ, Inserm, CESP, Anti-infective evasion and pharmacoepidemiology team, Montigny-le-Bretonneux, France.
Jazyk:	angličtina
Zdroj:	Journal of global health [J Glob Health] 2023 Apr 14; Vol. 13, pp. 04031. Date of Electronic Publication: 2023 Apr 14.
DOI:	10.7189/jogh.13.04031
Abstrakt:	Background: The exact timing, causes, and circumstances of stillbirth and neonatal mortality in low- and middle-income countries (LMICs) remain poorly described, especially for antenatal stillbirths and deaths occurring at home. We aimed to provide reliable estimates of the incidence of stillbirth and neonatal death in three LMICs (Madagascar, Cambodia and Senegal) and to identify their main causes and associated risk factors. Methods: This study is based on data from an international, multicentric, prospective, longitudinal, community-based mother-infant cohort. We included pregnant mothers and prospectively followed up their children in the community. Stillbirths and deaths were systematically reported; information across healthcare settings was collected and verbal autopsies were performed to document the circumstances and timing of death. Results: Among the 4436 pregnancies and 4334 live births, the peripartum period and the first day of life were the key periods of mortality. The estimated incidence of stillbirth was 11 per 1000 total births in Cambodia, 15 per 1000 in Madagascar, and 12 per 1000 in Senegal. We estimated neonatal mortality at 18 per 1000 live births in Cambodia, 24 per 1000 in Madagascar, and 23 per 1000 in Senegal. Based on ultrasound biometric data, 16.1% of infants in Madagascar were born prematurely, where 42% of deliveries and 33% of deaths occurred outside healthcare facilities. Risk factors associated with neonatal death were mainly related to delivery or to events that newborns faced during the first week of life. Conclusions: These findings underscore the immediate need to improve care for and monitoring of children at birth and during early life to decrease infant mortality. Surveillance of stillbirth and neonatal mortality and their causes should be improved to mitigate this burden in LMICs. Competing Interests: Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interests. (Copyright © 2023 by the Journal of Global Health. All rights reserved.)
Databáze:	MEDLINE
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