Neonatal mortality risk for vulnerable newborn types in 15 countries using 125.5 million nationwide birth outcome records, 2000-2020.

Autor: Suárez-Idueta L; Mexican Society of Public Health, Mexico City, Mexico., Blencowe H; Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK., Okwaraji YB; Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK., Yargawa J; Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK., Bradley E; Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK., Gordon A; Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia., Flenady V; Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia., Paixao ES; Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK.; Centre for Data Integration and Knowledge for Health (CIDACS), Instituto Gonçalo Moniz, Fiocruz Bahia, Fundação Oswaldo Cruz, Salvador, Brazil., Barreto ML; Centre for Data Integration and Knowledge for Health (CIDACS), Instituto Gonçalo Moniz, Fiocruz Bahia, Fundação Oswaldo Cruz, Salvador, Brazil., Lisonkova S; Department of Obstetrics & Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada., Wen Q; Department of Obstetrics & Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada., Velebil P; Department of Obstetrics and Gynaecology, Institute for the Care of Mother and Child, Prague, Czech Republic., Jírová J; Department of Data Analysis, Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic., Horváth-Puhó E; Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus N, Denmark., Sørensen HT; Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus N, Denmark., Sakkeus L; School of Governance, Law and Society, Estonian Institute for Population Studies, Tallinn University, Tallinn, Estonia., Abuladze L; School of Governance, Law and Society, Estonian Institute for Population Studies, Tallinn University, Tallinn, Estonia.; Finnish Population Research Institute, Väestöliitto, Helsinki, Finland., Yunis KA; Department of Paediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon., Al Bizri A; Department of Paediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon., Barranco A; Directorate of Health Information, Ministry of Health, Mexico City, Mexico., Broeders L; Perined, Utrecht, The Netherlands., van Dijk AE; Perined, Utrecht, The Netherlands., Alyafei F; Hamad Medical Corporation, Doha, Qatar., Olukade TO; Hamad Medical Corporation, Doha, Qatar., Razaz N; Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden., Söderling J; Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden., Smith LK; Department of Population Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK., Draper ES; Department of Population Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK., Lowry E; School of Natural and Built Environment, Queen's University Belfast, Belfast, UK., Rowland N; Queen's Management School, Queen's University Belfast, Belfast, UK., Wood R; Public Health Scotland, Edinburgh, UK.; Usher Institute, University of Edinburgh, Edinburgh, UK., Monteath K; Pregnancy, Birth and Child Health Team, Public Health Scotland, Edinburgh, UK., Pereyra I; Department of Wellness and Health, Catholic University of Uruguay, Montevideo, Uruguay., Pravia G; Department of Wellness and Health, Catholic University of Uruguay, Montevideo, Uruguay., Ohuma EO; Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK., Lawn JE; Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK.
Jazyk: angličtina
Zdroj: BJOG : an international journal of obstetrics and gynaecology [BJOG] 2023 May 08. Date of Electronic Publication: 2023 May 08.
DOI: 10.1111/1471-0528.17506
Abstrakt: 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.
(© 2023 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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