Young Infant Mortality Associated with Preterm and Small-for-Gestational-Age Births in Rural Bangladesh: A Prospective Cohort Study.

Autor: Applegate JA; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Electronic address: japplegate@jhu.edu., Islam MS; Projahnmo Research Foundation, Dhaka, Bangladesh., Khanam R; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD., Roy AD; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD., Chowdhury NH; Projahnmo Research Foundation, Dhaka, Bangladesh., Ahmed S; Projahnmo Research Foundation, Dhaka, Bangladesh., Mitra DK; Department of Public Health, School of Health and Life Sciences, North South University, Dhaka, Bangladesh., Mahmud A; Projahnmo Research Foundation, Dhaka, Bangladesh., Islam MS; Child Health Research Foundation, Dhaka, Bangladesh., Saha SK; Child Health Research Foundation, Dhaka, Bangladesh., Baqui AH; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
Jazyk: angličtina
Zdroj: The Journal of pediatrics [J Pediatr] 2024 Jun; Vol. 269, pp. 114001. Date of Electronic Publication: 2024 Mar 02.
DOI: 10.1016/j.jpeds.2024.114001
Abstrakt: Objective: To assess the relative risk of mortality in infants born preterm and small for gestational age (SGA) during the first and second months of life in rural Bangladesh.
Study Design: We analyzed data from a cohort of pregnant women and their babies in Sylhet, Bangladesh, assembled between 2011 and 2014. Community health workers visited enrolled babies up to 10 times from birth to age 59 days. Survival status was recorded at each visit. Gestational age was estimated from mother's reported last menstrual period. Birth weights were measured within 72 hours of delivery. SGA was defined using the INTERGROWTH-21st standard. We estimated unadjusted and adjusted hazard ratios (HRs) and corresponding 95% CIs for babies born preterm and SGA separately for the first and second month of life using bivariate and multivariable weighted Cox regression models.
Results: The analysis included 17 643 singleton live birth babies. Compared with infants born at term-appropriate for gestational age, in both unadjusted and adjusted analyses, infants born preterm-SGA had the greatest risk of death in the first (HR 13.25, 95% CI 8.65-20.31; adjusted HR 12.05, 95% CI 7.82-18.57) and second month of life (HR 4.65, 95% CI 1.93-11.23; adjusted HR 4.1, 95% CI 1.66-10.15), followed by infants born preterm-appropriate for gestational age and term-SGA.
Conclusions: The risk of mortality in infants born preterm and/or SGA is increased and extends through the second month of life. Appropriate interventions to prevent and manage complications caused by prematurity and SGA could improve survival during and beyond the neonatal period.
Competing Interests: Declaration of Competing Interest The study was funded by the Bill & Melinda Gates Foundation (grant no. OPPGH5307). The authors do not have a commercial or other association that might pose a conflict of interest in this research.
(Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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