Neonatal mortality risk of vulnerable newborns: A descriptive analysis of subnational, population-based birth cohorts for 238 203 live births in low- and middle-income settings from 2000 to 2017.

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dc.contributor.authorHazel EA
dc.contributor.authorErchick DJ
dc.contributor.authorKatz J
dc.contributor.authorLee ACC
dc.contributor.authorDiaz M
dc.contributor.authorWu LSF
dc.contributor.authorWest KP
dc.contributor.authorShamim AA
dc.contributor.authorChristian P
dc.contributor.authorAli H
dc.contributor.authorBaqui AH
dc.contributor.authorSaha SK
dc.contributor.authorAhmed S
dc.contributor.authorRoy AD
dc.contributor.authorSilveira MF
dc.contributor.authorBuffarini R
dc.contributor.authorShapiro R
dc.contributor.authorZash R
dc.contributor.authorKolsteren P
dc.contributor.authorLachat C
dc.contributor.authorHuybregts L
dc.contributor.authorRoberfroid D
dc.contributor.authorZhu Z
dc.contributor.authorZeng L
dc.contributor.authorGebreyesus SH
dc.contributor.authorTesfamariam K
dc.contributor.authorAdu-Afarwuah S
dc.contributor.authorDewey KG
dc.contributor.authorGyaase S
dc.contributor.authorPoku-Asante K
dc.contributor.authorBoamah Kaali E
dc.contributor.authorJack D
dc.contributor.authorRavilla T
dc.contributor.authorTielsch J
dc.contributor.authorTaneja S
dc.contributor.authorChowdhury R
dc.contributor.authorAshorn P
dc.contributor.authorMaleta K
dc.contributor.authorAshorn U
dc.contributor.authorMangani C
dc.contributor.authorMullany LC
dc.contributor.authorKhatry SK
dc.contributor.authorRamokolo V
dc.contributor.authorZembe-Mkabile W
dc.contributor.authorFawzi WW
dc.contributor.authorWang D
dc.contributor.authorSchmiegelow C
dc.contributor.authorMinja D
dc.contributor.authorMsemo OA
dc.contributor.authorLusingu JPA
dc.contributor.authorSmith ER
dc.contributor.authorMasanja H
dc.contributor.authorMongkolchati A
dc.contributor.authorKeentupthai P
dc.contributor.authorKakuru A
dc.contributor.authorKajubi R
dc.contributor.authorSemrau K
dc.contributor.authorHamer DH
dc.contributor.authorManasyan A
dc.contributor.authorPry JM
dc.contributor.authorChasekwa B
dc.contributor.authorHumphrey J
dc.contributor.authorBlack RE
dc.date.accessioned2025-09-17T10:25:38Z
dc.date.issued2023-May-08
dc.description.abstractOBJECTIVE: We aimed to understand the mortality risks of vulnerable newborns (defined as preterm and/or born weighing smaller or larger compared to a standard population), in low- and middle-income countries (LMICs). DESIGN: Descriptive multi-country, secondary analysis of individual-level study data of babies born since 2000. SETTING: Sixteen subnational, population-based studies from nine LMICs in sub-Saharan Africa, Southern and Eastern Asia, and Latin America. POPULATION: Live birth neonates. METHODS: We categorically defined five vulnerable newborn types based on size (large- or appropriate- or small-for-gestational age [LGA, AGA, SGA]), and term (T) and preterm (PT): T + LGA, T + SGA, PT + LGA, PT + AGA, and PT + SGA, with T + AGA (reference). A 10-type definition included low birthweight (LBW) and non-LBW, and a four-type definition collapsed AGA/LGA into one category. We performed imputation for missing birthweights in 13 of the studies. MAIN OUTCOME MEASURES: Median and interquartile ranges by study for the prevalence, mortality rates and relative mortality risks for the four, six and ten type classification. RESULTS: There were 238 203 live births with known neonatal status. Four of the six types had higher mortality risk: T + SGA (median relative risk [RR] 2.6, interquartile range [IQR] 2.0-2.9), PT + LGA (median RR 7.3, IQR 2.3-10.4), PT + AGA (median RR 6.0, IQR 4.4-13.2) and PT + SGA (median RR 10.4, IQR 8.6-13.9). T + SGA, PT + LGA and PT + AGA babies who were LBW, had higher risk compared with non-LBW babies. CONCLUSIONS: Small and/or preterm babies in LIMCs have a considerably increased mortality risk compared with babies born at term and larger. This classification system may advance the understanding of the social determinants and biomedical risk factors along with improved treatment that is critical for newborn health.
dc.identifier.doi10.1111/1471-0528.17518
dc.identifier.urihttps://pubs.cidrz.org/handle/123456789/11865
dc.identifier.uri.pubmedhttps://pubmed.ncbi.nlm.nih.gov/37156238/
dc.relation.affiliationInternational Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
dc.relation.affiliationInternational Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
dc.relation.affiliationInternational Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
dc.relation.affiliationPediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
dc.relation.affiliationInternational Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
dc.relation.affiliationInternational Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
dc.relation.affiliationDepartment of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
dc.relation.affiliationBRAC JP Grant School of Public Health, Dhaka, Bangladesh.
dc.relation.affiliationDepartment of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
dc.relation.affiliationJiVitA Maternal and Child Health Research Project, Rangpur, Bangladesh.
dc.relation.affiliationDepartment of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
dc.relation.affiliationChild Health Research Foundation, Dhaka, Bangladesh.
dc.relation.affiliationProjahnmo Research Foundation, Dhaka, Bangladesh.
dc.relation.affiliationProjahnmo Research Foundation, Dhaka, Bangladesh.
dc.relation.affiliationPost-Graduate Program in Epidemiology - Federal University of Pelotas, Pelotas, Brazil.
dc.relation.affiliationPost-Graduate Program in Epidemiology - Federal University of Pelotas, Pelotas, Brazil.
dc.relation.affiliationHarvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
dc.relation.affiliationBeth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
dc.relation.affiliationDepartment of Food Technology, Safety and Health, Ghent University, Ghent, Belgium.
dc.relation.affiliationDepartment of Food Technology, Safety and Health, Ghent University, Ghent, Belgium.
dc.relation.affiliationDepartment of Food Technology, Safety and Health, Ghent University, Ghent, Belgium.
dc.relation.affiliationPoverty, Health and Nutrition Division, International Food Policy Research Institute, Washington, District of Columbia, USA.
dc.relation.affiliationNamur University, Namur, Belgium.
dc.relation.affiliationBelgian Health Care Knowledge Centre, Brussels, Belgium.
dc.relation.affiliationDepartment of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Centre, Xi'an, China.
dc.relation.affiliationDepartment of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Centre, Xi'an, China.
dc.relation.affiliationDepartment of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
dc.relation.affiliationDepartment of Food Technology, Safety, and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium.
dc.relation.affiliationDepartment of Nutrition and Food Science, University of Ghana, Accra, Ghana.
dc.relation.affiliationDepartment of Nutrition, Institute for Global Nutrition, University of California, Davis, California, USA.
dc.relation.affiliationKintampo Health Research Centre, Kintampo, Ghana.
dc.relation.affiliationKintampo Health Research Centre, Kintampo, Ghana.
dc.relation.affiliationKintampo Health Research Centre, Kintampo, Ghana.
dc.relation.affiliationResearch and Development Division, Ghana Health Service, Accra, Ghana.
dc.relation.affiliationColumbia University's Mailman School of Public Health, New York, New York, USA.
dc.relation.affiliationAravind Eye Hospital, Madurai, India.
dc.relation.affiliationGeorge Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA.
dc.relation.affiliationCentre for Health Research and Development, Society for Applied Studies, New Delhi, India.
dc.relation.affiliationCentre for Health Research and Development, Society for Applied Studies, New Delhi, India.
dc.relation.affiliationFaculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland.
dc.relation.affiliationSchool of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi.
dc.relation.affiliationFaculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
dc.relation.affiliationSchool of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi.
dc.relation.affiliationInternational Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
dc.relation.affiliationNNIPS, Kathmandu, Nepal.
dc.relation.affiliationHIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa.
dc.relation.affiliationGertrude H Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, USA.
dc.relation.affiliationHealth Systems Research Unit, South African Medical Research Council, Cape Town, South Africa.
dc.relation.affiliationSouth African Research Chair in Social Policy at College Graduate of Studies, University of South Africa, Pretoria, South Africa.
dc.relation.affiliationHarvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
dc.relation.affiliationDepartment of Global and Community Health, College of Public Health, George Mason University, Fairfax, Virginia, USA.
dc.relation.affiliationCentre for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, and Department of Infectious Diseases, Copenhagen University Hospital, Copenhagen, Denmark.
dc.relation.affiliationNational Institute of Medical Research, Tanga, Tanzania.
dc.relation.affiliationNational Institute of Medical Research, Tanga, Tanzania.
dc.relation.affiliationNational Institute of Medical Research, Tanga, Tanzania.
dc.relation.affiliationDepartment of Global Health, Milken Institute School of Public Health, Washington, District of Columbia, USA.
dc.relation.affiliationIfakara Health Institute, Dar es Salaam, Tanzania.
dc.relation.affiliationASEAN Institute for Health Development, Mahidol University, Salaya, Thailand.
dc.relation.affiliationCollege of Medicine and Public Health, Ubon Ratchathani University, Ubon Ratchathani, Thailand.
dc.relation.affiliationInfectious Diseases Research Collaboration, Kampala, Uganda.
dc.relation.affiliationInfectious Diseases Research Collaboration, Kampala, Uganda.
dc.relation.affiliationAriadne Labs, Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
dc.relation.affiliationDivision of Global Health Equity, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
dc.relation.affiliationDepartment of Medicine, Harvard Medical School, Boston, Massachusetts, USA.
dc.relation.affiliationDepartment of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA.
dc.relation.affiliationSection of Infectious Diseases, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA.
dc.relation.affiliationUniversity of Alabama at Birmingham, Birmingham, Alabama, USA.
dc.relation.affiliationCentre for Infectious Disease Research in Zambia (CIDRZ)
dc.relation.affiliationZvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe.
dc.relation.affiliationInternational Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
dc.relation.affiliationInternational Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
dc.sourceBJOG : an international journal of obstetrics and gynaecology
dc.titleNeonatal mortality risk of vulnerable newborns: A descriptive analysis of subnational, population-based birth cohorts for 238 203 live births in low- and middle-income settings from 2000 to 2017.

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