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. 2023 May 8.
doi: 10.1111/1471-0528.17510. Online ahead of print.

Vulnerable newborn types: analysis of subnational, population-based birth cohorts for 541 285 live births in 23 countries, 2000-2021

D J Erchick  1 , E A Hazel  1 , J Katz  1 , A C C Lee  2 , M Diaz  1 , L S F Wu  1 , S Yoshida  3 , R Bahl  3 , C Grandi  4 , A B Labrique  1 , M Rashid  5 , S Ahmed  6 , A D Roy  6 , R Haque  7 , S Shaikh  7 , A H Baqui  1 , S K Saha  8 , R Khanam  1 , S Rahman  9 , R Shapiro  10 , R Zash  11 , M F Silveira  12 , R Buffarini  12 , P Kolsteren  13 , C Lachat  13 , L Huybregts  13   14 , D Roberfroid  15 , L Zeng  16 , Z Zhu  16 , J He  17 , X Qiu  17 , S H Gebreyesus  18 , K Tesfamariam  19 , D Bekele  20 , G Chan  21   22   23 , E Baye  2 , F Workneh  24 , K P Asante  25 , E B Kaali  25 , S Adu-Afarwuah  26 , K G Dewey  27 , S Gyaase  28 , B J Wylie  29 , B R Kirkwood  30 , A Manu  30   31 , R D Thulasiraj  32 , J Tielsch  33 , R Chowdhury  34 , S Taneja  34 , G R Babu  35 , P Shriyan  36 , P Ashorn  37 , K Maleta  38 , U Ashorn  37 , C Mangani  38 , S Acevedo-Gallegos  39 , M J Rodriguez-Sibaja  39 , S K Khatry  40 , S C LeClerq  1   40 , L C Mullany  1 , F Jehan  41 , M Ilyas  42 , S J Rogerson  43 , H W Unger  44 , R Ghosh  45 , S Musange  46 , V Ramokolo  47   48 , W Zembe-Mkabile  49   50 , M Lazzerini  51 , M Rishard  52   53 , D Wang  54 , W W Fawzi  55 , D T R Minja  56 , C Schmiegelow  57 , H Masanja  58 , E Smith  59 , J P A Lusingu  60 , O A Msemo  60 , F M Kabole  61 , S N Slim  61 , P Keentupthai  62 , A Mongkolchati  63 , R Kajubi  64 , A Kakuru  64 , P Waiswa  65   66 , D Walker  67 , D H Hamer  68   69 , K E A Semrau  70   71 , E B Chaponda  72 , R M Chico  73 , B Banda  74 , K Musokotwane  75 , A Manasyan  76 , J M Pry  77 , B Chasekwa  78 , J Humphrey  1 , R E Black  1 ; Subnational Vulnerable Newborn Prevalence Collaborative Group and Vulnerable Newborn Measurement Core Group
Collaborators, Affiliations

Vulnerable newborn types: analysis of subnational, population-based birth cohorts for 541 285 live births in 23 countries, 2000-2021

D J Erchick et al. BJOG. .

Abstract

Objective: To examine prevalence of novel newborn types among 541 285 live births in 23 countries from 2000 to 2021.

Design: Descriptive multi-country secondary data analysis.

Setting: Subnational, population-based birth cohort studies (n = 45) in 23 low- and middle-income countries (LMICs) spanning 2000-2021.

Population: Liveborn infants.

Methods: Subnational, population-based studies with high-quality birth outcome data from LMICs were invited to join the Vulnerable Newborn Measurement Collaboration. We defined distinct newborn types using gestational age (preterm [PT], term [T]), birthweight for gestational age using INTERGROWTH-21st standards (small for gestational age [SGA], appropriate for gestational age [AGA] or large for gestational age [LGA]), and birthweight (low birthweight, LBW [<2500 g], nonLBW) as ten types (using all three outcomes), six types (by excluding the birthweight categorisation), and four types (by collapsing the AGA and LGA categories). We defined small types as those with at least one classification of LBW, PT or SGA. We presented study characteristics, participant characteristics, data missingness, and prevalence of newborn types by region and study.

Results: Among 541 285 live births, 476 939 (88.1%) had non-missing and plausible values for gestational age, birthweight and sex required to construct the newborn types. The median prevalences of ten types across studies were T+AGA+nonLBW (58.0%), T+LGA+nonLBW (3.3%), T+AGA+LBW (0.5%), T+SGA+nonLBW (14.2%), T+SGA+LBW (7.1%), PT+LGA+nonLBW (1.6%), PT+LGA+LBW (0.2%), PT+AGA+nonLBW (3.7%), PT+AGA+LBW (3.6%) and PT+SGA+LBW (1.0%). The median prevalence of small types (six types, 37.6%) varied across studies and within regions and was higher in Southern Asia (52.4%) than in Sub-Saharan Africa (34.9%).

Conclusions: Further investigation is needed to describe the mortality risks associated with newborn types and understand the implications of this framework for local targeting of interventions to prevent adverse pregnancy outcomes in LMICs.

Keywords: low birthweight; newborn; preterm birth; small for gestational age.

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References

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