TY - JOUR
T1 - Estimates of burden and consequences of infants born small for gestational age in low and middle income countries with INTERGROWTH-21 st standard
T2 - Analysis of CHERG datasets
AU - Lee, Anne C.C.
AU - Kozuki, Naoko
AU - Cousens, Simon
AU - Stevens, Gretchen A.
AU - Blencowe, Hannah
AU - Silveira, Mariangela F.
AU - Sania, Ayesha
AU - Rosen, Heather E.
AU - Schmiegelow, Christentze
AU - Adair, Linda S.
AU - Baqui, Abdullah H.
AU - Barros, Fernando C.
AU - Bhutta, Zulfiqar A.
AU - Caulfield, Laura E.
AU - Christian, Parul
AU - Clarke, Siân E.
AU - Fawzi, Wafaie
AU - Gonzalez, Rogelio
AU - Humphrey, Jean
AU - Huybregts, Lieven
AU - Kariuki, Simon
AU - Kolsteren, Patrick
AU - Lusingu, John
AU - Manandhar, Dharma
AU - Mongkolchati, Aroonsri
AU - Mullany, Luke C.
AU - Ndyomugyenyi, Richard
AU - Nien, Jyh Kae
AU - Roberfroid, Dominique
AU - Saville, Naomi
AU - Terlouw, Dianne J.
AU - Tielsch, James M.
AU - Victora, Cesar G.
AU - Velaphi, Sithembiso C.
AU - Watson-Jones, Deborah
AU - Willey, Barbara A.
AU - Ezzati, Majid
AU - Lawn, Joy E.
AU - Black, Robert E.
AU - Katz, Joanne
N1 - Publisher Copyright:
© Published by the BMJ Publishing Group Limited.
PY - 2017
Y1 - 2017
N2 - Objectives To estimate small for gestational age birth prevalence and attributable neonatal mortality in low and middle income countries with the INTERGROWTH-21 st birth weight standard. Design Secondary analysis of data from the Child Health Epidemiology Reference Group (CHERG), including 14 birth cohorts with gestational age, birth weight, and neonatal follow-up. Small for gestational age was defined as infants weighing less than the 10th centile birth weight for gestational age and sex with the multiethnic, INTERGROWTH-21 st birth weight standard. Prevalence of small for gestational age and neonatal mortality risk ratios were calculated and pooled among these datasets at the regional level. With available national level data, prevalence of small for gestational age and population attributable fractions of neonatal mortality attributable to small for gestational age were estimated. Setting CHERG birth cohorts from 14 population based sites in low and middle income countries. Main outcome measures In low and middle income countries in the year 2012, the number and proportion of infants born small for gestational age; number and proportion of neonatal deaths attributable to small for gestational age; the number and proportion of neonatal deaths that could be prevented by reducing the prevalence of small for gestational age to 10%. Results In 2012, an estimated 23.3 million infants (uncertainty range 17.6 to 31.9; 19.3% of live births) were born small for gestational age in low and middle income countries. Among these, 11.2 million (0.8 to 15.8) were term and not low birth weight (≥2500 g), 10.7 million (7.6 to 15.0) were term and low birth weight (<2500 g) and 1.5 million (0.9 to 2.6) were preterm. In low and middle income countries, an estimated 606 500 (495 000 to 773 000) neonatal deaths were attributable to infants born small for gestational age, 21.9% of all neonatal deaths. The largest burden was in South Asia, where the prevalence was the highest (34%); about 26% of neonatal deaths were attributable to infants born small for gestational age. Reduction of the prevalence of small for gestational age from 19.3% to 10.0% in these countries could reduce neonatal deaths by 9.2% (254 600 neonatal deaths; 164 800 to 449 700). Conclusions In low and middle income countries, about one in five infants are born small for gestational age, and one in four neonatal deaths are among such infants. Increased efforts are required to improve the quality of care for and survival of these high risk infants in low and middle income countries.
AB - Objectives To estimate small for gestational age birth prevalence and attributable neonatal mortality in low and middle income countries with the INTERGROWTH-21 st birth weight standard. Design Secondary analysis of data from the Child Health Epidemiology Reference Group (CHERG), including 14 birth cohorts with gestational age, birth weight, and neonatal follow-up. Small for gestational age was defined as infants weighing less than the 10th centile birth weight for gestational age and sex with the multiethnic, INTERGROWTH-21 st birth weight standard. Prevalence of small for gestational age and neonatal mortality risk ratios were calculated and pooled among these datasets at the regional level. With available national level data, prevalence of small for gestational age and population attributable fractions of neonatal mortality attributable to small for gestational age were estimated. Setting CHERG birth cohorts from 14 population based sites in low and middle income countries. Main outcome measures In low and middle income countries in the year 2012, the number and proportion of infants born small for gestational age; number and proportion of neonatal deaths attributable to small for gestational age; the number and proportion of neonatal deaths that could be prevented by reducing the prevalence of small for gestational age to 10%. Results In 2012, an estimated 23.3 million infants (uncertainty range 17.6 to 31.9; 19.3% of live births) were born small for gestational age in low and middle income countries. Among these, 11.2 million (0.8 to 15.8) were term and not low birth weight (≥2500 g), 10.7 million (7.6 to 15.0) were term and low birth weight (<2500 g) and 1.5 million (0.9 to 2.6) were preterm. In low and middle income countries, an estimated 606 500 (495 000 to 773 000) neonatal deaths were attributable to infants born small for gestational age, 21.9% of all neonatal deaths. The largest burden was in South Asia, where the prevalence was the highest (34%); about 26% of neonatal deaths were attributable to infants born small for gestational age. Reduction of the prevalence of small for gestational age from 19.3% to 10.0% in these countries could reduce neonatal deaths by 9.2% (254 600 neonatal deaths; 164 800 to 449 700). Conclusions In low and middle income countries, about one in five infants are born small for gestational age, and one in four neonatal deaths are among such infants. Increased efforts are required to improve the quality of care for and survival of these high risk infants in low and middle income countries.
UR - http://www.scopus.com/inward/record.url?scp=85028680362&partnerID=8YFLogxK
U2 - 10.1136/bmj.j3677
DO - 10.1136/bmj.j3677
M3 - Article
C2 - 28819030
AN - SCOPUS:85028680362
SN - 0959-8146
VL - 358
JO - The BMJ
JF - The BMJ
M1 - j3677
ER -