TY - JOUR
T1 - Every newborn
T2 - Progress, priorities, and potential beyond survival
AU - Lawn, Joy E.
AU - Blencowe, Hannah
AU - Oza, Shefali
AU - You, Danzhen
AU - Lee, Anne C.C.
AU - Waiswa, Peter
AU - Lalli, Marek
AU - Bhutta, Zulfiqar
AU - Barros, Aluisio J.D.
AU - Christian, Parul
AU - Mathers, Colin
AU - Cousens, Simon N.
N1 - Funding Information:
Work for this Series paper was funded through a grant from the Children's Investment Fund Foundation (CIFF) and also draws on analyses funded by the Bill & Melinda Gates Foundation through the Child Health Epidemiology Reference Group (CHERG), Saving Newborn Lives, Save the Children, and US fund for UNICEF to the Countdown Equity Analysis group and the UN Interagency Group for Child Mortality Estimation (UN-IGME). We acknowledge the valuable contribution of the work of Naoko Kozuki, Joanne Katz, Sun Eun Lee, and others in the CHERG SGA-Preterm Birth analyses team, and the CHERG team for review and teamwork on the cause of death estimates. We thank Daniel Hogan for data on child deaths and the International Centre for Equity in Health for equity analyses. We thank Mary Kinney and Kate Kerber of Save the Children for data inputs. We thank Liz Mason and Matthews Mathai for co-chairing the Every Newborn target setting global review group, and the members including Robert Black, Danzhen You, Suzanne Fournier, John Grove, Marge Koblinsky, and Lily Kak.
PY - 2014
Y1 - 2014
N2 - In this Series paper, we review trends since the 2005 Lancet Series on Neonatal Survival to inform acceleration of progress for newborn health post-2015. On the basis of multicountry analyses and multi-stakeholder consultations, we propose national targets for 2035 of no more than 10 stillbirths per 1000 total births, and no more than 10 neonatal deaths per 1000 livebirths, compatible with the under-5 mortality targets of no more than 20 per 1000 livebirths. We also give targets for 2030. Reduction of neonatal mortality has been slower than that for maternal and child (1-59 months) mortality, slowest in the highest burden countries, especially in Africa, and reduction is even slower for stillbirth rates. Birth is the time of highest risk, when more than 40% of maternal deaths (total about 290 000) and stillbirths or neonatal deaths (5·5 million) occur every year. These deaths happen rapidly, needing a rapid response by health-care workers. The 2·9 million annual neonatal deaths worldwide are attributable to three main causes: infections (0·6 million), intrapartum conditions (0·7 million), and preterm birth complications (1·0 million). Boys have a higher biological risk of neonatal death, but girls often have a higher social risk. Small size at birth - due to preterm birth or small-for-gestational-Age (SGA), or both - is the biggest risk factor for more than 80% of neonatal deaths and increases risk of post-neonatal mortality, growth failure, and adult-onset non-communicable diseases. South Asia has the highest SGA rates and sub-Saharan Africa has the highest preterm birth rates. Babies who are term SGA low birthweight (10·4 million in these regions) are at risk of stunting and adult-onset metabolic conditions. 15 million preterm births, especially of those younger than 32 weeks' gestation, are at the highest risk of neonatal death, with ongoing post-neonatal mortality risk, and important risk of long-term neurodevelopmental impairment, stunting, and non-communicable conditions. 4 million neonates annually have other life-threatening or disabling conditions including intrapartum-related brain injury, severe bacterial infections, or pathological jaundice. Half of the world's newborn babies do not get a birth certificate, and most neonatal deaths and almost all stillbirths have no death certificate. To count deaths is crucial to change them. Failure to improve birth outcomes by 2035 will result in an estimated 116 million deaths, 99 million survivors with disability or lost development potential, and millions of adults at increased risk of non-communicable diseases after low birthweight. In the post-2015 era, improvements in child survival, development, and human capital depend on ensuring a healthy start for every newborn baby - the citizens and workforce of the future.
AB - In this Series paper, we review trends since the 2005 Lancet Series on Neonatal Survival to inform acceleration of progress for newborn health post-2015. On the basis of multicountry analyses and multi-stakeholder consultations, we propose national targets for 2035 of no more than 10 stillbirths per 1000 total births, and no more than 10 neonatal deaths per 1000 livebirths, compatible with the under-5 mortality targets of no more than 20 per 1000 livebirths. We also give targets for 2030. Reduction of neonatal mortality has been slower than that for maternal and child (1-59 months) mortality, slowest in the highest burden countries, especially in Africa, and reduction is even slower for stillbirth rates. Birth is the time of highest risk, when more than 40% of maternal deaths (total about 290 000) and stillbirths or neonatal deaths (5·5 million) occur every year. These deaths happen rapidly, needing a rapid response by health-care workers. The 2·9 million annual neonatal deaths worldwide are attributable to three main causes: infections (0·6 million), intrapartum conditions (0·7 million), and preterm birth complications (1·0 million). Boys have a higher biological risk of neonatal death, but girls often have a higher social risk. Small size at birth - due to preterm birth or small-for-gestational-Age (SGA), or both - is the biggest risk factor for more than 80% of neonatal deaths and increases risk of post-neonatal mortality, growth failure, and adult-onset non-communicable diseases. South Asia has the highest SGA rates and sub-Saharan Africa has the highest preterm birth rates. Babies who are term SGA low birthweight (10·4 million in these regions) are at risk of stunting and adult-onset metabolic conditions. 15 million preterm births, especially of those younger than 32 weeks' gestation, are at the highest risk of neonatal death, with ongoing post-neonatal mortality risk, and important risk of long-term neurodevelopmental impairment, stunting, and non-communicable conditions. 4 million neonates annually have other life-threatening or disabling conditions including intrapartum-related brain injury, severe bacterial infections, or pathological jaundice. Half of the world's newborn babies do not get a birth certificate, and most neonatal deaths and almost all stillbirths have no death certificate. To count deaths is crucial to change them. Failure to improve birth outcomes by 2035 will result in an estimated 116 million deaths, 99 million survivors with disability or lost development potential, and millions of adults at increased risk of non-communicable diseases after low birthweight. In the post-2015 era, improvements in child survival, development, and human capital depend on ensuring a healthy start for every newborn baby - the citizens and workforce of the future.
UR - http://www.scopus.com/inward/record.url?scp=84904185064&partnerID=8YFLogxK
U2 - 10.1016/S0140-6736(14)60496-7
DO - 10.1016/S0140-6736(14)60496-7
M3 - Review article
C2 - 24853593
AN - SCOPUS:84904185064
SN - 0140-6736
VL - 384
SP - 189
EP - 205
JO - The Lancet
JF - The Lancet
IS - 9938
ER -