Neonatal mortality risk for vulnerable newborn types in 15 countries using 125.5 million nationwide birth outcome records, 2000 to 2020

the National Vulnerable Newborn Mortality Collaborative Group and Vulnerable Newborn Measurement Core Group, Lorena Suárez-Idueta, Hannah Blencowe*, Yemisrach B. Okwaraji, Judith Yargawa, Ellen Bradley, Adrienne Gordon, Vicki Flenady, Enny S. Paixão, Maurício L. Barreto, Sarka Lisonkova, Qi Wen, Petr Velebil, Jitka Jírová, Erzsebet Horváth-Puhó, Henrik Toft Sørensen, Luule Sakkeus, Liili Abuladze, Khalid A. Yunis, Ayah Al BizriArturo Barranco, Lisa Broeders, Aimée E. van Dijk, Fawziya Alyafei, Tawa O. Olukade, Neda Razaz, Jonas Söderling, Lucy K. Smith, Elizabeth S. Draper, Estelle Lowry, Neil Rowland, Rachael Wood, Kirsten Monteath, Isabel Pereyra, Gabriella Pravia, Eric O. Ohuma, Joy E. Lawn

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Objective: To compare neonatal mortality associated with six novel vulnerable newborn types in 125.5 million livebirths across 15 countries, 2000 to 2020.
Design: Population-based, multi-country study.
Setting: National data systems in 15 middle and high-income countries.
Methods: We used individual-level datasets identified for the Vulnerable Newborn Measurement Collaboration. We examined the contribution to neonatal mortality of six newborn types combining gestational age (preterm, PT vs term, T) and size-for-gestational age (small (SGA, 90th centile)) according to INTERGROWTH-21st newborn standards. Newborn babies with PT or SGA were defined as small and T+LGA was considered as large. We calculated risk ratios (RRs) and population attributable risks (PAR%) for the six newborn types.
Main Outcome Measures Mortality of six newborn types
Results Of 125.5 million livebirths analysed, risk ratios were highest amongst PT+SGA (median: 67.2, Interquartile Range, IQR, 45.6, 73.9), PT+AGA (median: 34.3, IQR, 23.9, 37.5), and PT+LGA (median: 28.3, IQR, 18.4, 32.3). At the population level, PT+AGA was the greatest contributor to newborn mortality (median PAR%: 53.7, IQR, 44.5, 54.9). Mortality risk was highest among newborns Conclusion Preterm newborn types were the most vulnerable, and associated with highest mortality, particularly with co-existence of preterm and SGA. As PT+AGA is more prevalent, it is responsible for greatest burden of neonatal deaths at population level.
Original languageEnglish
JournalBJOG: An International Journal of Obstetrics and Gynaecology
Early online date8 May 2023
Publication statusE-pub ahead of print - 8 May 2023


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