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 Bizri; Arturo 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

doi:10.1111/1471-0528.17506

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

Deanery of Molecular, Genetic and Population Health Sciences

Research output: Contribution to journal › Article › peer-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 language	English
Journal	BJOG: An International Journal of Obstetrics and Gynaecology
Early online date	8 May 2023
DOIs	https://doi.org/10.1111/1471-0528.17506
Publication status	E-pub ahead of print - 8 May 2023

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MS-National-Mortality-25th-Jan-2023-REVIEWED_LS_EO30March2023 - AAMAccepted author manuscript, 2.42 MB
BJOG - 2023 - Su rez‐Idueta - Neonatal mortality risk for vulnerable newborn types in 15 countries using 125 5 millionFinal published version, 1.79 MBLicence: Creative Commons: Attribution (CC-BY)

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the National Vulnerable Newborn Mortality Collaborative Group and Vulnerable Newborn Measurement Core Group, Suárez-Idueta, L., Blencowe, H., Okwaraji, Y. B., Yargawa, J., Bradley, E., Gordon, A., Flenady, V., Paixão, E. S., Barreto, M. L., Lisonkova, S., Wen, Q., Velebil, P., Jírová, J., Horváth-Puhó, E., Sørensen, H. T., Sakkeus, L., Abuladze, L., Yunis, K. A., ... Lawn, J. E. (2023). Neonatal mortality risk for vulnerable newborn types in 15 countries using 125.5 million nationwide birth outcome records, 2000 to 2020. BJOG: An International Journal of Obstetrics and Gynaecology. https://doi.org/10.1111/1471-0528.17506

the National Vulnerable Newborn Mortality Collaborative Group and Vulnerable Newborn Measurement Core Group ; Suárez-Idueta, Lorena ; Blencowe, Hannah et al. / Neonatal mortality risk for vulnerable newborn types in 15 countries using 125.5 million nationwide birth outcome records, 2000 to 2020. In: BJOG: An International Journal of Obstetrics and Gynaecology. 2023.

@article{c18b0b2521d84757bbc6df7a6055c244,

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

abstract = "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.",

author = "{the National Vulnerable Newborn Mortality Collaborative Group and Vulnerable Newborn Measurement Core Group} and Lorena Su{\'a}rez-Idueta and Hannah Blencowe and Okwaraji, {Yemisrach B.} and Judith Yargawa and Ellen Bradley and Adrienne Gordon and Vicki Flenady and Paix{\~a}o, {Enny S.} and Barreto, {Maur{\'i}cio L.} and Sarka Lisonkova and Qi Wen and Petr Velebil and Jitka J{\'i}rov{\'a} and Erzsebet Horv{\'a}th-Puh{\'o} and S{\o}rensen, {Henrik Toft} and Luule Sakkeus and Liili Abuladze and Yunis, {Khalid A.} and {Al Bizri}, Ayah and Arturo Barranco and Lisa Broeders and {van Dijk}, {Aim{\'e}e E.} and Fawziya Alyafei and Olukade, {Tawa O.} and Neda Razaz and Jonas S{\"o}derling and Smith, {Lucy K.} and Draper, {Elizabeth S.} and Estelle Lowry and Neil Rowland and Rachael Wood and Kirsten Monteath and Isabel Pereyra and Gabriella Pravia and Ohuma, {Eric O.} and Lawn, {Joy E.}",

note = "Funding Information: This analysis was funded by Children's Investment Fund Foundation, prime grant 1803‐02535. The funders had no role in the study design, data collection, analysis or interpretation of the paper. ESP and MLB received funding from Wellcome Trust UK (202912/B/16/Z). NR received funding from Swedish Research Council (VR 2979/2020). ED received funding from the MBRRACE‐UK programme. Publisher Copyright: {\textcopyright} 2023 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.",

year = "2023",

month = may,

day = "8",

doi = "10.1111/1471-0528.17506",

language = "English",

journal = "BJOG: An International Journal of Obstetrics and Gynaecology",

issn = "1470-0328",

publisher = "Wiley",

}

the National Vulnerable Newborn Mortality Collaborative Group and Vulnerable Newborn Measurement Core Group, Suárez-Idueta, L, Blencowe, H, Okwaraji, YB, Yargawa, J, Bradley, E, Gordon, A, Flenady, V, Paixão, ES, Barreto, ML, Lisonkova, S, Wen, Q, Velebil, P, Jírová, J, Horváth-Puhó, E, Sørensen, HT, Sakkeus, L, Abuladze, L, Yunis, KA, Al Bizri, A, Barranco, A, Broeders, L, van Dijk, AE, Alyafei, F, Olukade, TO, Razaz, N, Söderling, J, Smith, LK, Draper, ES, Lowry, E, Rowland, N, Wood, R, Monteath, K, Pereyra, I, Pravia, G, Ohuma, EO & Lawn, JE 2023, 'Neonatal mortality risk for vulnerable newborn types in 15 countries using 125.5 million nationwide birth outcome records, 2000 to 2020', BJOG: An International Journal of Obstetrics and Gynaecology. https://doi.org/10.1111/1471-0528.17506

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; Suárez-Idueta, Lorena; Blencowe, Hannah et al.
In: BJOG: An International Journal of Obstetrics and Gynaecology, 08.05.2023.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Neonatal mortality risk for vulnerable newborn types in 15 countries using 125.5 million nationwide birth outcome records, 2000 to 2020

AU - the National Vulnerable Newborn Mortality Collaborative Group and Vulnerable Newborn Measurement Core Group

AU - Suárez-Idueta, Lorena

AU - Blencowe, Hannah

AU - Okwaraji, Yemisrach B.

AU - Yargawa, Judith

AU - Bradley, Ellen

AU - Gordon, Adrienne

AU - Flenady, Vicki

AU - Paixão, Enny S.

AU - Barreto, Maurício L.

AU - Lisonkova, Sarka

AU - Wen, Qi

AU - Velebil, Petr

AU - Jírová, Jitka

AU - Horváth-Puhó, Erzsebet

AU - Sørensen, Henrik Toft

AU - Sakkeus, Luule

AU - Abuladze, Liili

AU - Yunis, Khalid A.

AU - Al Bizri, Ayah

AU - Barranco, Arturo

AU - Broeders, Lisa

AU - van Dijk, Aimée E.

AU - Alyafei, Fawziya

AU - Olukade, Tawa O.

AU - Razaz, Neda

AU - Söderling, Jonas

AU - Smith, Lucy K.

AU - Draper, Elizabeth S.

AU - Lowry, Estelle

AU - Rowland, Neil

AU - Wood, Rachael

AU - Monteath, Kirsten

AU - Pereyra, Isabel

AU - Pravia, Gabriella

AU - Ohuma, Eric O.

AU - Lawn, Joy E.

N1 - Funding Information: This analysis was funded by Children's Investment Fund Foundation, prime grant 1803‐02535. The funders had no role in the study design, data collection, analysis or interpretation of the paper. ESP and MLB received funding from Wellcome Trust UK (202912/B/16/Z). NR received funding from Swedish Research Council (VR 2979/2020). ED received funding from the MBRRACE‐UK programme. Publisher Copyright: © 2023 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.

PY - 2023/5/8

Y1 - 2023/5/8

N2 - 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.

AB - 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.

U2 - 10.1111/1471-0528.17506

DO - 10.1111/1471-0528.17506

M3 - Article

SN - 1470-0328

JO - BJOG: An International Journal of Obstetrics and Gynaecology

JF - BJOG: An International Journal of Obstetrics and Gynaecology

ER -

the National Vulnerable Newborn Mortality Collaborative Group and Vulnerable Newborn Measurement Core Group, Suárez-Idueta L, Blencowe H, Okwaraji YB, Yargawa J, Bradley E et al. Neonatal mortality risk for vulnerable newborn types in 15 countries using 125.5 million nationwide birth outcome records, 2000 to 2020. BJOG: An International Journal of Obstetrics and Gynaecology. 2023 May 8. Epub 2023 May 8. doi: 10.1111/1471-0528.17506

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

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