Vulnerable newborn types: analysis of subnational, population-based birth cohorts for 541 285 live births in 23 countries, 2000-2021
Vulnerable newborn types: analysis of subnational, population-based birth cohorts for 541 285 live births in 23 countries, 2000-2021
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DOI：
10.1111/1471-0528.17510
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发表时间：
2023-05-08
影响因子：
5.8
通讯作者：
Black, R. E.
中科院分区：
文献类型：
--
作者：
Erchick, D. J.;Hazel, E. A.;Black, R. E.
目的：研究2000年至2021年23个国家541285例活产新生儿中新型新生儿类型的患病率。设计：描述性多国二级数据分析。背景：2000-2021年在23个低收入和中等收入国家（LMIC）进行的基于人口的次国家出生队列研究（n = 45）。人口：活产婴儿。研究方法：邀请来自中低收入国家的具有高质量出生结果数据的国家以下一级、基于人口的研究加入脆弱新生儿测量协作组织。我们根据胎龄定义了不同的新生儿类型（早产[PT]，足月[T]），使用INTERGROWTH-21标准的胎龄出生体重（小于胎龄[SGA]、适合胎龄[阿加]或大于胎龄[LGA]）和出生体重（低出生体重、LBW [< 2500 g]、非LBW）分为十种类型（使用所有三种结果）、六种类型（通过排除出生体重分类）和四种类型（通过折叠阿加和LGA类别）。我们将小体型定义为至少有LBW、PT或SGA中的一种分类的人。我们按地区和研究介绍了研究特征、参与者特征、数据缺失和新生儿类型的患病率。结果如下：在541285例活产婴儿中，476939例（88.1%）具有构建新生儿类型所需的胎龄、出生体重和性别的非缺失和合理值。研究中10种类型的中位患病率为T+阿加+非LBW（58.0%），T+LGA+非LBW（3.3%），T+阿加+LBW（0.5%），T+SGA+非LBW（14.2%），T+SGA+LBW（7.1%），PT+LGA+非LBW（1.6%），PT+LGA+LBW（0.2%），PT+阿加+非LBW PT+阿加+LBW（3.6%）和PT+SGA+LBW（1.0%）。各研究和区域内的小型（6种类型，37.6%）的中位患病率各不相同，南亚（52.4%）高于撒哈拉以南非洲（34.9%）。结论：需要进一步调查，以描述与新生儿类型相关的死亡风险，并了解这一框架对地方干预措施的影响，以防止在中低收入国家不良妊娠结局。
Objective: To examine prevalence of novel newborn types among 541 285 live births in 23 countries from 2000 to 2021. Design: Descriptive multicountry 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.