Garces Ana L, McClure Elizabeth M, Pérez Wilton, Hambidge K Michael, Krebs Nancy F, Figueroa Lester, Bose Carl L, Carlo Waldemar A, Tenge Constance, Esamai Fabian, Goudar Shivaprasad S, Saleem Sarah, Patel Archana B, Chiwila Melody, Chomba Elwyn, Tshefu Antoinette, Derman Richard J, Hibberd Patricia L, Bucher Sherri, Liechty Edward A, Bauserman Melissa, Moore Janet L, Koso-Thomas Marion, Miodovnik Menachem, Goldenberg Robert L
INCAP, Guatemala City, Guatemala.
RTI International, Durham, NC, USA.
Acta Paediatr. 2017 Jun;106(6):904-911. doi: 10.1111/apa.13805. Epub 2017 Apr 5.
This study estimated the causes of neonatal death using an algorithm for low-resource areas, where 98% of the world's neonatal deaths occur.
We enrolled women in India, Pakistan, Guatemala, the Democratic Republic of Congo, Kenya and Zambia from 2014 to 2016 and tracked their delivery and newborn outcomes for up to 28 days. Antenatal care and delivery symptoms were collected using a structured questionnaire, clinical observation and/or a physical examination. The Global Network Cause of Death algorithm was used to assign the cause of neonatal death, analysed by country and day of death.
One-third (33.1%) of the 3068 neonatal deaths were due to suspected infection, 30.8% to prematurity, 21.2% to asphyxia, 9.5% to congenital anomalies and 5.4% did not have a cause of death assigned. Prematurity and asphyxia-related deaths were more common on the first day of life (46.7% and 52.9%, respectively), while most deaths due to infection occurred after the first day of life (86.9%). The distribution of causes was similar to global data reported by other major studies.
The Global Network algorithm provided a reliable cause of neonatal death in low-resource settings and can be used to inform public health strategies to reduce mortality.
本研究使用一种针对资源匮乏地区的算法来估计新生儿死亡原因，全球98%的新生儿死亡发生在这些地区。
我们在2014年至2016年期间招募了印度、巴基斯坦、危地马拉、刚果民主共和国、肯尼亚和赞比亚的妇女，并跟踪她们的分娩及新生儿结局长达28天。通过结构化问卷、临床观察和/或体格检查收集产前护理和分娩症状。使用全球死亡原因网络算法来确定新生儿死亡原因，并按国家和死亡日期进行分析。
在3068例新生儿死亡中，三分之一（33.1%）归因于疑似感染，30.8%归因于早产，21.2%归因于窒息，9.5%归因于先天性异常，5.4%未确定死亡原因。早产和窒息相关死亡在出生第一天更为常见（分别为46.7%和52.9%），而大多数感染导致的死亡发生在出生第一天之后（86.9%）。死因分布与其他主要研究报告的全球数据相似。
全球网络算法在资源匮乏环境中提供了可靠的新生儿死亡原因，可用于为降低死亡率的公共卫生策略提供信息。
