Mubiri Paul, Nambuya Harriet, Kajjo Darious, Butrick Elizabeth, Namazzi Gertrude, Santos Nicole, Walker Dilys, Waiswa Peter
Makerere University School of Public Health College of Health Sciences Kampala Uganda.
Maternal, Newborn and Child Health Centre of Excellence, School of Public Health, College of Health Sciences Makerere University Kampala Uganda.
Health Sci Rep. 2020 Oct 28;3(4):e196. doi: 10.1002/hsr2.196. eCollection 2020 Dec.
An estimated 2.8 million neonatal deaths occur each year globally, which accounts for at least 45% of deaths in children aged less than 5 years. Birthweight and gestational age-specific mortality estimates are limited in low-resource countries like Uganda. A deeper analysis of mortality by birthweight and gestational age is critical in identifying the cause and potential solutions to decrease neonatal mortality.
We studied mortality before discharge in relation to birthweight and gestational age using a large sample size from selected tertiary care facilities in Uganda.
We used secondary data from the East Africa Preterm Birth Initiative study conducted in six tertiary care facilities. Birth records of infants born between October 2016 and March 2019 with a gestational age greater than or equal to 24 weeks and/or birthweight greater than or equal to 500 g were reviewed for inclusion in the analysis. Newborn death before discharge was the outcome variable of interest. Multivariable Poisson regression modeling was used to explore birthweight and gestational age-specific mortality rate.
We analysed 50 278 birth records. Among these 95.3% (47 913) were live births and 4.8% (2365) were stillbirths. Of the 47 913 live births, 50% (24 147) were males. Overall, pre-discharge mortality was 13.0 per 1000 live births. For each 1 kg increase in birthweight, mortality before discharge decreased by -0.016. As birthweight increases, the mortality before discharge decreased from 336 per 1000 live births among infants born between 500 and 999 g, to 4.7 per 1000 live births among infants born weighing 3500 to 3999 g, and increased again to 11.2 per 1000 live births among infants weighing more than 4500 g.
Our study highlights the need for further research to understand newborn survival across different birthweight and gestational categories.
全球每年估计有280万新生儿死亡，这至少占5岁以下儿童死亡人数的45%。在乌干达等资源匮乏的国家，针对出生体重和特定孕周的死亡率估计有限。深入分析出生体重和孕周相关的死亡率对于确定新生儿死亡原因及潜在解决方案至关重要。
我们利用乌干达选定的三级医疗保健机构的大样本，研究出院前死亡率与出生体重和孕周的关系。
我们使用了在六个三级医疗保健机构进行的东非早产倡议研究的二手数据。对2016年10月至2019年3月期间出生、孕周大于或等于24周和/或出生体重大于或等于500克的婴儿的出生记录进行审查，以纳入分析。出院前新生儿死亡是感兴趣的结局变量。采用多变量泊松回归模型探讨出生体重和特定孕周的死亡率。
我们分析了50278份出生记录。其中，95.3%（47913例）为活产，4.8%（2365例）为死产。在47913例活产中，50%（24147例）为男性。总体而言，出院前死亡率为每1000例活产13.0例。出生体重每增加1千克，出院前死亡率下降-0.016。随着出生体重增加，出院前死亡率从出生体重在500至999克之间的婴儿每1000例活产中的336例，降至出生体重为3500至3999克的婴儿每1000例活产中的4.7例，而出生体重超过4500克的婴儿每1000例活产中的死亡率又升至11.2例。
我们的研究强调需要进一步开展研究，以了解不同出生体重和孕周类别的新生儿生存情况。
