脆弱新生儿类型：对2000年至2021年23个国家541285例活产的基于人群的次国家级出生队列分析

Vulnerable newborn types: analysis of subnational, population-based birth cohorts for 541 285 live births in 23 countries, 2000-2021.

作者信息

Erchick D J, Hazel E A, Katz J, Lee A C C, Diaz M, Wu L S F, Yoshida S, Bahl R, Grandi C, Labrique A B, Rashid M, Ahmed S, Roy A D, Haque R, Shaikh S, Baqui A H, Saha S K, Khanam R, Rahman S, Shapiro R, Zash R, Silveira M F, Buffarini R, Kolsteren P, Lachat C, Huybregts L, Roberfroid D, Zeng L, Zhu Z, He J, Qiu X, Gebreyesus S H, Tesfamariam K, Bekele D, Chan G, Baye E, Workneh F, Asante K P, Kaali E B, Adu-Afarwuah S, Dewey K G, Gyaase S, Wylie B J, Kirkwood B R, Manu A, Thulasiraj R D, Tielsch J, Chowdhury R, Taneja S, Babu G R, Shriyan P, Ashorn P, Maleta K, Ashorn U, Mangani C, Acevedo-Gallegos S, Rodriguez-Sibaja M J, Khatry S K, LeClerq S C, Mullany L C, Jehan F, Ilyas M, Rogerson S J, Unger H W, Ghosh R, Musange S, Ramokolo V, Zembe-Mkabile W, Lazzerini M, Rishard M, Wang D, Fawzi W W, Minja D T R, Schmiegelow C, Masanja H, Smith E, Lusingu J P A, Msemo O A, Kabole F M, Slim S N, Keentupthai P, Mongkolchati A, Kajubi R, Kakuru A, Waiswa P, Walker D, Hamer D H, Semrau K E A, Chaponda E B, Chico R M, Banda B, Musokotwane K, Manasyan A, Pry J M, Chasekwa B, Humphrey J, Black R E

机构信息

Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

出版信息

BJOG. 2023 May 8. doi: 10.1111/1471-0528.17510.

DOI:10.1111/1471-0528.17510

PMID:37156239

Abstract

OBJECTIVE

To examine prevalence of novel newborn types among 541 285 live births in 23 countries from 2000 to 2021.

DESIGN

Descriptive multi-country 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.

摘要

目的

研究2000年至2021年期间23个国家541285例活产中新型新生儿类型的患病率。

设计

描述性多国二次数据分析。

背景

2000 - 2021年期间23个低收入和中等收入国家（LMICs）基于人群的次国家级出生队列研究（n = 45）。

研究对象

活产婴儿。

方法

邀请来自LMICs的具有高质量出生结局数据的基于人群的次国家级研究加入脆弱新生儿测量协作组。我们使用胎龄（早产[PT]、足月儿[T]）、根据INTERGROWTH - 21标准的胎龄别出生体重（小于胎龄儿[SGA]、适于胎龄儿[AGA]或大于胎龄儿[LGA]）以及出生体重（低出生体重，LBW[<2500 g]、非低出生体重）将不同的新生儿类型定义为十种类型（使用所有三个结局）、六种类型（排除出生体重分类）和四种类型（合并AGA和LGA类别）。我们将小类型定义为至少有一项LBW、PT或SGA分类的类型。我们按地区和研究展示了研究特征、参与者特征、数据缺失情况以及新生儿类型的患病率。

结果

在541285例活产中，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且合理的值。各项研究中十种类型的中位数患病率分别为T + AGA + 非LBW（58.0%）、T + LGA + 非LBW（3.3%）、T + AGA + 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 + AGA + 非LBW（3.7%）、PT + AGA + LBW（3.6%）和PT + SGA + LBW（1.0%）。小类型（六种类型，37.6%）的中位数患病率在不同研究和各地区内有所不同，南亚（52.4%）高于撒哈拉以南非洲（34.9%）。