Estimates of burden and consequences of infants born small for gestational age in low and middle income countries with INTERGROWTH-21 st standard: Analysis of CHERG datasets

Anne C.C. Lee, Naoko Kozuki, Simon Cousens, Gretchen A. Stevens, Hannah Blencowe, Mariangela F. Silveira, Ayesha Sania, Heather E. Rosen, Christentze Schmiegelow, Linda S. Adair, Abdullah Baqui, Fernando C. Barros, Zulfiqar A. Bhutta, Laura Caulfield, Parul S Christian, Siân E. Clarke, Wafaie Fawzi, Rogelio Gonzalez, Jean Hawes Humphrey, Lieven HuybregtsSimon Kariuki, Patrick Kolsteren, John Lusingu, Dharma Manandhar, Aroonsri Mongkolchati, Luke C Mullany, Richard Ndyomugyenyi, Jyh Kae Nien, Dominique Roberfroid, Naomi Saville, Dianne J. Terlouw, James M. Tielsch, Cesar G. Victora, Sithembiso C. Velaphi, Deborah Watson-Jones, Barbara A. Willey, Majid Ezzati, Joy E. Lawn, Robert E Black, Joanne Katz

Research output: Contribution to journalArticle

Abstract

Objectives To estimate small for gestational age birth prevalence and attributable neonatal mortality in low and middle income countries with the INTERGROWTH-21 st birth weight standard. Design Secondary analysis of data from the Child Health Epidemiology Reference Group (CHERG), including 14 birth cohorts with gestational age, birth weight, and neonatal follow-up. Small for gestational age was defined as infants weighing less than the 10th centile birth weight for gestational age and sex with the multiethnic, INTERGROWTH-21 st birth weight standard. Prevalence of small for gestational age and neonatal mortality risk ratios were calculated and pooled among these datasets at the regional level. With available national level data, prevalence of small for gestational age and population attributable fractions of neonatal mortality attributable to small for gestational age were estimated. Setting CHERG birth cohorts from 14 population based sites in low and middle income countries. Main outcome measures In low and middle income countries in the year 2012, the number and proportion of infants born small for gestational age; number and proportion of neonatal deaths attributable to small for gestational age; the number and proportion of neonatal deaths that could be prevented by reducing the prevalence of small for gestational age to 10%. Results In 2012, an estimated 23.3 million infants (uncertainty range 17.6 to 31.9; 19.3% of live births) were born small for gestational age in low and middle income countries. Among these, 11.2 million (0.8 to 15.8) were term and not low birth weight (≥2500 g), 10.7 million (7.6 to 15.0) were term and low birth weight (<2500 g) and 1.5 million (0.9 to 2.6) were preterm. In low and middle income countries, an estimated 606 500 (495 000 to 773 000) neonatal deaths were attributable to infants born small for gestational age, 21.9% of all neonatal deaths. The largest burden was in South Asia, where the prevalence was the highest (34%); about 26% of neonatal deaths were attributable to infants born small for gestational age. Reduction of the prevalence of small for gestational age from 19.3% to 10.0% in these countries could reduce neonatal deaths by 9.2% (254 600 neonatal deaths; 164 800 to 449 700). Conclusions In low and middle income countries, about one in five infants are born small for gestational age, and one in four neonatal deaths are among such infants. Increased efforts are required to improve the quality of care for and survival of these high risk infants in low and middle income countries.

Original languageEnglish (US)
Article numberj3677
JournalBMJ (Online)
Volume358
DOIs
StatePublished - Jan 1 2017

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Small for Gestational Age Infant
Gestational Age
Epidemiology
Birth Weight
Infant Mortality
Low Birth Weight Infant
Parturition
Datasets
Child Health
Term Birth
Perinatal Death
Quality of Health Care
Live Birth
Population
Uncertainty

ASJC Scopus subject areas

  • Medicine(all)

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Estimates of burden and consequences of infants born small for gestational age in low and middle income countries with INTERGROWTH-21 st standard : Analysis of CHERG datasets. / Lee, Anne C.C.; Kozuki, Naoko; Cousens, Simon; Stevens, Gretchen A.; Blencowe, Hannah; Silveira, Mariangela F.; Sania, Ayesha; Rosen, Heather E.; Schmiegelow, Christentze; Adair, Linda S.; Baqui, Abdullah; Barros, Fernando C.; Bhutta, Zulfiqar A.; Caulfield, Laura; Christian, Parul S; Clarke, Siân E.; Fawzi, Wafaie; Gonzalez, Rogelio; Humphrey, Jean Hawes; Huybregts, Lieven; Kariuki, Simon; Kolsteren, Patrick; Lusingu, John; Manandhar, Dharma; Mongkolchati, Aroonsri; Mullany, Luke C; Ndyomugyenyi, Richard; Nien, Jyh Kae; Roberfroid, Dominique; Saville, Naomi; Terlouw, Dianne J.; Tielsch, James M.; Victora, Cesar G.; Velaphi, Sithembiso C.; Watson-Jones, Deborah; Willey, Barbara A.; Ezzati, Majid; Lawn, Joy E.; Black, Robert E; Katz, Joanne.

In: BMJ (Online), Vol. 358, j3677, 01.01.2017.

Research output: Contribution to journalArticle

Lee, ACC, Kozuki, N, Cousens, S, Stevens, GA, Blencowe, H, Silveira, MF, Sania, A, Rosen, HE, Schmiegelow, C, Adair, LS, Baqui, A, Barros, FC, Bhutta, ZA, Caulfield, L, Christian, PS, Clarke, SE, Fawzi, W, Gonzalez, R, Humphrey, JH, Huybregts, L, Kariuki, S, Kolsteren, P, Lusingu, J, Manandhar, D, Mongkolchati, A, Mullany, LC, Ndyomugyenyi, R, Nien, JK, Roberfroid, D, Saville, N, Terlouw, DJ, Tielsch, JM, Victora, CG, Velaphi, SC, Watson-Jones, D, Willey, BA, Ezzati, M, Lawn, JE, Black, RE & Katz, J 2017, 'Estimates of burden and consequences of infants born small for gestational age in low and middle income countries with INTERGROWTH-21 st standard: Analysis of CHERG datasets', BMJ (Online), vol. 358, j3677. https://doi.org/10.1136/bmj.j3677
Lee, Anne C.C. ; Kozuki, Naoko ; Cousens, Simon ; Stevens, Gretchen A. ; Blencowe, Hannah ; Silveira, Mariangela F. ; Sania, Ayesha ; Rosen, Heather E. ; Schmiegelow, Christentze ; Adair, Linda S. ; Baqui, Abdullah ; Barros, Fernando C. ; Bhutta, Zulfiqar A. ; Caulfield, Laura ; Christian, Parul S ; Clarke, Siân E. ; Fawzi, Wafaie ; Gonzalez, Rogelio ; Humphrey, Jean Hawes ; Huybregts, Lieven ; Kariuki, Simon ; Kolsteren, Patrick ; Lusingu, John ; Manandhar, Dharma ; Mongkolchati, Aroonsri ; Mullany, Luke C ; Ndyomugyenyi, Richard ; Nien, Jyh Kae ; Roberfroid, Dominique ; Saville, Naomi ; Terlouw, Dianne J. ; Tielsch, James M. ; Victora, Cesar G. ; Velaphi, Sithembiso C. ; Watson-Jones, Deborah ; Willey, Barbara A. ; Ezzati, Majid ; Lawn, Joy E. ; Black, Robert E ; Katz, Joanne. / Estimates of burden and consequences of infants born small for gestational age in low and middle income countries with INTERGROWTH-21 st standard : Analysis of CHERG datasets. In: BMJ (Online). 2017 ; Vol. 358.
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title = "Estimates of burden and consequences of infants born small for gestational age in low and middle income countries with INTERGROWTH-21 st standard: Analysis of CHERG datasets",
abstract = "Objectives To estimate small for gestational age birth prevalence and attributable neonatal mortality in low and middle income countries with the INTERGROWTH-21 st birth weight standard. Design Secondary analysis of data from the Child Health Epidemiology Reference Group (CHERG), including 14 birth cohorts with gestational age, birth weight, and neonatal follow-up. Small for gestational age was defined as infants weighing less than the 10th centile birth weight for gestational age and sex with the multiethnic, INTERGROWTH-21 st birth weight standard. Prevalence of small for gestational age and neonatal mortality risk ratios were calculated and pooled among these datasets at the regional level. With available national level data, prevalence of small for gestational age and population attributable fractions of neonatal mortality attributable to small for gestational age were estimated. Setting CHERG birth cohorts from 14 population based sites in low and middle income countries. Main outcome measures In low and middle income countries in the year 2012, the number and proportion of infants born small for gestational age; number and proportion of neonatal deaths attributable to small for gestational age; the number and proportion of neonatal deaths that could be prevented by reducing the prevalence of small for gestational age to 10{\%}. Results In 2012, an estimated 23.3 million infants (uncertainty range 17.6 to 31.9; 19.3{\%} of live births) were born small for gestational age in low and middle income countries. Among these, 11.2 million (0.8 to 15.8) were term and not low birth weight (≥2500 g), 10.7 million (7.6 to 15.0) were term and low birth weight (<2500 g) and 1.5 million (0.9 to 2.6) were preterm. In low and middle income countries, an estimated 606 500 (495 000 to 773 000) neonatal deaths were attributable to infants born small for gestational age, 21.9{\%} of all neonatal deaths. The largest burden was in South Asia, where the prevalence was the highest (34{\%}); about 26{\%} of neonatal deaths were attributable to infants born small for gestational age. Reduction of the prevalence of small for gestational age from 19.3{\%} to 10.0{\%} in these countries could reduce neonatal deaths by 9.2{\%} (254 600 neonatal deaths; 164 800 to 449 700). Conclusions In low and middle income countries, about one in five infants are born small for gestational age, and one in four neonatal deaths are among such infants. Increased efforts are required to improve the quality of care for and survival of these high risk infants in low and middle income countries.",
author = "Lee, {Anne C.C.} and Naoko Kozuki and Simon Cousens and Stevens, {Gretchen A.} and Hannah Blencowe and Silveira, {Mariangela F.} and Ayesha Sania and Rosen, {Heather E.} and Christentze Schmiegelow and Adair, {Linda S.} and Abdullah Baqui and Barros, {Fernando C.} and Bhutta, {Zulfiqar A.} and Laura Caulfield and Christian, {Parul S} and Clarke, {Si{\^a}n E.} and Wafaie Fawzi and Rogelio Gonzalez and Humphrey, {Jean Hawes} and Lieven Huybregts and Simon Kariuki and Patrick Kolsteren and John Lusingu and Dharma Manandhar and Aroonsri Mongkolchati and Mullany, {Luke C} and Richard Ndyomugyenyi and Nien, {Jyh Kae} and Dominique Roberfroid and Naomi Saville and Terlouw, {Dianne J.} and Tielsch, {James M.} and Victora, {Cesar G.} and Velaphi, {Sithembiso C.} and Deborah Watson-Jones and Willey, {Barbara A.} and Majid Ezzati and Lawn, {Joy E.} and Black, {Robert E} and Joanne Katz",
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month = "1",
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TY - JOUR

T1 - Estimates of burden and consequences of infants born small for gestational age in low and middle income countries with INTERGROWTH-21 st standard

T2 - Analysis of CHERG datasets

AU - Lee, Anne C.C.

AU - Kozuki, Naoko

AU - Cousens, Simon

AU - Stevens, Gretchen A.

AU - Blencowe, Hannah

AU - Silveira, Mariangela F.

AU - Sania, Ayesha

AU - Rosen, Heather E.

AU - Schmiegelow, Christentze

AU - Adair, Linda S.

AU - Baqui, Abdullah

AU - Barros, Fernando C.

AU - Bhutta, Zulfiqar A.

AU - Caulfield, Laura

AU - Christian, Parul S

AU - Clarke, Siân E.

AU - Fawzi, Wafaie

AU - Gonzalez, Rogelio

AU - Humphrey, Jean Hawes

AU - Huybregts, Lieven

AU - Kariuki, Simon

AU - Kolsteren, Patrick

AU - Lusingu, John

AU - Manandhar, Dharma

AU - Mongkolchati, Aroonsri

AU - Mullany, Luke C

AU - Ndyomugyenyi, Richard

AU - Nien, Jyh Kae

AU - Roberfroid, Dominique

AU - Saville, Naomi

AU - Terlouw, Dianne J.

AU - Tielsch, James M.

AU - Victora, Cesar G.

AU - Velaphi, Sithembiso C.

AU - Watson-Jones, Deborah

AU - Willey, Barbara A.

AU - Ezzati, Majid

AU - Lawn, Joy E.

AU - Black, Robert E

AU - Katz, Joanne

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Objectives To estimate small for gestational age birth prevalence and attributable neonatal mortality in low and middle income countries with the INTERGROWTH-21 st birth weight standard. Design Secondary analysis of data from the Child Health Epidemiology Reference Group (CHERG), including 14 birth cohorts with gestational age, birth weight, and neonatal follow-up. Small for gestational age was defined as infants weighing less than the 10th centile birth weight for gestational age and sex with the multiethnic, INTERGROWTH-21 st birth weight standard. Prevalence of small for gestational age and neonatal mortality risk ratios were calculated and pooled among these datasets at the regional level. With available national level data, prevalence of small for gestational age and population attributable fractions of neonatal mortality attributable to small for gestational age were estimated. Setting CHERG birth cohorts from 14 population based sites in low and middle income countries. Main outcome measures In low and middle income countries in the year 2012, the number and proportion of infants born small for gestational age; number and proportion of neonatal deaths attributable to small for gestational age; the number and proportion of neonatal deaths that could be prevented by reducing the prevalence of small for gestational age to 10%. Results In 2012, an estimated 23.3 million infants (uncertainty range 17.6 to 31.9; 19.3% of live births) were born small for gestational age in low and middle income countries. Among these, 11.2 million (0.8 to 15.8) were term and not low birth weight (≥2500 g), 10.7 million (7.6 to 15.0) were term and low birth weight (<2500 g) and 1.5 million (0.9 to 2.6) were preterm. In low and middle income countries, an estimated 606 500 (495 000 to 773 000) neonatal deaths were attributable to infants born small for gestational age, 21.9% of all neonatal deaths. The largest burden was in South Asia, where the prevalence was the highest (34%); about 26% of neonatal deaths were attributable to infants born small for gestational age. Reduction of the prevalence of small for gestational age from 19.3% to 10.0% in these countries could reduce neonatal deaths by 9.2% (254 600 neonatal deaths; 164 800 to 449 700). Conclusions In low and middle income countries, about one in five infants are born small for gestational age, and one in four neonatal deaths are among such infants. Increased efforts are required to improve the quality of care for and survival of these high risk infants in low and middle income countries.

AB - Objectives To estimate small for gestational age birth prevalence and attributable neonatal mortality in low and middle income countries with the INTERGROWTH-21 st birth weight standard. Design Secondary analysis of data from the Child Health Epidemiology Reference Group (CHERG), including 14 birth cohorts with gestational age, birth weight, and neonatal follow-up. Small for gestational age was defined as infants weighing less than the 10th centile birth weight for gestational age and sex with the multiethnic, INTERGROWTH-21 st birth weight standard. Prevalence of small for gestational age and neonatal mortality risk ratios were calculated and pooled among these datasets at the regional level. With available national level data, prevalence of small for gestational age and population attributable fractions of neonatal mortality attributable to small for gestational age were estimated. Setting CHERG birth cohorts from 14 population based sites in low and middle income countries. Main outcome measures In low and middle income countries in the year 2012, the number and proportion of infants born small for gestational age; number and proportion of neonatal deaths attributable to small for gestational age; the number and proportion of neonatal deaths that could be prevented by reducing the prevalence of small for gestational age to 10%. Results In 2012, an estimated 23.3 million infants (uncertainty range 17.6 to 31.9; 19.3% of live births) were born small for gestational age in low and middle income countries. Among these, 11.2 million (0.8 to 15.8) were term and not low birth weight (≥2500 g), 10.7 million (7.6 to 15.0) were term and low birth weight (<2500 g) and 1.5 million (0.9 to 2.6) were preterm. In low and middle income countries, an estimated 606 500 (495 000 to 773 000) neonatal deaths were attributable to infants born small for gestational age, 21.9% of all neonatal deaths. The largest burden was in South Asia, where the prevalence was the highest (34%); about 26% of neonatal deaths were attributable to infants born small for gestational age. Reduction of the prevalence of small for gestational age from 19.3% to 10.0% in these countries could reduce neonatal deaths by 9.2% (254 600 neonatal deaths; 164 800 to 449 700). Conclusions In low and middle income countries, about one in five infants are born small for gestational age, and one in four neonatal deaths are among such infants. Increased efforts are required to improve the quality of care for and survival of these high risk infants in low and middle income countries.

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