Neonatal Mortality Risks Among Preterm Births in a Rural Bangladeshi Cohort. Issue 6 (16th September 2014)

• Record Type: Journal Article
• Authors: Shah, Rashed; Mullany, Luke C.; Darmstadt, Gary L.; Talukder, Radwanur Rahman; Rahman, Syed Moshfiqur; Mannan, Ishtiaq; Arifeen, Shams El; Baqui, Abdullah H.; ProjAHNMo Study Group in Bangladesh
• Is Part Of: Paediatric and perinatal epidemiology. Volume 28:Issue 6(2014)
• Page Start: 510
• Page End: 520
• Publication Date: 2014-09-16
• Subjects: Pediatrics -- Periodicals; Perinatology -- Periodicals; Pediatric epidemiology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; 618.92
• DOI: 10.1111/ppe.12145
• Languages: English
• ISSNs: 0269-5022

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="ppe12145-sec-0001" sec-type="section"> <title>Background</title> <p>Preterm birth leads to an estimated 35% of neonatal deaths worldwide. Our study analyses neonatal mortality risks among preterm births in rural Bangladesh.</p> </sec> <sec id="ppe12145-sec-0002" sec-type="section"> <title>Methods</title> <p>Trained community health workers (CHW) prospectively collected data between June 2007 and September 2009.</p> </sec> <sec id="ppe12145-sec-0003" sec-type="section"> <title>Results</title> <p>Among 32 126 livebirths, 22.3% were preterm (delivered at <37 weeks gestation) and almost half (46.4%) of all neonatal deaths occurred among preterm babies. Preterm babies who were born as the first child {[risk ratio (RR) 1.4; 95% confidence interval (CI) 1.1, 1.8]} and in the poorest households [RR 1.7; 95% CI 1.2, 2.4] were at higher mortality risk. Birth and newborn care preparedness was associated with lower risk of mortality [RR 0.3; 95% CI 0.2, 0.4] while preterm infants who had symptoms of infection [RR 5.6; 95% CI 4.3, 7.1] or whose mother suffered antenatal complications [RR 1.4; 95% CI 1.1, 1.8] were at higher mortality risk. Elimination of excess neonatal deaths caused by preterm would decrease population‐level neonatal mortality rate by 31.0% [95% CI 27.60%, 34.5%].</p> </sec> <sec id="ppe12145-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Given that 87% of preterm births and 60% of preterm deaths were in late or moderate preterm infants, and that 87% preterm babies received a visit from CHW within third day of life, a home‐based essential care package delivered by CHWs for sick preterm infants, specifically focused on birth preparedness, skin‐to‐skin care, immediate breast feeding, early recognition of danger signs, and linked through referral to intensive and quality care in health facilities, could be an effective approach in low resource settings.</p> </sec> </abstract>