Every Newborn: progress, priorities, and potential beyond survival

Lawn, Joy E; Blencowe, Hannah; Oza, Shefali; You, Danzhen; Lee, Anne C C; Waiswa, Peter; Lalli, Marek; Bhutta, Zulfiqar Ahmed; Barros, Aluísio J D; Christian, Parul; Mathers, Colin; Cousens, Simon

doi:10.1016/s0140-6736(14)60496-7

Cited by 1,533 publications

(1,514 citation statements)

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“…The Every Newborn Action Plan 2014 has set a target for all countries to achieve stillbirth rates of <10 per 1000 births (after 28 weeks’ gestation) by 2035 39. We believe that this target is achievable across the world provided that the social, nutritional and health‐care needs of women are met.…”

Section: Discussionmentioning

confidence: 99%

The antepartum stillbirth syndrome: risk factors and pregnancy conditions identified from the INTERGROWTH‐21^st Project

Hirst

Villar

Víctora

et al. 2016

BJOG

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ObjectivesTo identify risk factors for antepartum stillbirth, including fetal growth restriction, among women with well‐dated pregnancies and access to antenatal care.DesignPopulation‐based, prospective, observational study.SettingEight international urban populations.PopulationPregnant women and their babies enrolled in the Newborn Cross‐Sectional Study of the INTERGROWTH‐21st Project.MethodsCox proportional hazard models were used to compare risks among antepartum stillborn and liveborn babies.Main outcome measuresAntepartum stillbirth was defined as any fetal death after 16 weeks’ gestation before the onset of labour.ResultsOf 60 121 babies, 553 were stillborn (9.2 per 1000 births), of which 445 were antepartum deaths (7.4 per 1000 births). After adjustment for site, risk factors were low socio‐economic status, hazard ratio (HR): 1.6 (95% CI, 1.2–2.1); single marital status, HR 2.0 (95% CI, 1.4–2.8); age ≥40 years, HR 2.2 (95% CI, 1.4–3.7); essential hypertension, HR 4.0 (95% CI, 2.7–5.9); HIV/AIDS, HR 4.3 (95% CI, 2.0–9.1); pre‐eclampsia, HR 1.6 (95% CI, 1.1–3.8); multiple pregnancy, HR 3.3 (95% CI, 2.0–5.6); and antepartum haemorrhage, HR 3.3 (95% CI, 2.5–4.5). Birth weight <3rd centile was associated with antepartum stillbirth [HR, 4.6 (95% CI, 3.4–6.2)]. The greatest risk was seen in babies not suspected to have been growth restricted antenatally, with an HR of 5.0 (95% CI, 3.6–7.0). The population‐attributable risk of antepartum death associated with small‐for‐gestational‐age neonates diagnosed at birth was 11%.ConclusionsAntepartum stillbirth is a complex syndrome associated with several risk factors. Although small babies are at higher risk, current growth restriction detection strategies only modestly reduced the rate of stillbirth.Tweetable abstractInternational stillbirth study finds individual risks poor predictors of death but combinations promising.

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Section: Discussionmentioning

confidence: 99%

The antepartum stillbirth syndrome: risk factors and pregnancy conditions identified from the INTERGROWTH‐21^st Project

Hirst

Villar

Víctora

et al. 2016

BJOG

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“…Twins suffer more from congenital malformations and could also therefore be more vulnerable after the first year of life. 9 The fate of twins might be particularly precarious in sub-Saharan Africa where child mortality rates are the highest in the world, 11 where maternal and newborn care is weak, [11][12][13][14] and where the absolute number of children under 5 years, including twins, will increase by about 20% over the next decades. 15 High mortality rates among twins have been documented for many sub-Saharan sites or countries, with under-5 mortality rates ranging from over 200 to almost 400 deaths per 1000 livebirths.…”

Section: Introductionmentioning

confidence: 99%

Mortality among twins and singletons in sub-Saharan Africa between 1995 and 2014: a pooled analysis of data from 90 Demographic and Health Surveys in 30 countries

Monden

Smits

2017

The Lancet Global Health

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“…Sub-Saharan Africa has one of the highest neonatal mortality rates in the world at 28/1000 live births [3,4] with Uganda at 27/1000 live births [5]. Over 800,000 neonatal deaths annually could be prevented if breastfeeding practices were scaled up [6].…”

Section: Introductionmentioning

confidence: 99%

Factors associated with delayed initiation of breastfeeding: a survey in Northern Uganda

Mukunya

Tumwine

Nankabirwa

et al. 2017

Global Health Action

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Background: Initiation of breastfeeding later than 1 hour after birth is associated with increased neonatal morbidity and mortality. Objective: To determine the prevalence and factors associated with delayed initiation of breastfeeding. Methods: We conducted a survey in 2016 of 930 children under the age of 2 years in Lira district, northern Uganda. Mothers of the children were interviewed and data was collected on mobile phones using Open Data Kit software (https://opendatakit.org). Multivariable logistic regression was used to determine factors associated with delayed initiation of breastfeeding. Results: Almost half [48.2%, 95% confidence interval (CI) (44.3–52.1)] of the mothers delayed initiation of breastfeeding. Factors significantly associated with delayed initiation of breastfeeding in multivariable analysis included caesarean delivery [Adjusted Odds Ratio (AOR) 11.10 95% CI (3.73–33.04)], discarding initial breast milk [AOR 2.02 95% CI (1.41–2.88)], home delivery [AOR 1.43 95% CI (1.04–1.97)] and mother being responsible for initiating breastfeeding as compared to a health worker or relative [AOR 1.73 95% CI (1.33–2.26)]. Mothers having a secondary education were less likely [AOR 0.54 95% CI (0.30–0.96)] to delay initiation of breastfeeding as compared to those with no education. Conclusion: About half the mothers delayed initiation of breastfeeding until after 1 hour after birth. Programs to promote, protect and support breastfeeding in this post conflict region are urgently needed.

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Every Newborn: progress, priorities, and potential beyond survival

Cited by 1,533 publications

References 73 publications

The antepartum stillbirth syndrome: risk factors and pregnancy conditions identified from the INTERGROWTH‐21^st Project

The antepartum stillbirth syndrome: risk factors and pregnancy conditions identified from the INTERGROWTH‐21^st Project

Mortality among twins and singletons in sub-Saharan Africa between 1995 and 2014: a pooled analysis of data from 90 Demographic and Health Surveys in 30 countries

Factors associated with delayed initiation of breastfeeding: a survey in Northern Uganda

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Every Newborn: progress, priorities, and potential beyond survival

Cited by 1,533 publications

References 73 publications

The antepartum stillbirth syndrome: risk factors and pregnancy conditions identified from the INTERGROWTH‐21st Project

The antepartum stillbirth syndrome: risk factors and pregnancy conditions identified from the INTERGROWTH‐21st Project

Mortality among twins and singletons in sub-Saharan Africa between 1995 and 2014: a pooled analysis of data from 90 Demographic and Health Surveys in 30 countries

Factors associated with delayed initiation of breastfeeding: a survey in Northern Uganda

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The antepartum stillbirth syndrome: risk factors and pregnancy conditions identified from the INTERGROWTH‐21^st Project

The antepartum stillbirth syndrome: risk factors and pregnancy conditions identified from the INTERGROWTH‐21^st Project