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J Perinatol. 2013 Dec;33(12):977-81. doi: 10.1038/jp.2013.91. Epub 2013 Aug 15.

Preterm birth and neonatal mortality in a rural Bangladeshi cohort: implications for health programs.

Author information

1
1] Department of International Health, International Center for Maternal and Newborn Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA [2] Center for Child and Adolescent Health, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, Bangladesh.

Abstract

OBJECTIVE:

To estimate the burden of prematurity, determine gestational age (GA)-specific neonatal mortality rates and provide recommendations for country programs.

STUDY DESIGN:

Prospective data on pregnancy, childbirth, GA and newborn mortality collected by trained community health workers from 10 585 mother-newborn pairs in a community-based study.

RESULT:

A total of 19.4% of newborn infants were preterm; 13.5% were late preterm (born between 34 and 36 weeks of gestation), 3.3% were moderate preterm (born at 32 to 33 weeks) and 2.6% were extremely preterm (born at 28 to 31 weeks of gestation). Preterm babies experienced 46% of all neonatal deaths; 40% of preterm deaths were in late preterm, 20% in moderate preterm and 40% in very preterm infants. The population attributable fraction of neonatal mortality in premature babies was 0.16 for very preterm, 0.07 for moderately preterm and 0.10 for late preterm.

CONCLUSION:

In settings where the majority of births and newborn deaths occur at home and successful referral is a challenge, moderate and late preterm babies may be an important target group for home-based or first-level facility-based management.

PMID:
23949837
DOI:
10.1038/jp.2013.91
[Indexed for MEDLINE]

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