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Pediatr Res. 2013 Dec;74 Suppl 1:17-34. doi: 10.1038/pr.2013.204.

Preterm birth-associated neurodevelopmental impairment estimates at regional and global levels for 2010.

Author information

1
Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
2
1] Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland [2] Department of Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
3
The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland.
4
1] Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK [2] Public Health Planning Division, National Health Systems Resource Centre, New Delhi, India.
5
1] New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York [2] Peking University Center of Medical Genetics, Beijing, China.
6
World Health Organization, Geneva, Switzerland.
7
Division of Medicine, Section of Neonatal Medicine, Imperial College London, London, UK.
8
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
9
1] Institute for Health Metrics and Evaluation, Seattle, Washington [2] University of Queensland, School of Population Health, Herston, Australia.
10
EGA Institute for Women's Health, University College London, London, UK.
11
1] Centre for Maternal Reproductive & Child Health, London School of Hygiene and Tropical Medicine, London, UK [2] Saving Newborn Lives/Save the Children, Washington, DC.

Abstract

BACKGROUND:

In 2010, there were an estimated 15 million preterm births worldwide (<37 wk gestation). Survivors are at risk of adverse outcomes, and burden estimation at global and regional levels is critical for priority setting.

METHODS:

Systematic reviews and meta-analyses were undertaken to estimate the risk of long-term neurodevelopmental impairment for surviving preterm babies according to the level of care. A compartmental model was used to estimate the number of impaired postneonatal survivors following preterm birth in 2010. A separate model (DisMod-MR) was used to estimate years lived with disability (YLDs) for the global burden of disease 2010 study. Disability adjusted life years (DALYs) were calculated as the sum of YLDs and years of life lost (YLLs).

RESULTS:

In 2010, there were an estimated 13 million preterm births who survived beyond the first month. Of these, 345,000 (2.7%, uncertainty range: 269,000-420,000) were estimated to have moderate or severe neurodevelopmental impairment, and a further 567,000 (4.4%, (445,000-732,000)) were estimated to have mild neurodevelopmental impairment. Many more have specific learning or behavioral impairments or reduced physical or mental health. Fewest data are available where the burden is heaviest. Preterm birth was responsible for 77 million DALYs, 3.1% of the global total, of which only 3 million were YLDs.

CONCLUSION:

Most preterm births (>90%) survive without neurodevelopmental impairment. Developing effective means of prevention of preterm birth should be a longer term priority, but major burden reduction could be made immediately with improved coverage and quality of care. Improved newborn care would reduce mortality, especially in low-income countries and is likely to reduce impairment in survivors, particularly in middle-income settings.

PMID:
24366461
PMCID:
PMC3873710
DOI:
10.1038/pr.2013.204
[Indexed for MEDLINE]
Free PMC Article

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