Neonatal death in low- to middle-income countries: a global network study.
OBJECTIVE
To determine population-based neonatal mortality rates in low- and middle-income countries and to examine gestational age, birth weight, and timing of death to assess the potentially preventable neonatal deaths.


METHODS
A prospective observational study was conducted in communities in five low-income countries (Kenya, Zambia, Guatemala, India, and Pakistan) and one middle-income country (Argentina). Over a 2-year period, all pregnant women in the study communities were enrolled by trained study staff and their infants followed to 28 days of age.


RESULTS
Between October 2009 and March 2011, 153,728 babies were delivered and followed through day 28. Neonatal death rates ranged from 41 per 1000 births in Pakistan to 8 per 1000 in Argentina; 54% of the neonatal deaths were >37 weeks and 46% weighed 2500 g or more. Half the deaths occurred within 24 hours of delivery.


CONCLUSIONS
In our population-based low- and middle-income country registries, the majority of neonatal deaths occurred in babies >37 weeks' gestation and almost half weighed at least 2500 g. Most deaths occurred shortly after birth. With access to better medical care and hospitalization, especially in the intrapartum and early neonatal period, many of these neonatal deaths might be prevented.
Institute for Clinical Effectiveness, Buenos Aires, Argentina.
José M
JM
Belizán
Elizabeth M
EM
McClure
Shivaprasad S
SS
Goudar
Omrana
O
Pasha
Fabian
F
Esamai
Archana
A
Patel
Elwyn
E
Chomba
Ana
A
Garces
Linda L
LL
Wright
Marion
M
Koso-Thomas
Janet
J
Moore
Fernando
F
Althabe
Bhala S
BS
Kodkany
Neelofar
N
Sami
Albert
A
Manasyan
Richard J
RJ
Derman
Edward A
EA
Liechty
Patricia
P
Hibberd
Waldemar A
WA
Carlo
K Michael
KM
Hambidge
Pierre
P
Buekens
Alan H
AH
Jobe
Robert L
RL
Goldenberg
D001724:Birth Weight; D003906:Developing Countries; D005260:Female; D005865:Gestational Age; D014943:Global Health; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D008297:Male; D008427:Maternal Health Services; D008428:Maternal Mortality; D011203:Poverty; D011446:Prospective Studies