Preterm birth and neonatal mortality in a rural Bangladeshi cohort: implications for health programs.
OBJECTIVE
To estimate the burden of prematurity, determine gestational age (GA)-specific neonatal mortality rates and provide recommendations for country programs.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
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.
A H
AH
Baqui
H E
HE
Rosen
A C C
AC
Lee
J A
JA
Applegate
S
S
El Arifeen
S M
SM
Rahman
N
N
Begum
R
R
Shah
G L
GL
Darmstadt
R E
RE
Black
D001459:Bangladesh / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D050498:Live Birth / Q000453:epidemiology; D008297:Male; D011247:Pregnancy; D047928:Premature Birth / Q000401:mortality*