title: Preterm birth-associated neurodevelopmental impairment estimates at regional and global levels for 2010.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Hannah
authors.initials: H
authors.lastname: Blencowe
authors.affiliation: 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.
authors.forename: Anne C C
authors.initials: AC
authors.lastname: Lee
authors.affiliation: Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Cousens
authors.affiliation: The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland.
authors.forename: Adil
authors.initials: A
authors.lastname: Bahalim
authors.affiliation: 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.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Narwal
authors.affiliation: 1] New York State Institute for Basic Research in Developmental Disabilities, Staten Island, New York [2] Peking University Center of Medical Genetics, Beijing, China.
authors.forename: Nanbert
authors.initials: N
authors.lastname: Zhong
authors.affiliation: World Health Organization, Geneva, Switzerland.
authors.forename: Doris
authors.initials: D
authors.lastname: Chou
authors.affiliation: World Health Organization, Geneva, Switzerland.
authors.forename: Lale
authors.initials: L
authors.lastname: Say
authors.affiliation: Division of Medicine, Section of Neonatal Medicine, Imperial College London, London, UK.
authors.forename: Neena
authors.initials: N
authors.lastname: Modi
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Joanne
authors.initials: J
authors.lastname: Katz
authors.affiliation: 1] Institute for Health Metrics and Evaluation, Seattle, Washington [2] University of Queensland, School of Population Health, Herston, Australia.
authors.forename: Theo
authors.initials: T
authors.lastname: Vos
authors.affiliation: EGA Institute for Women's Health, University College London, London, UK.
authors.forename: Neil
authors.initials: N
authors.lastname: Marlow
authors.affiliation: 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.
authors.forename: Joy E
authors.initials: JE
authors.lastname: Lawn
mesh_terms: D002658:Developmental Disabilities / Q000453:epidemiology* / Q000266:history; D014943:Global Health / Q000706:statistics & numerical data*; D049674:History, 21st Century; D006801:Humans; D007231:Infant, Newborn; D015233:Models, Statistical; D047928:Premature Birth / Q000453:epidemiology* / Q000266:history; D018570:Risk Assessment