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

Journal of Perinatology volume 33, pages 977–981 (2013)Cite this article

Subjects

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.

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Acknowledgements

This research was funded by the United States Agency for International Development (USAID), through cooperative agreements with the Johns Hopkins Bloomberg School of Public Health and the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), and by the Saving Newborn Lives Program of Save the Children-US through a grant from the Bill and Melinda Gates Foundation. The study was conducted by the Projahnmo study group in Bangladesh. Projhanmo is a partnership of the ICDDR,B; the Bangladesh government’s Ministry of Health and Family Welfare; Bangladeshi nongovernmental organizations, including Shimantik, Save the Children-US, Dhaka Shishu Hospital and the Institute of Child and Mother Health and the Johns Hopkins Bloomberg School of Public Health. We thank the members of the Projahnmo study team and colleagues at the Bangladesh Ministry of Health and Family Welfare at the sub-district, district and central levels for their valuable help and advice. We thank the many individuals in Sylhet district who gave their time generously as well as Projahnmo field and data management staff who worked tirelessly.

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Authors and Affiliations

  1. Department of International Health, International Center for Maternal and Newborn Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA

    A H Baqui, H E Rosen, A C C Lee, J A Applegate, N Begum, R Shah & R E Black

  2. Center for Child and Adolescent Health, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka, Bangladesh

    A H Baqui, S El Arifeen & S M Rahman

  3. Global Development Division, Family Health Program, Bill and Melinda Gates Foundation, Seattle, WA, USA

    G L Darmstadt

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  1. A H Baqui
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Correspondence to A H Baqui.

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Baqui, A., Rosen, H., Lee, A. et al. Preterm birth and neonatal mortality in a rural Bangladeshi cohort: implications for health programs. J Perinatol 33, 977–981 (2013). https://doi.org/10.1038/jp.2013.91

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  • DOI: https://doi.org/10.1038/jp.2013.91

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