小婴儿,大风险:全球估计易受伤害的新生儿的患病率和死亡率,以加快变化和改善计数
Joy E Lawn1, Eric O Ohuma1, Ellen Bradley1
1Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK.
Lancet (London, England)
|May 11, 2023
概括
小的易受伤害的新生儿 (SVN) 包括早产的非SGA,终产的SGA和早产的SGA. 超过一半的新生儿死亡和许多死胎与这些SVN类型有关,突出显示需要更好的数据和有针对性的干预措施.
科学领域:
- 新生儿健康
- 全球公共卫生
- 生产周边流行病学
背景情况:
- 小新生儿面临严重的死亡风险和终身人力资本损失.
- 现有的新生儿脆弱性措施,如低出生体重 (LBW),是不够的,因为LBW减少目标仍未实现.
- 低出生体重是由早产或胎儿生长限制 (FGR) 引起的,导致婴儿的妊娠年龄较小 (SGA).
研究的目的:
- 估计三种相互排斥的小脆弱新生儿 (SVN) 的全球患病率:早产非SGA,晚产SGA和早产SGA.
- 评估这些SVN类型对新生儿死亡率和死胎的贡献.
- 倡导改善针对性干预的新生儿数据收集和分类.
主要方法:
- 使用来自23个国家数据集的个人数据 (约. 已有1亿个活产婴儿) 和31个研究 (约. 在2010年至2020年间,
- 估计了2020年早产非SGA,早产SGA和早产SGA活产的发生率.
- 分析了国家死亡出生数据 (妊娠22周以上),以确定SGA的早产和终产死亡的比例.
主要成果:
- 2020年,全球估计显示有1190万名非SGA早产,2190万名SGA终产,以及150万名SGA早产.
- 在2020年全球240万新生儿死亡中,小的脆弱新生儿占比超过一半 (55.3%).
- 约有74%的死产是早产,其中16%是早产SGA,约有五分之一的死产是SGA.
结论:
- 将小型新生儿分为特定的脆弱类型 (早产非SGA,晚产SGA,早产SGA) 对于了解它们对死亡率的影响至关重要.
- 将死胎纳入负担评估和相关指标是必不可少的,因为每年估计有190万死胎具有类似的脆弱性路径.
- 通过系统地记录所有新生儿的体重,妊娠年龄和分类来改善数据,可以加快预防和针对最脆弱的婴儿的治疗.
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