{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:41:18Z","timestamp":1787013678120,"version":"build-2736575974"},"reference-count":53,"publisher":"Wiley","issue":"S8","license":[{"start":{"date-parts":[[2023,5,8]],"date-time":"2023-05-08T00:00:00Z","timestamp":1683504000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010409","name":"Children's Investment Fund Foundation","doi-asserted-by":"publisher","award":["2004\u201004670"],"award-info":[{"award-number":["2004\u201004670"]}],"id":[{"id":"10.13039\/100010409","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2025,11]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n We aimed to understand the mortality risks of vulnerable newborns (defined as preterm and\/or born weighing smaller or larger compared to a standard population), in low\u2010 and middle\u2010income countries (LMICs).<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Descriptive multi\u2010country, secondary analysis of individual\u2010level study data of babies born since 2000.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Sixteen subnational, population\u2010based studies from nine LMICs in sub\u2010Saharan Africa, Southern and Eastern Asia, and Latin America.<\/jats:p>\n <\/jats:sec>\n \n Population<\/jats:title>\n Live birth neonates.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We categorically defined five vulnerable newborn types based on size (large\u2010 or appropriate\u2010 or small\u2010for\u2010gestational age [LGA, AGA, SGA]), and term (T) and preterm (PT): T\u2009+\u2009LGA, T\u2009+\u2009SGA, PT\u2009+\u2009LGA, PT\u2009+\u2009AGA, and PT\u2009+\u2009SGA, with T\u2009+\u2009AGA (reference). A 10\u2010type definition included low birthweight (LBW) and non\u2010LBW, and a four\u2010type definition collapsed AGA\/LGA into one category. We performed imputation for missing birthweights in 13 of the studies.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measures<\/jats:title>\n Median and interquartile ranges by study for the prevalence, mortality rates and relative mortality risks for the four, six and ten type classification.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n There were 238\u2009203 live births with known neonatal status. Four of the six types had higher mortality risk: T\u2009+\u2009SGA (median relative risk [RR] 2.6, interquartile range [IQR] 2.0\u20132.9), PT\u2009+\u2009LGA (median RR 7.3, IQR 2.3\u201310.4), PT\u2009+\u2009AGA (median RR 6.0, IQR 4.4\u201313.2) and PT\u2009+\u2009SGA (median RR 10.4, IQR 8.6\u201313.9). T\u2009+\u2009SGA, PT\u2009+\u2009LGA and PT\u2009+\u2009AGA babies who were LBW, had higher risk compared with non\u2010LBW babies.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Small and\/or preterm babies in LIMCs have a considerably increased mortality risk compared with babies born at term and larger. This classification system may advance the understanding of the social determinants and biomedical risk factors along with improved treatment that is critical for newborn health.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/1471-0528.17518","type":"journal-article","created":{"date-parts":[[2023,5,8]],"date-time":"2023-05-08T18:30:15Z","timestamp":1683570615000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Neonatal mortality risk of vulnerable newborns: A descriptive analysis of subnational, population\u2010based birth cohorts for 238\u2009203 live births in low\u2010 and middle\u2010income settings from 2000 to 2017"],"prefix":"10.1111","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9176-3278","authenticated-orcid":false,"given":"Elizabeth A.","family":"Hazel","sequence":"first","affiliation":[{"name":"International Health Department Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2852-280X","authenticated-orcid":false,"given":"Daniel J.","family":"Erchick","sequence":"additional","affiliation":[{"name":"International Health Department Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Katz","sequence":"additional","affiliation":[{"name":"International Health Department Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2654-9862","authenticated-orcid":false,"given":"Anne C. C.","family":"Lee","sequence":"additional","affiliation":[{"name":"Pediatric Newborn Medicine Brigham and Women's Hospital, Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Diaz","sequence":"additional","affiliation":[{"name":"International Health Department Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee S. 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