{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T15:36:30Z","timestamp":1788363390794,"version":"build-2803163510"},"reference-count":47,"publisher":"Wiley","issue":"S8","license":[{"start":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T00:00:00Z","timestamp":1705363200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe the mortality risks by fine strata of gestational age and birthweight among 230\u2009679 live births in nine low\u2010 and middle\u2010income countries (LMICs) from 2000 to 2017.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Descriptive multi\u2010country secondary data analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Nine LMICs in sub\u2010Saharan Africa, Southern and Eastern Asia, and Latin America.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>Liveborn infants from 15 population\u2010based cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Subnational, population\u2010based studies with high\u2010quality birth outcome data were invited to join the Vulnerable Newborn Measurement Collaboration. All studies included birthweight, gestational age measured by ultrasound or last menstrual period, infant sex and neonatal survival. We defined adequate birthweight as 2500\u20133999\u2009g (reference category), macrosomia as \u22654000\u2009g, moderate low as 1500\u20132499\u2009g and very low birthweight as &lt;1500\u2009g. We analysed fine strata classifications of preterm, term and post\u2010term: \u226542\n                      <jats:sup>+0<\/jats:sup>\n                      , 39\n                      <jats:sup>+0<\/jats:sup>\n                      \u201341\n                      <jats:sup>+6<\/jats:sup>\n                      (reference category), 37\n                      <jats:sup>+0<\/jats:sup>\n                      \u201338\n                      <jats:sup>+6<\/jats:sup>\n                      , 34\n                      <jats:sup>+0<\/jats:sup>\n                      \u201336\n                      <jats:sup>+6<\/jats:sup>\n                      ,34\n                      <jats:sup>+0<\/jats:sup>\n                      \u201336\n                      <jats:sup>+6<\/jats:sup>\n                      ,32\n                      <jats:sup>+0<\/jats:sup>\n                      \u201333\n                      <jats:sup>+6<\/jats:sup>\n                      , 30\n                      <jats:sup>+0<\/jats:sup>\n                      \u201331\n                      <jats:sup>+6<\/jats:sup>\n                      , 28\n                      <jats:sup>+0<\/jats:sup>\n                      \u201329\n                      <jats:sup>+6<\/jats:sup>\n                      and less than 28\u2009weeks.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Median and interquartile ranges by study for neonatal mortality rates (NMR) and relative risks (RR). We also performed meta\u2010analysis for the relative mortality risks with 95% confidence intervals (CIs) by the fine categories, stratified by regional study setting (sub\u2010Saharan Africa and Southern Asia) and study\u2010level NMR (\u226425 versus &gt;25 neonatal deaths per 1000 live births).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We found a dose\u2013response relationship between lower gestational ages and birthweights with increasing neonatal mortality risks. The highest NMR and RR were among preterm babies born at &lt;28\u2009weeks (median NMR 359.2 per 1000 live births; RR 18.0, 95% CI 8.6\u201337.6) and very low birthweight (462.8 per 1000 live births; RR 43.4, 95% CI 29.5\u201363.9). We found no statistically significant neonatal mortality risk for macrosomia (RR 1.1, 95% CI 0.6\u20133.0) but a statistically significant risk for all preterm babies, post\u2010term babies (RR 1.3, 95% CI 1.1\u20131.5) and babies born at 37\n                      <jats:sup>0<\/jats:sup>\n                      \u201338\n                      <jats:sup>6<\/jats:sup>\n                      \u2009weeks (RR 1.2, 95% CI 1.0\u20131.4). There were no statistically significant differences by region or underlying neonatal mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In addition to tracking vulnerable newborn types, monitoring finer categories of birthweight and gestational age will allow for better understanding of the predictors, interventions and health outcomes for vulnerable newborns. It is imperative that all newborns from live births and stillbirths have an accurate recorded weight and gestational age to track maternal and neonatal health and optimise prevention and care of vulnerable newborns.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.17743","type":"journal-article","created":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T22:48:29Z","timestamp":1705445309000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Neonatal mortality risk of vulnerable newborns by fine stratum of gestational age and birthweight for 230\u2009679 live births in nine low\u2010 and middle\u2010income countries, 2000\u20132017"],"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  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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