Estimating baseline rates of adverse perinatal and neonatal outcomes using a facility-based surveillance approach: A prospective observational study from the WHO Global Vaccine Safety Multi-Country Collaboration on safety in pregnancy.

Sharan, Apoorva, Stuurman, Anke L, Jahagirdar, Shubhashri, Elango, Varalakshmi, Riera-Montes, Margarita, Kashyap, Neeraj Kumar, Biccler, Jorne, Poluru, Ramesh, Arora, Narendra Kumar, Mathai, Matthews ORCID: https://orcid.org/0000-0002-7352-9330, Mangtani, Punam, Devlieger, Hugo, Anderson, Steven, Whitaker, Barbee, Wong, Hui-Lee, Moran, Allisyn and Maure, Christine Guillard (2022) 'Estimating baseline rates of adverse perinatal and neonatal outcomes using a facility-based surveillance approach: A prospective observational study from the WHO Global Vaccine Safety Multi-Country Collaboration on safety in pregnancy.'. EClinicalMedicine, Vol 50, e101506.

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Abstract

Background
Most perinatal and neonatal deaths occur in low- and middle-income countries (LMICs), yet, quality data on burden of adverse outcomes of pregnancy is limited in such countries.

Methods
A network of 21 maternity units, across seven countries, undertook surveillance for low birthweight, preterm birth, small for gestational age (SGA), stillbirths, congenital microcephaly, in-hospital neonatal deaths, and neonatal infections in a cohort of over 85,000 births from May 2019 - August 2020. For each outcome, site-specific rates per 1,000 livebirths (or per 1,000 total births for stillbirth) and 95% confidence intervals (CI) were calculated. Descriptive sensitivity analysis was conducted to gain insight regarding underreporting of four outcomes at 16 sites.

Findings
Estimated rates varied across countries and sites, ranging between 43·3-329·5 and 21·4-276·6/1000 livebirths for low birthweight and preterm birth respectively and 11·8-81/1,000 livebirths for SGA. No cases of congenital microcephaly were reported by three sites while the highest estimated rate was 13/1,000 livebirths. Neonatal infection and neonatal death rates varied between 1·8-73 and 0-59·9/1000 livebirths respectively while stillbirth rates ranged between 0-57·1/1000 total births across study sites. Results from the sensitivity analysis confirmed the underreporting of congenital microcephaly and SGA in our study.

Interpretation
Our study establishes site-specific baseline rates for important adverse perinatal and neonatal outcomes and addresses a critical evidence gap towards improved monitoring of benefits and risks of emerging pregnancy and neonatal interventions.

Item Type:	Article
Subjects:	WA Public Health > Preventive Medicine > WA 115 Immunization WA Public Health > Health Administration and Organization > WA 530 International health administration WQ Obstetrics > Childbirth. Prenatal Care > WQ 175 Prenatal care WQ Obstetrics > WQ 500 Postnatal care WS Pediatrics > By Age Groups > WS 420 Newborn infants. Neonatology
Faculty: Department:	Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.1016/j.eclinm.2022.101506
SWORD Depositor:	JISC Pubrouter
Depositing User:	JISC Pubrouter
Date Deposited:	19 Oct 2022 12:11
Last Modified:	14 Jun 2023 10:18
URI:	https://archive.lstmed.ac.uk/id/eprint/20903

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