CHERG has identified the need for additional work on intra-uterine growth restriction (IUGR) and pre-term birth. Both these conditions, individually and together, are important risk factors for neonatal (and perhaps later) mortality. Initially, CHERG examined the contribution of low birth weight at term (< 2500g) to neonatal mortality, and, in the latest iteration, estimates were made disaggregating the incidence of neonatal mortality by cause amongst newborns weighing 1500-1999g, and 2000-2499g, as opposed to weighing more than 2500g at term. Deaths amongst newborns weighing less than 1500g were considered to be completely due to prematurity, and no deaths due to prematurity were estimated otherwise. There are recognized limitations to this approach, which was formulated within the strictures of the published data available. Information in this field is rapidly changing and new data are emerging that can be used to improve current estimates of the magnitude and distribution of the problem of IUGR and preterm birth, as well as their individual and combined contribution to neonatal and infant morbidity and mortality. Specifically, there are community-based studies where reasonably good estimates of gestational age are available that could now address this question more effectively. This type of information is important for program and research priority-setting, as it provides the basis for defining risk factors and for evaluating the impact of interventions to prevent these two different contributors to the mortality burden among the most vulnerable newborns. There are 3 specific aims proposed for this activity: - Estimate global and region-specific incidence of preterm and IUGR
- Estimate the disease burden (morbidity and mortality in neonates and infants) associated with IUGR and preterm globally and by region
- Identify maternal risk factors, with emphasis on nutrition, for IUGR and preterm, and estimate the disease burden attributable to these conditions.
After suitable data sets are identified, an investigators' collaborative group will be formed to plan the analyses. The investigators' group will then reconvene to provide feedback on analyses and interpretation of results. The results will be published in a peer-reviewed journal and made publicly available. Moderate to Severe, but Not Mild, Maternal Anemia, Is Associated with Increased Risk of Small-for-Gestational-Age Outcome. (2011). Naoko Kozuki, Anne C. Lee, Joanne Katz, and on behalf of the Child Health Epidemiology Reference Group. J Nutr. 2011 Dec 21. jn.111.149237 [Epub ahead of print]. |
