The dangers of being born too small or too soon

摘要

Birth is dangerous, especially for infants born too small or too soon. Although much is known about the mortality risk for such infants in high-income countries, little is known about the risk in poorer countries. In The Lancet, Joanne Katz and colleagues begin to fill in the gap on just how dangerous it is to be born too small or too soon in a low-income or middle-income country/The investigators analysed more than 2 million birth outcomes from resource-poor countries in Asia, Africa, and Latin America and calculated the regional risk of neonatal and post-neonatal mortality associated with being born preterm, small-for-gestational age (SGA), or both. Using data from 20 cohorts in 13 countries, Katz and colleagues show that being born SGA increased the risk of neonatal mortality by two to five times across the three regions, but being born preterm (<37 completed weeks of gestation) raised the risk by six to 26 times. When children were born both SGA and preterm, neonatal mortality was ten to 39 times higher than in otherwise normal neonates. These findings provide the first solid estimates of the excess risk of dying for infants in these categories of births for countries where 135 million babies are born every year. Katz and colleagues' findings advance our knowledge by going beyond the use of low birthweight (<2500 g) as a means of identifying infants in danger. The low birthweight category includes both premature and growth-restricted infants.