Preterm births and deaths: from counting to classification

12 October, 2022

Dear HIFA and CHIFA colleagues,

Citation, extracts and a comment from me below.

CITATION: COMMENT| VOLUME 10, ISSUE 11, E1537-E1538, NOVEMBER 01, 2022

Preterm births and deaths: from counting to classification

Deepak Chawla, Ramesh Agarwal

Lancet Global Health

Published:November, 2022 DOI:https://doi.org/10.1016/S2214-109X(22)00422-3

EXTRACTS

Preterm birth and related complications cause 1 million child deaths every year...

We can classify prematurity based on how soon a baby is born or on maternal, placental, and fetal pathologies contributing to preterm birth...

With the project to understand and research preterm pregnancy outcomes and stillbirths in South Asia (PURPOSe) study, published in this issue of The Lancet Global Health, Sangappa M Dhaded and colleagues... adds several important insights into the causes of deaths associated with preterm birth.

First, in about a third of neonatal deaths, the mothers had hypertensive disorders (204 [33%] of 615 cases)...

Second, the study reports evidence of congenital infections...

Third... of all neonatal deaths during the study period, about a quarter (189 of 804) were excluded as their birthweight was less than 1000 g...

PURPOSe has filled an important void in the knowledge about causes of preterm death in resource-limited settings...

COMMENT

The authors acknowledge that many preterm deaths can be averted using evidence-based interventions'. Conversely, it is clear that poor quality care contributes enormously to the burden of death and longterm disability in preterm infants. When we talk about 'causes of death', we need to be paying at least as much attention to quality of care and the availability (or otherwise) of relevant, reliable healthcare information. We need to be talking about 'healthcare-associated' causes of avoidable death and disability at least as much as classifying deaths by medical causes.

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Neil Pakenham-Walsh, Global Coordinator HIFA, www.hifa.org neil@hifa.org

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