Evidence map›Paper›PMID 35440021›Full record

ArticleBMC pregnancy and childbirth2022

Perinatal Risks of Neonatal and Infant Mortalities in a Sub-provincial Region of China: A Livebirth Population-based Cohort Study.

Yaling Xu, Xiaojing Guo, Zhaojun Pan, Guofang Zheng, Xiaoqiong Li, Tingting Qi, Xiaoqin Zhu, Hui Wang, Weijie Ding, Zhaofang Tian and 4 more

Abstract read
In one paragraph

Article in BMC pregnancy and childbirth, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Yaling XuThe National Commission of Health Laboratory of Neonatal Diseases; National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China.
Xiaojing GuoThe National Commission of Health Laboratory of Neonatal Diseases; National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China.
Zhaojun PanDepartment of Neonatology, Huai'an Women and Children's Hospital, Huai'an, Jiangsu, China.
Guofang ZhengDepartment of Neonatology, Huai'an Women and Children's Hospital, Huai'an, Jiangsu, China.
Xiaoqiong LiDepartment of Obstetrics, Huai'an Women and Children's Hospital, Huai'an, Jiangsu, China.
Tingting QiDepartment of Obstetrics, Huai'an Women and Children's Hospital, Huai'an, Jiangsu, China.
Xiaoqin ZhuUnit of Population Health Information, Huai'an Women and Children's Hospital, Huai'an, Jiangsu, China.
Hui WangUnit of Population Health Information, Huai'an Women and Children's Hospital, Huai'an, Jiangsu, China.
Weijie DingUnit of Population Health Information, Huai'an Women and Children's Hospital, Huai'an, Jiangsu, China.
Zhaofang TianDepartment of Neonatology, The Affiliated Huai'an First People's Hospital of Nanjing Medical University, Huai'an, Jiangsu, China.
Haijun WangDepartment of Neonatology, Lianshui County Hospital, Huai'an, Jiangsu, China.
Hongni YueDepartment of Neonatology, Huai'an Women and Children's Hospital, Huai'an, Jiangsu, China. yuehongni@hotmail.com.
Bo SunThe National Commission of Health Laboratory of Neonatal Diseases; National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China. bsun@shmu.edu.cn.
Huai’an Perinatal-Neonatal Collaborative Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCurrent vital statistics of birth population and neonatal outcome in China lacked information and definition of deaths at delivery and during hospitalization, especially for extreme preterm (EPT) birth. This study aims to delineate the prevalence of neonatal hospitalization, neonatal and infant mortality rates (NMR, IMR) and associated perinatal risks based on all livebirths in Huai'an, an evolving sub-provincial region in eastern China.

methodsThis retrospective cohort study established a comprehensive database linking information of whole regional livebirths and neonatal hospitalization in 2015, including deaths at delivery and EPT livebirths. The primary outcomes were NMR and IMR stratified by gestational age (GA) and birthweight (BW) with 95% confidence intervals. Causes of the neonatal and infant deaths were categorized according to the International Statistical Classification of Diseases 10th version, and population attributable fractions of GA and BW strata were analyzed. Perinatal risks of infant mortalities in continuum periods were estimated by Cox regression models.

resultsAmong the whole livebirth population (59056), 7960 were hospitalized (prevalence 13.5%), with 168 (2.8‰) in-hospital deaths. The NMR was 3.6 (3.2, 4.1)‰ and IMR 4.9 (1.4, 4.5)‰, with additionally 35 (0.6‰) deaths at delivery. The major causes of infant deaths were perinatal conditions (2.6‰, mainly preterm-related), congenital anomalies (1.5‰), sudden unexpected death in infancy (0.6‰) and other causes (0.2‰). The deaths caused by preterm and low BW (LBW) accounted for 50% and 40% of NMR and IMR, with 20-30% contributed by EPT or extremely LBW, respectively. Multivariable Cox regression analysis revealed that peripartum factors and LBW strata had strong association with early- and late-neonatal deaths, whereas those of GA < 28 weeks were highly associated with postneonatal deaths. Congenital anomalies and neonatal hospitalization remained high death risks over the entire infancy, whereas maternal co-morbidities/complications were modestly associated with neonatal but not postneonatal infant mortality.

conclusionsThe NMR, IMR, major causes of deaths and associated perinatal risks in continuum periods of infancy, denote the status and quality improvement of the regional perinatal-neonatal care associated with socioeconomic development. The study concept, applicability and representativeness may be validated in other evolving regions or countries for genuine comparison and better maternal-infant healthcare.

Indexed as

Infant DeathInfant MortalityBirth WeightChinaCohort StudiesFemaleHumansInfantInfant, NewbornPregnancyRetrospective StudiesInfant mortality rateLivebirthNeonatal hospitalizationNeonate mortality rateRisk

Identifiers

PMID35440021
PMCPMC9020038

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.