Evidence map›Paper›PMID 35589346›Full record

ArticleBMJ open2022

Does higher early neonatal mortality in boys reverse over the neonatal period? A pooled analysis from three trials of Nepal.

Seema Subedi, Joanne Katz, Daniel Joseph Erchick, Andrea Verhulst, Subarna K Khatry, Luke C Mullany, James M Tielsch, Steven C LeClerq, Parul Christian, Keith P West and 1 more

3 registry-linked trialsOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
4.9field-weighted citation impact, top 5% of its field
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.

NCT00109616 phase3completednot on this map

Newborn Antiseptic Washing and Neonatal Mortality-Nepal

TypeinterventionalSponsorEunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)Ran2002 to 2006Enrolled17,000ConditionsNeonatal MortalityArmsNewborn skin cleansing with 0.25% chlorhexidine solution, Cleansing of umbilical cord with soap and water solution, Cleansing of umbilical cord with 4% chlorhexidine
NCT00115271 phase3completednot on this map

Maternal Micronutrient Supplementation to Reduce Low Birth Weight and Infant and Maternal Morbidity in Rural Nepal

TypeinterventionalSponsorJohns Hopkins Bloomberg School of Public HealthRan1999 to 2001Enrolled5,000ConditionsLow Birth Weight, Infant Mortality, Pregnancy, Nutritional StatusArmsNutritional supplements
NCT01177111 phase3completednot on this map

Impact of Sunflower Seed Oil Massage on Neonatal Mortality and Morbidity in Nepal

TypeinterventionalSponsorJohns Hopkins Bloomberg School of Public HealthRan2010 to 2017Enrolled29,260ConditionsNeonatal Mortality, Neonatal SepsisArmsSunflower seed oil, Mustard seed oil
3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 13 citations in OpenAlex.

  1. Trial
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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

11 authors at 3 institutions in 1 country.

Seema SubediInternational Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA ssubedi2@jhu.edu.ORCID 0000-0002-6360-3998
Joanne KatzInternational Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
Daniel Joseph ErchickInternational Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.ORCID 0000-0002-2852-280X
Andrea VerhulstPopulation Studies Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID 0000-0003-0571-1330
Subarna K KhatryNepal Nutrition Intervention Project, Sarlahi, Kathmandu, Nepal.
Luke C MullanyInternational Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
James M TielschGlobal Health, George Washington University School of Public Health and Health Services, Washington, District of Columbia, USA.
Steven C LeClerqInternational Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
Parul ChristianInternational Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
Keith P WestInternational Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
Michel GuillotPopulation Studies Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Johns Hopkins University · USUniversity of Pennsylvania · USGeorge Washington University · US

Funding

Global Age Patterns of Under-Five MortalityR01HD090082 · NICHD · UNIVERSITY OF PENNSYLVANIA · PI GUILLOT, MICHEL · 2017 to 2021
$3.6M
ZINC SUPPLEMENTATION IMPACT ON CHILD MORTALITY--NEPALR01HD038753 · NICHD · JOHNS HOPKINS UNIVERSITY · PI TIELSCH, JAMES M · 2000 to 2003
$3.5M
Impact of Sunflower Oil Massage on Neonatal Mortality in NepalR01HD060712 · NICHD · JOHNS HOPKINS UNIVERSITY · PI MULLANY, LUKE C · 2009 to 2013
$2.9M
Newborn Antiseptic Washing and Neonatal Mortality-NepalR01HD044004 · NICHD · JOHNS HOPKINS UNIVERSITY · PI TIELSCH, JAMES M · 2003 to 2005
$1.5M
Prioritization of modifiable risk factors for adverse pregnancy outcomes and neonatal mortality in rural NepalR01HD092411 · NICHD · JOHNS HOPKINS UNIVERSITY · PI KATZ, JOANNE · 2018 to 2020
$822k
NICHD NIH HHS R01 HD038753NICHD NIH HHS R01 HD044004NICHD NIH HHS R01 HD060712NICHD NIH HHS R01 HD090082NICHD NIH HHS R01 HD092411
6 · The paper itself

Abstract

objectivesNeonatal mortality is generally 20% higher in boys than girls due to biological phenomena. Only a few studies have examined more finely categorised age patterns of neonatal mortality by sex, especially in the first few days of life. The objective of this study is to examine sex differentials in neonatal mortality by detailed ages in a low-income setting.

designThis is a secondary observational analysis of data.

settingRural Sarlahi district, Nepal.

participantsNeonates born between 1999 and 2017 in three randomised controlled trials. OUTCOME MEASURES: We calculated study-specific and pooled mortality rates for boys and girls by ages (0-1, 1-3, 3-7, 7-14, 14-21 and 21-28 days) and estimated HR using Cox proportional hazards models for male versus female mortality for treatment and control groups together (n=59 729).

resultsNeonatal mortality was higher in boys than girls in individual studies: 44.2 vs 39.7 in boys and girls in 1999-2000; 30.0 vs 29.6 in 2002-2006; 33.4 vs 29.4 in 2010-2017; and 33.0 vs 30.2 in the pooled data analysis. Pooled data found that early neonatal mortality (HR=1.17; 95% CI: 1.06 to 1.30) was significantly higher in boys than girls. All individual datasets showed a reversal in mortality by sex after the third week of life. In the fourth week, a reversal was observed, with mortality in girls 2.43 times higher than boys (HR=0.41; 95% CI: 0.31 to 0.79).

conclusionsBoys had higher mortality in the first week followed by no sex difference in weeks 2 and 3 and a reversal in risk in week 4, with girls dying at more than twice the rate of boys. This may be a result of gender discrimination and social norms in this setting. Interventions to reduce gender discrimination at the household level may reduce female neonatal mortality. TRIAL REGISTRATION NUMBER: NCT00115271, NCT00109616, NCT01177111.

Indexed as

Infant MortalityRural PopulationFamily CharacteristicsFemaleHumansInfant, NewbornMaleNepalObservational Studies as TopicSexismCommunity child healthEPIDEMIOLOGYNEONATOLOGY

Identifiers

PMID35589346
PMCPMC9121405
OpenAlexW4280594350

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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.