Neonatal death, birth to 28 completed days

Overview

Definition

Death of a liveborn infant within 28 completed days of life, counted from birth, as the ACTION-I trial defined it

Unit

infants

Measured in

Studies in this atlas that report this outcome, by the claim each finding supports. Each finding keeps its own population, denominator and time window on the study page.

• Primary endpoint WHO ACTION-I trial · See the findings

  Applies to Newborn

  • Liveborn infants of the randomized women. The window of 26 weeks 0 days to 33 weeks 6 days is the mother's gestational age when she entered the trial. It does not limit the infant's gestational age at birth, and the research gives no such limit. Birth occurred before 37 weeks for 90.0% of infants in the dexamethasone group and 90.8% of infants in the placebo group.
  • Hospital-based: 29 secondary- and tertiary-level hospitals across six study sites. The hospitals were chosen after a standard assessment so that the WHO conditions for antenatal corticosteroid use could reasonably be met.
  • Bangladesh, India, Kenya, Nigeria and Pakistan
  • Neonatal period, birth to 28 days
  • Gestational age Not reported
  • Postnatal age 0 days to 0 days

  Follow-up Infants entered the analysis at birth and were followed until 28 days after birth or death, whichever came first. Neonatal death means death of a liveborn within 28 completed days of life. The postnatal age bounds give age at entry, not the length of follow-up.
  In the ACTION-I trial, pregnant women at risk of imminent preterm birth, from 26 weeks 0 days to 33 weeks 6 days of pregnancy, received either dexamethasone or a dummy injection. Fewer of their liveborn babies died in the first 28 days of life in the dexamethasone group: 278 of 1417 (19.6%) against 331 of 1406 (23.5%) in the placebo group (relative risk 0.84, 95% CI 0.72 to 0.97). The medicine was given to the mother, and the outcome counted here is the baby's.

  Limitations. One placebo-controlled trial in 29 secondary- and tertiary-level hospitals in five low-resource countries. The hospitals were chosen so that the WHO conditions for steroid use could reasonably be met, so the result does not describe lower-level facilities or the community. The trial stopped early for benefit, short of its planned sample. About 90% of the infants were born before 37 weeks. The authors report that 45% of women received fewer than four doses, and name the difficulty of standardizing care across sites and the use of third-trimester ultrasound to confirm gestational age for many participants as limits. The relative risk is model-based, adjusted for site and for multiple births, with intervals adjusted for multiplicity. Figures come from the PubMed abstract and the Author Final Manuscript; the version of record was not fetched (HTTP 403) and the figures were not checked against it.

Record details

Record id

maternal:outcome-neonatal-death-28d

Content hash

1e1a8610036405465be6ea89d967c68dabc0bc30bb37da6ee6482dc4319ed2dd