Vulnerable newborn types: Analysis of population‐based registries for 165 million births in 23 countries, 2000–2021

Lorena Suárez‐Idueta, Judith Yargawa, Hannah Blencowe, Ellen Bradley, Yemisrach B. Okwaraji, Veronica Pingray, Luz Gibbons, Adrienne Gordon, Kara Warrilow, Enny S. Paixao, Ila Rocha Falcão, Sarka Lisonkova, Qi Wen, Francisco Mardones, Raúl Caulier‐Cisterna, Petr Velebil, Jitka Jírová, Erzsebet Horváth‐Puhó, Henrik Toft Sørensen, Luule SakkeusLili Abuladze, Mika Gissler, Mohammad Heidarzadeh, Maziar Moradi‐Lakeh, Khalid A. Yunis, Ayah Al Bizri, Shamala D. Karalasingam, Ravichandran Jeganathan, Arturo Barranco, Lisa Broeders, Aimée E. van Dijk, Luis Huicho, Hugo Guillermo Quezada‐Pinedo, Kim Nail Cajachagua‐Torres, Fawziya Alyafei, Mai AlQubaisi, Geum Joon Cho, Ho Yeon Kim, Neda Razaz, Jonas Söderling, Lucy K. Smith, Jennifer Kurinczuk, Estelle Lowry, Neil Rowland, Rachael Wood, Kirsten Monteath, Isabel Pereyra, Gabriella Pravia, Eric O. Ohuma*, Robert E. Black, the National Vulnerable Newborn Prevalence Collaborative Group and Vulnerable Newborn Measurement Core Group

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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To examine the prevalence of novel newborn types among 165 million live births in 23 countries from 2000 to 2021.

Population-based, multi-country analysis.

National data systems in 23 middle- and high-income countries.

Liveborn infants.

Country teams with high-quality data were invited to be part of the Vulnerable Newborn Measurement Collaboration. We classified live births by six newborn types based on gestational age information (preterm 90th centile) for gestational age, according to INTERGROWTH-21st standards. We considered small newborn types of any combination of preterm or SGA, and term + LGA was considered large. Time trends were analysed using 3-year moving averages for small and large types.

Main outcome measures
Prevalence of six newborn types.

We analysed 165 017 419 live births and the median prevalence of small types was 11.7% – highest in Malaysia (26%) and Qatar (15.7%). Overall, 18.1% of newborns were large (term + LGA) and was highest in Estonia 28.8% and Denmark 25.9%. Time trends of small and large infants were relatively stable in most countries.

The distribution of newborn types varies across the 23 middle- and high-income countries. Small newborn types were highest in west Asian countries and large types were highest in Europe. To better understand the global patterns of these novel newborn types, more information is needed, especially from low- and middle-income countries.
Original languageEnglish
JournalBJOG: An International Journal of Obstetrics and Gynaecology
Early online date08 May 2023
Publication statusEarly online date - 08 May 2023


  • low birthweight
  • newborn
  • preterm birth
  • size for gestational age


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