Publications by authors named "Hannah Blencowe"

Article Synopsis
  • Post-term pregnancy, reaching or exceeding 42 weeks of gestation, is linked to negative birth outcomes, and while high-income countries often induce labor, low- and middle-income countries lag behind.
  • The study aims to examine the prevalence of post-term births, associated risk factors, and their connections to small-for-gestational-age (SGA) neonates and infant mortality in middle-income settings like Brazil, Mexico, and Palestinian refugees.
  • Analyzing over 45 million live births, the research found that post-term deliveries significantly increased the risk of SGA neonates and infant mortality, suggesting the need for induction strategies to address these issues.
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Background: Training health workers might facilitate respectful maternity care (RMC); however, the content and design of RMC training remain unclear.

Objective: To explore the content and design of RMC training packages for health workers in sub-Saharan Africa.

Search Strategy: MEDLINE, EMBASE, CINAHL Complete, Web of Science Core Collections, SCOPUS, and grey literature sources (including websites of RMC-focused key organizations and Ministries of Health) were searched for journal papers, reports, and training guides from January 2006 up to August 2022.

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Background: Ninety-eight percent of neonatal deaths worldwide occur in low- and middle-income countries (LMICs), yet there is little bereavement care guidance available for these settings.

Objectives: To explore parents', families' and healthcare professionals' experiences of care after neonatal death in healthcare facilities in LMICs.

Search Strategy And Selection Criteria: Four databases were searched for peer-reviewed literature, meeting the inclusion criteria of qualitative studies exploring the experiences of people who provided or received bereavement care following neonatal death in a LMIC healthcare setting.

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Background: Over 250 million children are not reaching their developmental potential globally. The impact of prenatal factors and their interplay with postnatal environmental factors on child neurodevelopment, is still unclear-particularly in low- and middle-income settings. This study aims to understand the impact of pregnancy complications as well as environmental, psychosocial, and biological predictors on neurodevelopmental trajectories.

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Despite efforts to reduce stillbirths and neonatal deaths, inconsistent definitions and reporting practices continue to hamper global progress. Existing data frequently being limited in terms of quality and comparability across countries. This paper addresses this critical issue by outlining the new International Classification of Disease (ICD-11) recommendations for standardized recording and reporting of perinatal deaths to improve data accuracy and international comparison.

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Objective: To compare stillbirth rates and risks for small for gestational age (SGA), large for gestational age (LGA) and appropriate for gestational age (AGA) pregnancies at 24-44 completed weeks of gestation using a birth-based and fetuses-at-risk approachs.

Design: Population-based, multi-country study.

Setting: National data systems in 15 high- and middle-income countries.

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Background: PRECISE-DYAD is an observational cohort study of mother-child dyads running in urban and rural communities in The Gambia and Kenya. The cohort is being followed for two years and includes uncomplicated pregnancies and those that suffered pregnancy hypertension, fetal growth restriction, preterm birth, and/or stillbirth.

Methods: The PRECISE-DYAD study will follow up ~4200 women and their children recruited into the original PRECISE study.

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Background: Low birthweight (LBW; <2500 g) is an important predictor of health outcomes throughout the life course. We aimed to update country, regional, and global estimates of LBW prevalence for 2020, with trends from 2000, to assess progress towards global targets to reduce LBW by 30% by 2030.

Methods: For this systematic analysis, we searched population-based, nationally representative data on LBW from Jan 1, 2000, to Dec 31, 2020.

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Background: In 2021, Uganda's neonatal mortality rate was approximately 19 deaths per 1000 live births, with an estimated stillbirth rate of 15.1 per 1000 total births. Data are critical for indicating areas where deaths occur and why, hence driving improvements.

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Background: Despite global efforts to reduce maternal and neonatal mortality, stillbirths remain a significant public health challenge in many low- and middle-income countries. District health systems, largely seen as the backbone of health systems, are pivotal in addressing the data gaps reported for stillbirths. Available, accurate and complete data is essential for District Health Management Teams (DHMTs) to understand the burden of stillbirths, evaluate interventions and tailor health facility support to address the complex challenges that contribute to stillbirths.

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Objective: To examine the contribution of preterm birth and size-for-gestational age in stillbirths using six 'newborn types'.

Design: Population-based multi-country analyses.

Setting: Births collected through routine data systems in 13 countries.

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Article Synopsis
  • - The study analyzed data from 115.6 million live births across 15 countries from 2000 to 2020 to assess the prevalence and neonatal mortality rates associated with large for gestational age (LGA) and macrosomia.
  • - Results indicated that LGA babies (those above the 90th percentile) had a lower risk of neonatal mortality compared to appropriate for gestational age (AGA) infants, while overall macrosomia (≥4000 g) also did not show increased mortality risk, except for higher weight categories.
  • - The findings suggest that a birthweight of ≥4500 g is a key indicator for increased early mortality risk in larger infants, which could help inform clinical decisions regarding their care. *
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Objective: Low birthweight (<2500 g) and preterm birth (<37 weeks) are markers of newborn vulnerability. To facilitate informed decisions about investments in prevention and care, it is imperative to enhance data quality and use. Hence, the objective of this study is to systematically assess the quality of data concerning low birthweight and preterm births within routine administrative data sources.

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Background: Preterm birth is the leading cause of neonatal mortality and is associated with long-term physical, neurodevelopmental, and socioeconomic effects. This study updated national preterm birth rates and trends, plus novel estimates by gestational age subgroups, to inform progress towards global health goals and targets, and aimed to update country, regional, and global estimates of preterm birth for 2020 in addition to trends between 2010 and 2020.

Methods: We systematically searched population-based, nationally representative data on preterm birth from Jan 1, 2010, to Dec 31, 2020 and study data (26 March-14 April, 2021) for countries and areas with no national-level data.

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Objective: To estimate the prevalence and risk of stillbirths by biologic vulnerability phenotypes in a cohort of pregnant women in the municipality of São Paulo, Brazil, 2017-2019.

Methods: Retrospective population-based cohort study. Fetuses were assessed as small for gestational age (SGA), large for gestational age (LGA), adequate for gestational age (AGA), preterm (PT) as less than 37 weeks of gestation, non-PT (NPT) as 37 weeks of gestation or more, low birth weight (LBW) as less than 2500 g, and non-LBW (NLBW) as 2500 g or more.

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Background: In 2021, Uganda had an estimated 25,855 stillbirths and 32,037 newborn deaths. Many Adverse Pregnancy Outcomes (APOs) go unreported despite causing profound grief and other mental health effects. This study explored psychosocial effects of APOs and their influence on reporting these events during surveys and surveillance settings in Uganda.

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Background: Despite progress, stillbirth rates in many high- and upper-middle income countries remain high, and the majority of these deaths are preventable. We introduce the Ending Preventable Stillbirths (EPS) Scorecard for High- and Upper Middle-Income Countries, a tool to track progress against the Lancet's 2016 EPS Series Call to Action, fostering transparency, consistency and accountability.

Methods: The Scorecard for EPS in High- and Upper-Middle Income Countries was adapted from the Scorecard for EPS in Low-Income Countries, which includes 20 indicators to track progress against the eight Call to Action targets.

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Article Synopsis
  • The text discusses a new model for understanding maternal mortality, stillbirths, and neonatal deaths, highlighting how these issues are interconnected and often analyzed separately, despite affecting nearly 5 million lives annually.* -
  • Researchers developed a five-phase transition model based on data from 151 countries, where lower phases indicate higher mortality rates, to track progress from 2000 to 2020 and to evaluate factors influencing health outcomes.* -
  • Findings showed that many countries advanced in their transition phases, with improvements in mortality ratios and health service coverage, particularly in professional healthcare delivery, antenatal care, and reduced fertility rates, indicating overall progress in maternal and neonatal health.*
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Article Synopsis
  • This umbrella review examines how size at birth (birth weight and gestation) impacts the health, growth, and development of children and adolescents up to 18 years old, synthesizing evidence from systematic reviews and meta-analyses.
  • The review screened over 16,000 articles and found 302 relevant systematic reviews, highlighting that small size at birth was linked to many negative outcomes, whereas large size had fewer established associations.
  • The authors suggest that future research should address gaps in understanding large birth size effects, explore outcomes that lack comprehensive reviews, and focus on underrepresented populations to better analyze developmental consequences.
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Background: Sub-Saharan African (SSA) countries have high stillbirth rates compared with high-income countries, yet research on risk factors for stillbirth in SSA remain scant.

Objectives: To identify the modifiable risk factors of stillbirths in SSA and investigate their strength of association using a systematic review.

Search Strategy: CINAHL Plus, EMBASE, Global Health and MEDLINE databases were searched for literature.

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Background Reducing low birthweight (LBW, weight at birth less than 2,500g) prevalence by at least 30% between 2012 and 2025 is a target endorsed by the World Health Assembly that can contribute to achieving Sustainable Development Goal 2 (Zero Hunger) by 2030. The 2019 LBW estimates indicated a global prevalence of 14.6% (20.

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Small newborns are vulnerable to mortality and lifelong loss of human capital. Measures of vulnerability previously focused on liveborn low-birthweight (LBW) babies, yet LBW reduction targets are off-track. There are two pathways to LBW, preterm birth and fetal growth restriction (FGR), with the FGR pathway resulting in the baby being small for gestational age (SGA).

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