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. 2016 Apr 25;36(Suppl 1):S1–S11. doi: 10.1038/jp.2016.27

Table 2. Summary of studies that reported cause-specific mortality by day of life.

Study/country Study design Study population Sample size Methods Results Comments
Studies providing data for all the time points (included in initial as well as final analysis)
Baqui et al.,7 India Prospective Data from two districts of Uttar Pradesh Neonatal deaths: 618 Data collected by data collectors Cause of death assigned by WHO VA algorithm Cause Days Weeks Deaths secondary to tetanus and diarrhea were included in sepsis deaths
            0 1 2 3 4 5 6 2 3–4  
          Birth asphyxia/injury (n=87) 61 (70.1) 6 (6.8) 7 (8.0) 3 (3.4) 1 (1.1) 4 (4.5) 3 (3.4) 2 (2.2) 0  
          Prematurity (n=166) 52 (31.3) 18 (10.8) 14 (8.4) 14 (8.4) 8 (4.8) 7 (4.2) 11 (6.6) 18 (10.8) 24 (14.4)  
          Sepsis/pneumonia (n=149) 16 (10.7) 11 (7.3) 14 (9.3) 10 (6.7) 8 (5.3) 7 (4.6) 10 (6.7) 41 (27.5) 32 (21.4)  
          Tetanus (n=25) 0 0 0 5 (20) 2 (8) 2 (8) 0 10 (40) 6 (24)  
          Diarrhea (n=10) 1 (10) 0 0 0 0 0 2 (20) 2 (20) 5 (50)  
          Congenital anomaly (n=40) 19 (47.5) 2 (5) 1 (2.5) 3 (7.5) 2 (5) 2 (5) 1 (2.5) 5 (12.5) 5 (12.5)  
          Not identified 48 (36.6) 11 (8.3) 26 (19.8) 11 (8.3) 4 (3) 6 (4.5) 4 (3) 14 (10.6) 7 (5.3)  
                               
Waiswa et al.,14 Uganda Prospective; January 2005–December 2008 Iganga/Mayug districts Neonatal deaths: 64 VA Cause Day 0 Day 1 Days 2–28             Data were included in initial analysis for asphyxia and congenital anomalies; for prematurity and sepsis, data were extrapolated Deaths secondary to tetanus were included in sepsis deaths
          Birth asphyxia (n=19) 12 (63.1) 7 (36.8) 0              
          Prematurity (n=16) 8 (50) 0 8 (50)              
          Sepsis/pneumonia (n=20) 6 (30) 0 14 (70)              
          Tetanus (n=2) 0 0 2 (100)              
          Congenital defects (n=1) 0 1 (100) 0              
          Not identified (n=6) 4 (66.6) 0 2 (33.3)              
                               
Studies providing data for at least three time points (but not all time points; included in the final analysis)
Bang et al.,12 India Prospective; 1995–1996 Rural India Neonatal deaths: 40 Cause of death assigned by neonatologist based on maternal and neonatal records Cause Days 0–3 Days 4–7 Week 2 Weeks 3–4            
          Birth asphyxia (n=8) 7 (87.5) 1 (12.5) 0 0            
          Prematurity (n=6) 6 (100) 0 0 0            
          Sepsis/pneumonia (n=21) 0 5 (23.8) 11 (52.3) 5 (23.8)            
          Tetanus (n=0) 0 0 0 0            
          Hypothermia (n=1) 0 1 (100) 0 0            
          Others/not known 1 (7.1) 2 (22.2) 0 1(16.7)            
                               
Edmond et al.,13 Ghana Prospective; January 2003–June 2004 Central Ghana Neonatal deaths: 590 VA Cause Day 0 Days 1–6 Weeks 2–4              
          Infection (n=236) 16 (6.7) 91 (38.5) 129 (54.6)              
          Birth asphyxia (n=196) 148 (75.5) 45 (22.9) 3 (1.5)              
          Prematurity (n=118) 64 (54.2) 43 (36.4) 11 (9.3)              
          Congenital defects (n=16) 6 (37.5) 9 (56.2) 1 (6.2)              
          Others (n=6) 4 (66.7) 0 2 (33.3)              
          Unexplained (n=8) 3 (37.5) 3 (37.5) 2 (25)              
                               
Jehan et al.,18 Pakistan Prospective Data collected from four units of Latifabad, Pakistan Total live births: 1121 Neonatal deaths: 53 Cause of death assigned by neonatologist as per Pattinson's adaptation of Aberdeen classification Cause Days 0–2 Days 3–6 Weeks 2–4             Outcome at 28 days known only for 1121 of the 1280 enrolled women
          Asphyxia (n=14) 8 (57.1) 6 (42.8) 0              
          Prematurity (n=14) 11 (78.5) 2 (14.2) 1 (7.14)              
          Infections (n=12) 0 5 (41.6) 7 (58.3)              
          Congenital defects (n=4) 0 2 (50) 2 (50)              
          Others (n=5) 1 (20) 2 (40) 2 (40)              
          Undetermined (n=4) 2 (50) 0 2 (50)              
                               
Khanal et al.,19 Nepal Prospective Morang district in rural Nepal Neonatal deaths: 183 VA by community health volunteers Cause Days 0–3 Days 4–7 Weeks 2–4              
          Birth asphyxia (n=68) 65 (95.5) 2 (2.9) 1 (1.4)              
          Prematurity (n=21) 16 (76.1) 5 (23.8) 0              
          Infection (n=75) 16 (21.3) 27 (36.0) 32 (42.7)              
          LBW-related (n=8) 6 (75) 0 2 (25)              
          Congenital defects (n=4) 1 (25) 2 (50) 1 (25)              
          Hypothermia (n=3) 2 (66.7) 1 (33.3) 0              
          HDN (n=2) 0 1 (50) 1 (50)              
          Others (n=2) 1 (50) 1(50) 0              
                               
Nga et al.,9 Vietnam Prospective July 2008–June 2010 Data collected in 14 districts of Quang Ninh Province, Vietnam, as part of NeoKIP Neonatal deaths for which VA performed: 233 VA using questionnaire derived from WHO causes of death assigned by three experienced pediatricians reviewing forms independently Cause Day 0 (n=136) Days 1–6 (n=52) Weeks 2–4 (n=45)              
          Birth asphyxia (n=79) 61 (77.2) 14 (17.7) 4 (5.1)              
          Prematurity/LBW(n=90) 58 (64.4) 15 (16.7) 17 (18.9)              
          Infection (n=31) 0 (0) 14 (45.2) 17 (54.8)              
          Congenital defects (n=16) 9 (56.3) 4 (25) 3 (18.7)              
          Others/unknown (n=17) 8 (47.1) 5 (29.4) 4 (23.5)              
                               
Other studies (not included in the pooled analysis)
Baiden et al.,25 Ghana Retrospective Demographic surveillance system data (1995–2002) Neonatal deaths: 1068 VA conducted by field workers Cause of death assigned independently by three physicians Agreement of at least two physicians required Cause Early Late                
          Infections 37% 63%                
          Prematurity/LBW 88% 12%                
          Birth injury 97% 3%                
          Infanticide 46% 54%                
          Others 63% 37%                
          Undiagnosed 63% 37%                
Ngoc et al.,20 Argentina, Egypt, India, Peru, South Africa, Vietnam Prospective Data from multicenter study Early neonatal deaths: 71 Cause of death assigned by one of the investigators Early neonatal deaths (n=71) Prematurity: 43/71 (60.6%) Asphyxia and birth trauma: 16 (22.5%) Infection: 1/71 (1.4%) Congenital anomalies: 9/71 (12.7%) Others: 2/71 (2.8%)                   WHO multicenter study on calcium supplementation for prevention of pre-eclampsia
                               
Kalter et al.,21 Palestine Prospective Clusters from West Bank, East Jerusalem, Gaza Strip Neonatal deaths: 68 Data collected by field workers, supervised and cause of death assigned by two investigators Cause Early Late               No details on the place of delivery; respiratory distress syndrome added to prematurity Cases with two different causes of death not included
          Asphyxia (n=7) 6 (85.7) 1 (14.2)                
          Prematurity/LBW (n=16) 11 (68.7) 5 (31.2)                
          Congenital anomaly (n=15) 12 (80) 3 (20)                
          Sepsis (n=10) 7 (70) 3 (30)                
          Others (n=8) 4 (50) 4 (50)                
                               
Chowdhury et al.,22 Bangladesh Retrospective; 2003–2004 Data from HDSS Neonatal deaths: 365 VA by interviewers Three physicians assigned cause of death Agreement of at least two physicians required Cause Early Late               No details on the place of delivery; respiratory distress syndrome added to prematurity
          Asphyxia (n=164) 162 (98.7) 2 (1.2)                
          Prematurity/LBW (n=80) 76 (95) 4 (5)                
          Sepsis (n=45) 17 (37.7) 28 (62.2)                
          Pneumonia (n=20) 9 (45) 11 (55)                
          Others (n=56) 43 (76.7) 13 (23.2)                
                               
Gill et al.,17 Zambia Prospective; June 2006–November 2008 Data from Lufwanyama district Neonatal deaths in the control group: 58 Data collected by data collectors; helped by birth attendants Cause of death assigned by WHO VA algorithm Cause Days 0–1 Days 2–27               Data taken from the control group of cluster RCT
          Serious infection (n=17) 6 (64.7) 11 (35.2)                
          Birth asphyxia (n=21) 21 (100) 0                
          Prematurity (n=10) 8 (80) 2 (20)                
          Congenital defects (n=2) 2 (100) 0                
          Diarrhea (n=4) 0 4 (100)                
          Others/unknown (n=4) 3 (75) 1 (25)                
                               
Bapat et al.,15 India Prospective; 2005–2007 48 slum settlements in Mumbai Newborn deaths: 210 (but data available only for 116) VA by trained field researchers Cause of death classified by clinicians Cause Early (n=87) (%) Late (n=29) (%)                
          Asphyxia (n=33) 32 (97) 1 (3.0)                
          Prematurity/LBW (n=27) 27 (100) 0 (0)                
          Sepsis (n=25) 5 (20) 20 (80)                
          Congenital anomalies (n=7) 5 (71.4) 2 (28.6)                
          Others/unclassified (n=24) 18 (75) 6 (25)                

Abbreviations: HDN, hemorrhagic disease of newborn; HDSS, health and demographic surveillance system; LBW, low birth weight; NeoKIP, Knowledge into Practice for Improving Neonatal Survival; VA, verbal autopsy; WHO, World Health Organization.