Beyond Newborn Survival: The Global Burden of Disease Due to Neonatal Morbidity

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Every year, 135 million newborns enter the world, each arriving naked and apparently equal. Yet, their chances of surviving and thriving vary dramatically depending on which world these babies are born into—ranging from high-income countries with universal neonatal intensive care to the world of home births without midwives, medical supplies, or health system support.

The Beyond Newborn Survival supplement in Pediatric Research, published by Nature, includes an editorial and six research articles presenting the first systematic estimates of impairment after neonatal morbidity. It brings together the work of almost 50 authors representing 35 institutions from 12 countries, from more than a thousand different data inputs. The authors summarize global estimates of the incidence of impairments in the year 2010 as a result of four major neonatal conditions: preterm birth (including separate estimates of visual impairment due to retinopathy of prematurity), intrapartum-associated neonatal encephalopathy (sometimes referred to as “birth asphyxia”), severe neonatal infections, and hyperbilirubinemia (seen clinically as jaundice).

Worldwide, of the 15.1 million preterm babies, 13 million survived beyond the first month of life. Of the survivors, 345,000 (2.7 percent) had moderate or severe impairment and 567,000 (4.4 percent) had mild impairment. 


  • In upper-income countries, more than 80 percent of babies born under 37 weeks survive and thrive. Risk of death and disability is greatest for those born at less than 28 weeks.
  • In middle-income countries great progress has been made in reducing deaths. But, the risk of disability for babies born at 28-32 weeks is double that of high-income countries.
  • In low-income countries, preterm babies are >10 times more likely to die than those in high-income countries. Without basic care, few survive with severe disabilities. 
  • Preterm babies are also vulnerable to eye complications. Of the 185,000 newborns affected by Retinopathy of prematurity, about 20,000 suffer from moderate disabilities, including blindness. 



The four worlds into which 135 million newborns are born each year. Republished with permission from the Born Too Soon report.

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