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

From: When do newborns die? A systematic review of timing of overall and cause-specific neonatal deaths in developing countries

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	Day s							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.

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

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