Birthweight: EN-BIRTH multi-country validation study
Abstract Background Accurate birthweight is critical to inform clinical care at the individual level and tracking progress towards national/global targets at the population level. Low birthweight (LBW) < 2500 g affects over 20.5 million newborns annually. However, data are lacking and may be affe...
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2021-03-01
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Series: | BMC Pregnancy and Childbirth |
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Online Access: | https://doi.org/10.1186/s12884-020-03355-3 |
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doaj-f9322be9f9b6454eb01e29acc411c467 |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Stefanie Kong Louise T. Day Sojib Bin Zaman Kimberly Peven Nahya Salim Avinash K. Sunny Donat Shamba Qazi Sadeq-ur Rahman Ashish K.C. Harriet Ruysen Shams El Arifeen Paul Mee Miriam E. Gladstone Hannah Blencowe Joy E. Lawn EN-BIRTH Study Group |
spellingShingle |
Stefanie Kong Louise T. Day Sojib Bin Zaman Kimberly Peven Nahya Salim Avinash K. Sunny Donat Shamba Qazi Sadeq-ur Rahman Ashish K.C. Harriet Ruysen Shams El Arifeen Paul Mee Miriam E. Gladstone Hannah Blencowe Joy E. Lawn EN-BIRTH Study Group Birthweight: EN-BIRTH multi-country validation study BMC Pregnancy and Childbirth Birth Newborn Maternal Stillbirth Coverage Validity |
author_facet |
Stefanie Kong Louise T. Day Sojib Bin Zaman Kimberly Peven Nahya Salim Avinash K. Sunny Donat Shamba Qazi Sadeq-ur Rahman Ashish K.C. Harriet Ruysen Shams El Arifeen Paul Mee Miriam E. Gladstone Hannah Blencowe Joy E. Lawn EN-BIRTH Study Group |
author_sort |
Stefanie Kong |
title |
Birthweight: EN-BIRTH multi-country validation study |
title_short |
Birthweight: EN-BIRTH multi-country validation study |
title_full |
Birthweight: EN-BIRTH multi-country validation study |
title_fullStr |
Birthweight: EN-BIRTH multi-country validation study |
title_full_unstemmed |
Birthweight: EN-BIRTH multi-country validation study |
title_sort |
birthweight: en-birth multi-country validation study |
publisher |
BMC |
series |
BMC Pregnancy and Childbirth |
issn |
1471-2393 |
publishDate |
2021-03-01 |
description |
Abstract Background Accurate birthweight is critical to inform clinical care at the individual level and tracking progress towards national/global targets at the population level. Low birthweight (LBW) < 2500 g affects over 20.5 million newborns annually. However, data are lacking and may be affected by heaping. This paper evaluates birthweight measurement within the Every Newborn Birth Indicators Research Tracking in Hospitals (EN-BIRTH) study. Methods The EN-BIRTH study took place in five hospitals in Bangladesh, Nepal and Tanzania (2017–2018). Clinical observers collected time-stamped data (gold standard) for weighing at birth. We compared accuracy for two data sources: routine hospital registers and women’s report at exit interview survey. We calculated absolute differences and individual-level validation metrics. We analysed birthweight coverage and quality gaps including timing and heaping. Qualitative data explored barriers and enablers for routine register data recording. Results Among 23,471 observed births, 98.8% were weighed. Exit interview survey-reported weighing coverage was 94.3% (90.2–97.3%), sensitivity 95.0% (91.3–97.8%). Register-reported coverage was 96.6% (93.2–98.9%), sensitivity 97.1% (94.3–99%). Routine registers were complete (> 98% for four hospitals) and legible > 99.9%. Weighing of stillbirths varied by hospital, ranging from 12.5–89.0%. Observed LBW rate was 15.6%; survey-reported rate 14.3% (8.9–20.9%), sensitivity 82.9% (75.1–89.4%), specificity 96.1% (93.5–98.5%); register-recorded rate 14.9%, sensitivity 90.8% (85.9–94.8%), specificity 98.5% (98–99.0%). In surveys, “don’t know” responses for birthweight measured were 4.7%, and 2.9% for knowing the actual weight. 95.9% of observed babies were weighed within 1 h of birth, only 14.7% with a digital scale. Weight heaping indices were around two-fold lower using digital scales compared to analogue. Observed heaping was almost 5% higher for births during the night than day. Survey-report further increased observed birthweight heaping, especially for LBW babies. Enablers to register birthweight measurement in qualitative interviews included digital scale availability and adequate staffing. Conclusions Hospital registers captured birthweight and LBW prevalence more accurately than women’s survey report. Even in large hospitals, digital scales were not always available and stillborn babies not always weighed. Birthweight data are being captured in hospitals and investment is required to further improve data quality, researching of data flow in routine systems and use of data at every level. |
topic |
Birth Newborn Maternal Stillbirth Coverage Validity |
url |
https://doi.org/10.1186/s12884-020-03355-3 |
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doaj-f9322be9f9b6454eb01e29acc411c4672021-03-28T11:16:18ZengBMCBMC Pregnancy and Childbirth1471-23932021-03-0121S111910.1186/s12884-020-03355-3Birthweight: EN-BIRTH multi-country validation studyStefanie Kong0Louise T. Day1Sojib Bin Zaman2Kimberly Peven3Nahya Salim4Avinash K. Sunny5Donat Shamba6Qazi Sadeq-ur Rahman7Ashish K.C.8Harriet Ruysen9Shams El Arifeen10Paul Mee11Miriam E. Gladstone12Hannah Blencowe13Joy E. Lawn14EN-BIRTH Study GroupCentre for Maternal, Adolescent, Reproductive & Child Health (MARCH), London School of Hygiene & Tropical Medicine (LSHTM)Centre for Maternal, Adolescent, Reproductive & Child Health (MARCH), London School of Hygiene & Tropical Medicine (LSHTM)Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)Centre for Maternal, Adolescent, Reproductive & Child Health (MARCH), London School of Hygiene & Tropical Medicine (LSHTM)Department of Paediatrics and Child Health, Muhimbili University of Health and Allied Sciences (MUHAS)Golden CommunityDepartment of Health Systems, Impact Evaluation and Policy, Ifakara Health Institute (IHI)Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)Department of Women’s and Children’s Health, Uppsala UniversityCentre for Maternal, Adolescent, Reproductive & Child Health (MARCH), London School of Hygiene & Tropical Medicine (LSHTM)Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Public Health, London School of Hygiene and Tropical MedicineCentre for Maternal, Adolescent, Reproductive & Child Health (MARCH), London School of Hygiene & Tropical Medicine (LSHTM)Centre for Maternal, Adolescent, Reproductive & Child Health (MARCH), London School of Hygiene & Tropical Medicine (LSHTM)Centre for Maternal, Adolescent, Reproductive & Child Health (MARCH), London School of Hygiene & Tropical Medicine (LSHTM)Abstract Background Accurate birthweight is critical to inform clinical care at the individual level and tracking progress towards national/global targets at the population level. Low birthweight (LBW) < 2500 g affects over 20.5 million newborns annually. However, data are lacking and may be affected by heaping. This paper evaluates birthweight measurement within the Every Newborn Birth Indicators Research Tracking in Hospitals (EN-BIRTH) study. Methods The EN-BIRTH study took place in five hospitals in Bangladesh, Nepal and Tanzania (2017–2018). Clinical observers collected time-stamped data (gold standard) for weighing at birth. We compared accuracy for two data sources: routine hospital registers and women’s report at exit interview survey. We calculated absolute differences and individual-level validation metrics. We analysed birthweight coverage and quality gaps including timing and heaping. Qualitative data explored barriers and enablers for routine register data recording. Results Among 23,471 observed births, 98.8% were weighed. Exit interview survey-reported weighing coverage was 94.3% (90.2–97.3%), sensitivity 95.0% (91.3–97.8%). Register-reported coverage was 96.6% (93.2–98.9%), sensitivity 97.1% (94.3–99%). Routine registers were complete (> 98% for four hospitals) and legible > 99.9%. Weighing of stillbirths varied by hospital, ranging from 12.5–89.0%. Observed LBW rate was 15.6%; survey-reported rate 14.3% (8.9–20.9%), sensitivity 82.9% (75.1–89.4%), specificity 96.1% (93.5–98.5%); register-recorded rate 14.9%, sensitivity 90.8% (85.9–94.8%), specificity 98.5% (98–99.0%). In surveys, “don’t know” responses for birthweight measured were 4.7%, and 2.9% for knowing the actual weight. 95.9% of observed babies were weighed within 1 h of birth, only 14.7% with a digital scale. Weight heaping indices were around two-fold lower using digital scales compared to analogue. Observed heaping was almost 5% higher for births during the night than day. Survey-report further increased observed birthweight heaping, especially for LBW babies. Enablers to register birthweight measurement in qualitative interviews included digital scale availability and adequate staffing. Conclusions Hospital registers captured birthweight and LBW prevalence more accurately than women’s survey report. Even in large hospitals, digital scales were not always available and stillborn babies not always weighed. Birthweight data are being captured in hospitals and investment is required to further improve data quality, researching of data flow in routine systems and use of data at every level.https://doi.org/10.1186/s12884-020-03355-3BirthNewbornMaternalStillbirthCoverageValidity |