Jennifer Harris Requejo

Bio: Jennifer Harris Requejo is an academic researcher from Johns Hopkins University. The author has contributed to research in topics: Population & Child mortality. The author has an hindex of 28, co-authored 55 publications receiving 5466 citations. Previous affiliations of Jennifer Harris Requejo include World Health Organization.

The Worldwide Incidence of Preterm Birth: A Systematic Review of Maternal Mortality and morbidity/Incidence Mondiale De la Missance Avant Terme: Revue Sytemtique De la Mortalite et De la Morbidite maternelle/Incidencia Mundial De Parto Prematuro: Revision Sistematica De la Morbilidad Y Mortalidad Maternas

Abstract: Introduction Preterm birth, defined as childbirth occurring at less than 37 completed weeks or 259 days of gestation, is a major determinant of neonatal mortality and morbidity and has long-term adverse consequences for health. (1-3) Children who are born prematurely have higher rates of cerebral palsy, sensory deficits, learning disabilities and respiratory illnesses compared with children born at term. The morbidity associated with preterm birth often extends to later life, resulting in enormous physical, psychological and economic costs. (4,5) Estimates indicate that in 2005 the costs to the United States of America alone in terms of medical and educational expenditure and lost productivity associated with preterm birth were more than USS 26.2 billion. (6) Of all early neonatal deaths (deaths within the first 7 days of life) that are not related to congenital malformations, 28% are due to preterm birth. (7) Preterm birth rates have been reported to range from 5% to 7% of live births in some developed countries, but are estimated to be substantially higher in developing countries. (8) These figures appear to be on the rise. (9) Events leading to preterm birth are still not completely understood, although the etiology is thought to be multifactorial. It is, however, unclear whether preterm birth results from the interaction of several pathways or the independent effect of each pathway. Causal factors linked to preterm birth include medical conditions of the mother or fetus, genetic influences, environmental exposure, infertility treatments, behavioural and socioeconomic factors and iatrogenic prematurity. (9) Approximately 45-50% of preterm births are idiopathic, 30% are related to preterm rupture of membranes (PROM) and another 15-20% are attributed to medically indicated or elective preterm deliveries. (10,11) Estimation of preterm birth rates and, ideally, their proper categorization (e.g. spontaneous versus indicated) are essential for accurate determination of global incidence in order to inform policy and programmes on interventions to reduce the risk of premature labour and delivery. No data have been published on the global incidence of preterm birth. Preterm birth rates available from some developed countries, such as the United Kingdom, the United States and the Scandinavian countries, show a dramatic rise over the past 20 years. (6,12) Factors possibly contributing to but not completely explaining this upward trend include increasing rates of multiple births, greater use of assisted reproduction techniques, increases in the proportion of births among women over 34 years of age and changes in clinical practices, such as greater use of elective Caesarean section. For example, the increasing use of ultrasonography rather than the date of the last menstrual period to estimate gestational age may have resulted in larger numbers of births being classified as preterm. Changes in the definitions of fetal loss, stillbirth and early neonatal death may also have contributed to the substantial increases in preterm birth rates recorded in developed countries in the past two decades. (13,14) In developing countries, accurate and complete population data and medical records usually do not exist. Furthermore, estimates of the rate of preterm birth in developing countries are influenced by a range of factors including varying procedures used to determine gestational age, national differences in birth registration processes, heterogeneous definitions used for preterm birth, differences in perceptions of the viability of preterm infants and variations in religious practices such as local burial customs, which can discourage the registering of preterm births. (15) These issues make measurement of preterm birth and comparisons across and between developing countries difficult. The World Health Organization (WHO) conducted a systematic review of the worldwide incidence/prevalence of maternal mortality and morbidity in the period 1997-2002 to contribute to the knowledge base in this area. …

Countdown to 2015: A decade of tracking progress for maternal newborn and child survival. The 2015 Report.

Abstract: This report includes an updated country profile for each of the 75 Countdown countries which together account for more than 95% of the world’s maternal newborn and child deaths. This final Countdown to 2015 report begins with a summary of results from 2015 based on the data presented in those country profiles and builds on a companion article that was published simultaneously in The Lancet. It examines trends in mortality and nutrition; intervention coverage (including inequality); financial flows to reproductive maternal newborn and child health; and supportive policy and systems measures. The report then assesses changes in data availability and their implications for program managers and decision makers. It concludes by turning a critical lens on the Sustainable Development Goals framework and future accountability efforts drawing from Countdown’s 10 years of monitoring experience. The report shows that although some health issues and some countries have seen considerable progress important gaps remain that must not be forgotten in the transition to the Sustainable Development Goals.