Mortality and Morbidity Patterns of Very Low Birth Weight Newborns in Eastern Mediterranean Region: A Meta-Analysis Study

Context: Preterm and low-birth weight are of the most common causes of mortality and critical disabilities in newborns. Although advances in neonatal care improved survival and quality of life in the developed countries, mortality and morbidity due to prematurity are still high in the developing and underdeveloped countries such countries in Eastern Mediterranean Region (EMR). The study aimed at evaluating mortality and morbidity among Very Low Birth Weight (VLBW) and Very Preterm (VP) neonates in EMR. Data Sources: A systematic search was conducted in CINAHL, Cochrane Library, Current Contents, Database of Abstracts of Reviews of Effects (DARE), Google Scholar, PubMed, PsycINFO, Thomson Reuters, Scientific Information Database (SID), and Medical Library (MedLib) as well as regional WHO database to detect relevant studies published from 1996 to 2016. Study Selection: English Language Literature From EMR countries, which reporting outcomes of VLBW and VP were considered. Finally, 32 full text articles were included.
Data Extraction: Data on VLBW and VP outcomes including mortality, and short- and long-term morbidities were extracted. Meta-analysis results of prevalence of mortality among VLBW newborns was obtained as 32.0%, which was different from Asian and African countries (23% vs. 55%). Pooled odds ratio of mortality among VLBW newborns was estimated as 2.41. The most prevalent comorbidity in VLBW and VP newborns were allocated to septicemia and Neurodevelopmental Delay (NDD), and the rarest belonged to Periventricular Leukomalacia (PVL) and Necrotizing Enterocolitis (NEC). The main limitation of the current study was lack of relevant studies and adequate sample size. It seems that indicators in EMR should be evaluated independently in Asian and African countries. Septicemia, as relatively curable cause of morbidity, is the most prevalent comorbidity among VLBW infants.