Small vulnerable newborns—big potential for impact

UNICEF–WHO Low Birthweight Estimates Group, Per Ashorn, Ulla Ashorn, Yvonne Muthiani, Samira Aboubaker, Sufia Askari, Rajiv Bahl, Robert E. Black, Nita Dalmiya, Christopher P. Duggan, G. Justus Hofmeyr, Stephen H. Kennedy, Nigel Klein, Joy E. Lawn, Jeremy Shiffman, Jonathon Simon, Marleen Temmerman

Research output: Contribution to journalReview Articlepeer-review

36 Citations (Scopus)
11 Downloads (Pure)


Despite major achievements in child survival, the burden of neonatal mortality has remained high and even increased in some countries since 1990. Currently, most neonatal deaths are attributable to being born preterm, small for gestational age (SGA), or with low birthweight (LBW). Besides neonatal mortality, these conditions are associated with stillbirth and multiple morbidities, with short-term and long-term adverse consequences for the newborn, their families, and society, resulting in a major loss of human capital. Prevention of preterm birth, SGA, and LBW is thus critical for global child health and broader societal development. Progress has, however, been slow, largely because of the global community's failure to agree on the definition and magnitude of newborn vulnerability and best ways to address it, to frame the problem attractively, and to build a broad coalition of actors and a suitable governance structure to implement a change. We propose a new definition and a conceptual framework, bringing preterm birth, SGA, and LBW together under a broader umbrella term of the small vulnerable newborn (SVN). Adoption of the framework and the unified definition can facilitate improved problem definition and improved programming for SVN prevention. Interventions aiming at SVN prevention would result in a healthier start for live-born infants, while also reducing the number of stillbirths, improving maternal health, and contributing to a positive economic and social development in the society.

Original languageEnglish
Pages (from-to)1692-1706
Number of pages15
JournalThe Lancet
Issue number10389
Publication statusPublished - 20 May 2023
Publication typeA2 Review article in a scientific journal

Publication forum classification

  • Publication forum level 3

ASJC Scopus subject areas

  • General Medicine


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