employed, it should be possible even in resource-limited settings to shift the risk curve for those babies who will be born early, small, or both, despite best efforts. Before birth, this includes potentially antenatal steroid administration to promote lung development;49 at birth, this requires presence of adequately trained and equipped neonatal resuscitation services;50, 51 post-delivery, it should include physicians with neonatal specialisation and availability of supportive equipment such as continuous positive airway pressure.52 Facility-based infection control measures are crucial to prevent nosocomial transmission, as such events are highly lethal in low birthweight or short gestation neonates.53 The inclusion of this risk for a major cause of DALYs—namely, neonatal mortality—also expands the share of overall burden that can be attributed to risks in general. More work remains, however, to understand the relationship between low birthweight and short gestation and childhood growth failure after 1 month. Our analysis to date may actually underestimate the importance of this risk if the share of childhood growth failure that can be traced to low birthweight and gestational age is fully established.
