Abstract:
BACKGROUND:Neonatal deaths in first 28-days of life represent 47% of all deaths under the age of five years globally and are a focus of the United Nation's (UN's) Sustainable Development Goals. Pregnant women are delivering in facilities but that does not indicate quality of care during delivery and the postpartum period. The World Health Organization's Essential Newborn Care (ENC) package reduces neonatal mortality, but lacks a simple and valid composite index that measures its effectiveness. METHODS:Data on 5 intra-partum and 3 post-partum practices (indicators) recommended as part of ENC, routinely collected in NICHD's Global Network's (GN) Maternal Newborn Health Registry (MNHR) between 2010 and 2013, were included. We evaluated if all 8 practices (Care around Delivery - CAD), combined as an index was associated with reduced early neonatal mortality rates (days 0-6 of life). RESULTS:A total of 150,848 live births were included in the analysis. The individual indicators varied across sites. All components were present in 19.9% births (range 0.4 to 31% across sites). Present indicators (8 components) were associated with reduced early neonatal mortality [adjusted RR (95% CI):0.81 (0.77, 0.85); p < 0.0001]. Despite an overall association between CAD and early neonatal mortality (RR < 1.0 for all early mortality): delivery by skilled birth attendant; presence of fetal heart and delayed bathing were associated with increased early neonatal mortality. CONCLUSIONS:Present indicators (8 practices) of CAD were associated with a 19% reduction in the risk of neonatal death in the diverse health facilities where delivery occurred within the GN MNHR. These indicators could be monitored to identify facilities that need to improve compliance with ENC practices to reduce preventable neonatal deaths. Three of the 8 indicators were associated with increased neonatal mortality, due to baby being sick at birth. Although promising, this composite index needs refinement before use to monitor facility-based quality of care in association with early neonatal mortality. Trial registration The identifier of the Maternal Newborn Health Registry at ClinicalTrials.gov is NCT01073475.
journal_name
Reprod Healthjournal_title
Reproductive healthauthors
Patel AB,Simmons EM,Rao SR,Moore J,Nolen TL,Goldenberg RL,Goudar SS,Somannavar MS,Esamai F,Nyongesa P,Garces AL,Chomba E,Mwenechanya M,Saleem S,Naqvi F,Bauserman M,Bucher S,Krebs NF,Derman RJ,Carlo WA,Koso-ThomasMdoi
10.1186/s12978-020-01010-wsubject
Has Abstractpub_date
2020-11-30 00:00:00pages
156issue
Suppl 2issn
1742-4755pii
10.1186/s12978-020-01010-wjournal_volume
17pub_type
杂志文章abstract::Surrogacy involves one woman (surrogate mother) carrying a child for another person/s (commissioning person/couple), based on a mutual agreement requiring the child to be handed over to the commissioning person/couple following birth. Reasons for seeking surrogacy include situations where a woman has non-functional or...
journal_title:Reproductive health
pub_type: 社论
doi:10.1186/1742-4755-5-9
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journal_title:Reproductive health
pub_type: 杂志文章
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journal_title:Reproductive health
pub_type: 杂志文章,评审
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更新日期:2017-03-11 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2017-05-18 00:00:00
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journal_title:Reproductive health
pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1186/s12978-020-00966-z
更新日期:2020-08-03 00:00:00
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journal_title:Reproductive health
pub_type: 杂志文章,评审
doi:10.1186/1742-4755-9-34
更新日期:2012-12-22 00:00:00
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pub_type: 杂志文章
doi:10.1186/s12978-017-0309-2
更新日期:2017-04-05 00:00:00
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journal_title:Reproductive health
pub_type: 杂志文章
doi:10.1186/s12978-018-0477-8
更新日期:2018-03-13 00:00:00
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pub_type: 杂志文章
doi:10.1186/s12978-018-0645-x
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pub_type: 杂志文章
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章
doi:10.1186/s12978-016-0166-4
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更新日期:2011-10-12 00:00:00
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pub_type: 杂志文章
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journal_title:Reproductive health
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journal_title:Reproductive health
pub_type: 杂志文章
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更新日期:2005-10-21 00:00:00
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pub_type: 杂志文章
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