Article type
Abstract
Introduction: Near-term and intrapartum care play pivotal roles in ensuring a safe and healthy childbirth experience and are essential components of a comprehensive approach to maternal and neonatal health.
Methods: With a focus on low- and lower-middle-income countries (LMICs), this publication is a part of a supplement that builds on to the evidence described in the Every Newborn 2014 series. The following intervention topics were identified: antibiotics for premature rupture of membrane, antenatal corticosteroids for fetal lung maturation, partogram use during labor and delivery, induction of labor at or post term, skilled birth care and safe childbirth checklist during labor and delivery. A scoping exercise was conducted to ascertain the most up-to-date evidence, and reviews of topics of interest were updated in case the evidence was not recent.
Results: Antibiotics reduced the overall risk of neonatal infection including pneumonia [RR 0.67 (95%CI 0.52 to 0.85)]. LMIC-specific evidence shows a significant effect of antenatal steroids on the risk of neonatal mortality [RR 0.64 (95%CI 0.43 to 0.97)] and respiratory distress syndrome [RR 0.65 (95%CI 0.44 to 0.96)].
Induction of labor practices at term or post-term reduces the risk of meconium aspiration syndrome [RR 0.51 (95%CI 0.34 to 0.76)]. The use of the WHO childbirth checklist significantly raised the standard of pre-eclampsia care [OR 8.09 (95%CI 2.55 to 25.63)] as well as of maternal infection management [OR 25.44 (95%CI 4.09 to 158.08)]. LMIC-specific evidence also demonstrates a significant reduction in the risk of stillbirth [OR 0.92 (95%CI 0.87 to 0.96)].
Conclusion: Research initiatives can contribute to a more inclusive understanding of health challenges and when combined with capacity building, can facilitate the implementation of effective health strategies that benefit the more vulnerable populations.
Methods: With a focus on low- and lower-middle-income countries (LMICs), this publication is a part of a supplement that builds on to the evidence described in the Every Newborn 2014 series. The following intervention topics were identified: antibiotics for premature rupture of membrane, antenatal corticosteroids for fetal lung maturation, partogram use during labor and delivery, induction of labor at or post term, skilled birth care and safe childbirth checklist during labor and delivery. A scoping exercise was conducted to ascertain the most up-to-date evidence, and reviews of topics of interest were updated in case the evidence was not recent.
Results: Antibiotics reduced the overall risk of neonatal infection including pneumonia [RR 0.67 (95%CI 0.52 to 0.85)]. LMIC-specific evidence shows a significant effect of antenatal steroids on the risk of neonatal mortality [RR 0.64 (95%CI 0.43 to 0.97)] and respiratory distress syndrome [RR 0.65 (95%CI 0.44 to 0.96)].
Induction of labor practices at term or post-term reduces the risk of meconium aspiration syndrome [RR 0.51 (95%CI 0.34 to 0.76)]. The use of the WHO childbirth checklist significantly raised the standard of pre-eclampsia care [OR 8.09 (95%CI 2.55 to 25.63)] as well as of maternal infection management [OR 25.44 (95%CI 4.09 to 158.08)]. LMIC-specific evidence also demonstrates a significant reduction in the risk of stillbirth [OR 0.92 (95%CI 0.87 to 0.96)].
Conclusion: Research initiatives can contribute to a more inclusive understanding of health challenges and when combined with capacity building, can facilitate the implementation of effective health strategies that benefit the more vulnerable populations.