Navigation Links
UAB-led study shows simple steps could reduce stillbirths by up to 1 million
Date:2/18/2010

BIRMINGHAM, Ala - New findings in a study led by the director of the University of Alabama at Birmingham (UAB) Division of Neonatology show that that training birth attendants in essential newborn-care techniques reduced stillbirths by more than 30 percent - and potentially could save as many as 1 million lives worldwide each year.

Ninety-eight percent of the 3.7 million neonatal deaths and 3.3 million stillbirths each year occur in developing countries. This project, spearheaded by UAB's Waldemar A. Carlo, M.D., was designed to train birth attendants, including doctors, midwives, nurses and traditional birth attendants, in communities and hospitals in 96 communities worldwide. The findings were published in the Feb. 18 edition of the New England Journal of Medicine.

"The birth attendants were trained to do several easy steps that are critical for babies to survive at birth and be kept alive through the first week of life," said Carlo, the lead author who worked with a large group of American and international colleagues. "We selected the World Health Organization course on essential newborn care because it contains what we believed are the essential interventions necessary to sustain life in many infants and created an educational package that included interventions that could be used by any birth attendant anywhere in the world."

Using the train-the-trainer model, local instructors trained birth attendants from rural communities in Argentina, Democratic Republic of Congo, Guatemala, India, Pakistan and Zambia. They used the World Health Organization (WHO) newborn-care course (routine neonatal care, resuscitation, thermoregulation, breastfeeding, kangaroo care, care of the small baby and common illnesses) and a modified version of the American Academy of Pediatrics Neonatal Resuscitation Program (in-depth basic resuscitation).

The goal was to see if training birth attendants to use these interventions would reduce perinatal and neonatal mortality in the first week of life in infants weighing at least 1500 grams in rural communities in developing countries.

"Major global causes of perinatal mortality are birth asphyxia and low birth weight/prematurity," Carlo said. "We wanted to find out if these low-cost interventions, including neonatal resuscitation training and kangaroo care, effectively reduced deaths from these causes worldwide. A preliminary smaller study in Zambia has shown that improved skill and knowledge in birth attendants in perinatal care reduced neonatal mortality."

Kangaroo care is a technique used on a newborn, usually a preterm infant, wherein the infant is held, skin-to-skin, with an adult. It is used to provide closeness of the newborn with mother and/or father to ensure physiological and psychological warmth and bonding. The kangaroo position also provides ready access to nourishment. The mother's body responds to the needs of the infant directly, helping regulate the infant's body temperature more smoothly than an incubator; her milk adjusts to the nutritional and immunological needs of her fragile infant, and the baby sleeps more soundly.

The train-the-trainer program used various teaching methods, including clinical practice sessions and demonstrations for the trainers. Carlo and his colleagues also developed instructions on the essential techniques with visual cues to assist birth attendants who could not read. The essential newborn-care intervention was assessed with a before-and-after design. The neonatal resuscitation program intervention was assessed as a cluster randomized control trial.

The stillbirth rate decreased significantly for nurses/midwives and traditional birth attendants following essential newborn care training. The stillbirth rate also decreased among home deliveries. There was not a significant decrease in all-cause first week mortality or stillbirth for those using the in-depth neonatal resuscitation program.

Carlo said it is plausible that the observed reduction in stillbirths may be due to essential newborn-care training. Live-born infants without obvious signs of life may have been misidentified as stillbirths before this training; such misclassifications have been reported in the literature. After training, resuscitation was more likely, and stillbirths decreased.

Carlo added that though the data show that training in basic neonatal care has an important role in improving perinatal outcomes in the developing world, more scaled-up research is needed to prove that the training reduces mortality in other health-care systems.

"A package of essential newborn-care interventions, if implemented worldwide, might decrease perinatal deaths by about 1 million per year," he said.


'/>"/>

Contact: Jennifer Lollar
jpark@uab.edu
205-934-3888
University of Alabama at Birmingham
Source:Eurekalert

Related medicine news :

1. Untreated poor vision in elderly linked to dementia, University of Michigan study shows
2. Study supports alternative anti-seizure medication following acute brain injury
3. Scripps Health Begins Pioneering Study of Human Tumor Sequencing in Cancer Patients
4. Study reveals genetic link between mammographic density and breast cancer
5. Cancer publishes study confirming disparity in breast cancer treatment
6. New study suggests stem cells sabotage their own DNA to produce new tissues
7. Another Study Refutes Vaccination-Autism Link
8. Chocolate lovers could be lowering their risk of stroke: Study
9. Allegheny General Hospital Study Demonstrates Safety and Potential Efficacy of Oral Allergy Treatment
10. Protecting patients: Study shows that Johns Hopkins flu vaccination rates twice national average
11. New Study Uses Adult Stem Cells in Effort to Save Limbs of Patients with Peripheral Arterial Disease
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/4/2016)... ... May 04, 2016 , ... The Lymphoma ... innovative lymphoma research and serving the lymphoma community through a comprehensive series of ... the esteemed Quaker Ridge Golf Club in Scarsdale, New York on May 23, ...
(Date:5/4/2016)... ... May 04, 2016 , ... The Spiritual Care ... recognize chaplains for their valuable support to patients and their families, and their overall ... , To mark Spiritual Care Day, SCA has sent “Thank You Chaplain” cards with ...
(Date:5/4/2016)... ... , ... Hight-Doland Insurance Agency’s new community involvement program which serves families of ... of Southwest Louisiana to help provide positive mentoring for local youth. Donations to this ... of Southwest Louisiana has been helping to guide the area’s youth for over 30 ...
(Date:5/4/2016)... Island (PRWEB) , ... May 04, 2016 , ... ... in April 2016. SS&A teamed up with one of the top website design ... information portal contains informative legal articles related to the law firm's main practice ...
(Date:5/4/2016)... ... May 04, 2016 , ... Recognizing that lifestyle medicine is essential ... Verywell, have tapped David Katz, MD, MPH, president of the American College of ... to lifestyle medicine is especially gratifying,” said Katz. “There is so much opportunity to ...
Breaking Medicine News(10 mins):
(Date:5/4/2016)... DUBLIN , May 4, 2016 /PRNewswire/ ... the addition of the  "Global Multiple Myeloma ...  report to their offering.       ... Multiple Myeloma Market and Competitive Landscape Highlights ... pipeline products, Multiple Myeloma epidemiology, Multiple Myeloma ...
(Date:5/4/2016)... Research and Markets has ... Keratosis Market and Competitive Landscape Highlights - ...      (Logo: http://photos.prnewswire.com/prnh/20160330/349511LOGO ) , ... Highlights 2016, provides comprehensive insights into Actinic ... Keratosis market valuations and forecast, Actinic Keratosis ...
(Date:5/3/2016)... May 3, 2016 BioNovus Innovations LLC ... for Advancing Medical Innovation (IAMI) today announced a ... diagnostics and medical devices. An agreement ... rights to license, develop and commercialize medical innovations ... "This partnership represents a significant advance in ...
Breaking Medicine Technology: