Effective Interventions to Reduce Neonatal Mortality and Morbidity From Perinatal Infection

Bhutta, Zulfiqar A.; Costello, A.; Manandhar, D.

doi:10.1142/9781848160705_0016

Cited by 10 publications

(13 citation statements)

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“…A large proportion of early-onset neonatal infections in developing countries may also be related to vertically transmitted infections from the maternal genital tract. 21,25,419 Thus, there is interest in evaluating lowcost strategies for preventing and reducing infectious Sweden; multicenter trial; RCT Women in the screened group (n ϭ 7617) had 2 screening ultrasound evaluations to assess fetal growth to assess whether screening would encourage smoking cessation.…”

Section: Maternal Vaginal and Newborn Skin Antisepsismentioning

confidence: 99%

“…[573][574][575] However, the benefit and costeffectiveness of such interventions in developingcountry settings, in which survival rates of VLBW infants are low, remain unclear; few VLBW infants survive to develop chronic lung disease. 419 community-based evidence. We identified 3 studies that evaluated the impact of vitamin A supplementation during the neonatal period on neonatal and/or infant outcomes in developing countries in both rural and urban settings (Table 35).…”

Section: Odusanya Et Al 725mentioning

confidence: 99%

“…620 Although hyperbilirubinemia may not be a major direct cause of mortality in developing countries, delayed detection and therapy may predispose infants to bilirubin encephalopathy and kernicterus, 621,622 both of which are common causes of handicaps in developing countries. 419,623 It is not the purpose of this review to discuss the numerous options for management of hyperbilirubinemia but rather to evaluate strategies for its early recognition in community settings. Management of this condition has been reviewed extensively, and interventions such as phototherapy and medical therapy (eg, phenobarbital, exchange transfusion, and management of underlying conditions such as sepsis, hemoglobinopathies, and blood-group incompatibilities) largely pertain to hospital settings.…”

Section: Hyperbilirubinemia Screeningmentioning

confidence: 99%

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Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence

et al. 2005

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ABSTRACT. Background. Infant and under-5 childhood mortality rates in developing countries have declined significantly in the past 2 to 3 decades. However, 2 critical indicators, maternal and newborn mortality, have hardly changed. World leaders at the United Nations Millennium Summit in September 2000 agreed on a critical goal to reduce deaths of children <5 years by two thirds, but this may be unattainable without halving newborn deaths, which now comprise 40% of all under-5 deaths. Greater emphasis on wide-scale implementation of proven, cost-effective measures is required to save women's and newborns' lives. Approximately 99% of neonatal deaths take place in developing countries, mostly in homes and communities. A comprehensive review of the evidence base for impact of interventions on neonatal health and survival in developingcountry communities has not been reported.Objective. This review of community-based antenatal, intrapartum, and postnatal intervention trials in developing countries aimed to identify (1) key behaviors and interventions for which the weight of evidence is sufficient to recommend their inclusion in communitybased neonatal care programs and (2) key gaps in knowledge and priority areas for future research and program learning.Methods. Available published and unpublished data on the impact of community-based strategies and interventions on perinatal and neonatal health status outcomes were reviewed. Evidence was summarized systematically and categorized into 4 levels of evidence based on study size, location, design, and reported impact, particularly on perinatal or neonatal mortality. The evidence was placed in the context of biological plausibility of the intervention; evidence from relevant developed-country studies; health care program experience in implementation; and recommendations from the World Health Organization and other leading agencies.Results. A paucity of community-based data was found from developing-country studies on health status impact for many interventions currently being considered for inclusion in neonatal health programs. However, review of the evidence and consideration of the broader context of knowledge, experience, and recommendations regarding these interventions enabled us to categorize them according to the strength of the evidence base and confidence regarding their inclusion now in programs. This article identifies a package of priority interventions to include in programs and formulates research priorities for advancing the state of the art in neonatal health care.Conclusions. This review emphasizes some new findings while recommending an integrated approach to safe motherhood and newborn health. The results of this study provide a foundation for policies and programs related to maternal and newborn health and emphasizes the importance of health systems research and evaluation of interventions. The review offers compelling support for using research to identify the most effective measures to save newborn lives. It also may facilitate dialogue with policy...

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Section: Maternal Vaginal and Newborn Skin Antisepsismentioning

confidence: 99%

Section: Odusanya Et Al 725mentioning

confidence: 99%

Section: Hyperbilirubinemia Screeningmentioning

confidence: 99%

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Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence

et al. 2005

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“…Cord cutting and tying practices have been identified as risk factors for neonatal infection. 9,10,[19][20][21] and studies suggest low coverage of clean cord care practices among home deliveries in South Asia. [22][23][24] Review studies have noted the lack of cost-effectiveness studies for strategies to improve clean delivery practices, including training of traditional birth attendants.…”

Section: Clean Cord Carementioning

confidence: 99%

Newborn care in rural Uttar Pradesh

et al. 2007

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“…The vast majority of neonatal deaths occur in lowand middle-income countries, and severe infections account for approximately 28% of these deaths. The lack of appropriate hygiene during labor and delivery, postnatal care, and feeding are major contributors to the development of systemic infections and death in vulnerable newborns (3)(4)(5), and neonatal infections remain prevalent despite the use of potent antibacterial agents and supportive care (1,(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

The Clinical Characteristics of Neonatal Sepsis Infection in Southwest China

et al. 2016

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Objective To identify the pathogens responsible for neonatal sepsis in a high-volume women and children's hospital in Southwest China. Methods We retrospectively studied 133 neonates who were admitted to the West China Women and Children's Hospital between 2008 and 2012 for sepsis. The clinical characteristics of the patients were recorded, and the antibiotic sensitivities of the isolated bacteria were determined. Results All of the included patients had clinical symptoms of sepsis, and subsequent blood cultures confirmed the infection. Almost 80% of patients were infected with coagulase-negative staphylococci (52.8%), Escherichia coli (23.6%), Klebsiella pneumoniae (16.0%) or Staphylococcus aureus (7.5%). Neonates who were infected with gram-negative bacteria, particularly K. pneumoniae, had lower birth weights and were admitted to hospital within 24 hours of birth. Additionally, 87.5% of the isolated K. pneumoniae strains were resistant to third generation cephalosporins. Conclusion Coagulase-negative staphylococci were the most common pathogens found in neonatal sepsis. Moreover, neonatal sepsis caused by gram-negative bacteria was more often observed in newborns of low birth weight. The isolated strains of gram-negative bacteria were highly resistant to cephalosporins. This observation highlights the issue of antibiotic-resistant pathogens in the clinical setting, which poses an added risk to infants presenting with sepsis.

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Effective Interventions to Reduce Neonatal Mortality and Morbidity From Perinatal Infection

Cited by 10 publications

References 0 publications

Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence

Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence

Newborn care in rural Uttar Pradesh

The Clinical Characteristics of Neonatal Sepsis Infection in Southwest China

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