Nutritional Supplementation and the Outcome of Pregnancy. III. Perinatal and Neonatal Mortality

Mora, José O.; Clément, Jean‐Pierre; Christiansen, N; Suescun, J; Wagner, M; Herrera, M G

doi:10.1097/00006254-197906000-00005

Cited by 15 publications

(53 citation statements)

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“…Although a trend toward increased weight gain of the supplemented mothers was observed in 2 studies, the differences were nonsignificant. 105,114 Moreover, other studies showed no impact on maternal weight gain. 116,117 In the few studies that examined effects on the stillbirth 104,105 and perinatal mortality 104,105,118 rates, reductions were seen.…”

Section: Tontisirin Et Al 110mentioning

confidence: 99%

“…105,114 Moreover, other studies showed no impact on maternal weight gain. 116,117 In the few studies that examined effects on the stillbirth 104,105 and perinatal mortality 104,105,118 rates, reductions were seen. The largest of these studies 104 was undertaken in The Gambia, where, in an RCT, chronically undernourished pregnant women were provided a higher-energy supplement (3780 kJ), largely toward the last trimester, with little micronutrient content.…”

Section: Tontisirin Et Al 110mentioning

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: Tontisirin Et Al 110mentioning

confidence: 99%

Section: Tontisirin Et Al 110mentioning

confidence: 99%

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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“…Although several developed country trials of protein supplementation have not shown a reduction in stillbirth, trials in The Gambia and Columbia both showed significant reductions in stillbirth rates [72,73]. While anemia has been associated with stillbirth, trials of iron supplementation have also not shown reductions in stillbirth [34].…”

Section: Reducing Stillbirthsmentioning

confidence: 99%

Stillbirth in developing countries

McClure

Nalubamba-Phiri

Goldenberg

2006

Intl J Gynecology & Obste

146

151

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“…Introduction of various nutritional strategies specifically aimed at reducing a common cause of stillbirth, preeclampsia, including caloric and protein supplementation, vitamin/mineral supplementation, antioxidants, and probably calcium, have generally been ineffective. (57–59) Few nutritional supplementation trials have specifically evaluated stillbirths; however, several caloric supplementation trials in very low-resource settings have significantly improved pregnancy outcomes. (60,61) Thus, while malnutrition is a recognized factor for adverse pregnancy outcomes, further research is needed to identify effective interventions in these settings.…”

Section: Strategies To Reduce Stillbirthmentioning

confidence: 99%

Stillbirth in developing countries: a review of causes, risk factors and prevention strategies

McClure

Saleem

Pasha

et al. 2009

The Journal of Maternal-Fetal & Neonatal Medicine

200

190

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In reviewing the research on stillbirth in developing countries, it becomes clear that because almost half of the deliveries in these settings occur at home, under-reporting of stillbirths is a significant problem, and reliable data about rates and causes are unavailable in some areas of the world. Nevertheless, of the estimated 3 million stillbirths which occur yearly, the vast majority in developing countries, with rates in many developing countries ten-fold higher than elsewhere. Classification systems have been adapted for developing countries; however, there is not a standard international system, nor is there agreement about stillbirth definitions making comparisons of cause of stillbirth over time or between sites problematic. From available data, prolonged and obstructed labor, and various infections all without adequate treatment, appear to account for the majority of stillbirths in developing countries. Strategies that have effectively reduced stillbirth in developed countries have had mixed results in developing countries or have not yet been tested; however, identification and treatment of infections such as syphilis has been shown effective in reducing stillbirth risk, while strategies to improve obstetric care have not been widely evaluated. Despite the large number of stillbirths worldwide, the topic of stillbirths in developing countries has received very little research, programmatic or policy attention. Better access to appropriate obstetric care, especially during labor, should reduce developing country stillbirth rates dramatically.

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Nutritional Supplementation and the Outcome of Pregnancy. III. Perinatal and Neonatal Mortality

Cited by 15 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

Stillbirth in developing countries

Stillbirth in developing countries: a review of causes, risk factors and prevention strategies

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