Evidence-based interventions to reduce mortality among preterm and low-birthweight neonates in low-income and middle-income countries: a systematic review and meta-analysis
نویسندگان
چکیده
Background Preterm birth is the leading cause of under-five-mortality worldwide, with highest burden in low-income and middle-income countries (LMICs). The aim this study was to synthesise evidence-based interventions for preterm low birthweight (LBW) neonates LMICs, their associated neonatal mortality rate (NMR), barriers facilitators implementation. This updates all existing evidence on topic reviews that have not been previously considered current WHO recommendations. Methods Six electronic databases were searched until 3 March 2020 randomised controlled trials reporting NMR and/or LBW newborns following any intervention LMICs. Risk ratios outcomes pooled where appropriate using a random effects model (PROSPERO registration number: CRD42019139267). Results 1236 studies identified, which 49 narratively synthesised 9 contributed meta-analysis. included 39 21 46 993 participants. High-quality suggested significant reduction antenatal corticosteroids (Pakistan risk ratio (RR) 0.89; 95% CI 0.80 0.99|Guatemala 0.74; 0.68 0.81), single cord (0.65; 0.50 0.86) skin cleansing chlorhexidine (0.72; 0.55 0.95), early BCG vaccine (0.64; 0.48 0.86; I 2 0%), community kangaroo mother care (OR 0.73; 0.97; 0%) home-based newborn (preterm 0.25; 0.14 0.48|LBW 0.42; 0.27 0.65). No perinatal (essential 1.02; 0.91 1.14|neonatal resuscitation 0.95; 0.84 1.07) or 7-day 1.03; 0.83 1.27|neonatal 0.92; 0.77 1.09) observed after training attendants. Conclusion findings encourage implementation additional, (WHO) guidelines be selective usage corticosteroids, reduce among Given global commitment end preventable deaths by 2030, continuous evaluation improvement should priority agenda.
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ژورنال
عنوان ژورنال: BMJ Global Health
سال: 2021
ISSN: ['2059-7908']
DOI: https://doi.org/10.1136/bmjgh-2020-003618