Journal article
The effect of providing skilled birth attendance and emergency obstetric care in preventing stillbirths
BMC public health, Vol.11(3), pp.S7-S7
04/13/2011
DOI: 10.1186/1471-2458-11-S3-S7
PMCID: PMC3231913
PMID: 21501458
Abstract
Background: Of the global burden of 2.6 million stillbirths, around 1.2 million occur during labour i.e. are intrapartum deaths. In low-/middle-income countries, a significant proportion of women give birth at home, usually in the absence of a skilled birth attendant. This review discusses the impact of skilled birth attendance (SBA) and the provision of Emergency Obstetric Care (EOC) on stillbirths and perinatal mortality.
Methods: A systematic literature search was performed on PubMed/MEDLINE, Cochrane Database and the WHO regional libraries. Data of all eligible studies were extracted into a standardized Excel sheet containing variables such as participants' characteristics, sample size, location, setting, blinding, allocation concealment, intervention and control details and limitations. We undertook a meta-analysis of the impact of SBA on stillbirths. Given the paucity of data from randomized trials or robust quasi-experimental designs, we undertook an expert Delphi consultation to determine impact estimates of provision of Basic and Comprehensive EOC on reducing stillbirths if there would be universal coverage (99%).
Results: The literature search yielded 871 hits. A total of 21 studies were selected for data abstraction. Our meta-analysis on community-based skilled birth attendance based on two before-after studies showed a 23% significant reduction in stillbirths (RR = 0.77; 95% CI: 0.69 - 0.85). The overall quality grade of available evidence for this intervention on stillbirths was 'moderate'. The Delphi process supported the estimated reduction in stillbirths by skilled attendance and experts further suggested that the provision of Basic EOC had the potential to avert intrapartum stillbirths by 45% and with provision of Comprehensive EOC this could be reduced by 75%. These estimates are conservative, consistent with historical trends in maternal and perinatal mortality from both developed and developing countries, and are recommended for inclusion in the Lives Saved Tool (LiST) model.
Conclusions: Both Skilled Birth Attendance and Emergency/or Essential Obstetric Care have the potential to reduce the number of stillbirths seen globally. Further evidence is needed to be able to calculate an effect size.
Details
- Title: Subtitle
- The effect of providing skilled birth attendance and emergency obstetric care in preventing stillbirths
- Creators
- Mohammad Yawar Yakoob - Aga Khan UniversityMahrukh Ayesha Ali - Aga Khan UniversityMohammad Usman Ali - Aga Khan UniversityAamer Imdad - Aga Khan UniversityJoy E. Lawn - Saving Newborn Lives Save Children US, Cape Town, South AfricaNynke Van Den Broek - Liverpool School of Tropical MedicineZulfiqar A. Bhutta - Aga Khan University
- Resource Type
- Journal article
- Publication Details
- BMC public health, Vol.11(3), pp.S7-S7
- DOI
- 10.1186/1471-2458-11-S3-S7
- PMID
- 21501458
- PMCID
- PMC3231913
- NLM abbreviation
- BMC Public Health
- ISSN
- 1471-2458
- eISSN
- 1471-2458
- Publisher
- Springer Nature
- Number of pages
- 8
- Grant note
- 43386 / Bill & Melinda Gates Foundation; CGIAR
- Language
- English
- Date published
- 04/13/2011
- Academic Unit
- Stead Family Department of Pediatrics; Gastroenterology, Hepatology, Pancreatology, and Nutrition
- Record Identifier
- 9984446442902771
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