High mortality rates for very low birth weight infants in developing countries despite training

Waldemar A. Carlo, Shivaprasad S. Goudar, Imtiaz Jehan, Elwyn Chomba, Antoinette Tshefu, Ana Garces, Sailajanandan Parida, Fernando Althabe, Elizabeth M. McClure, Richard J. Derman, Robert L. Goldenberg, Carl Bose, Michael Hambidge, Pinaki Panigrahi, Pierre Buekens, Hrishikesh Chakraborty, Tyler D. Hartwell, Janet Moore, Linda L. Wright

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

OBJECTIVE: The goal was to determine the effect of training in newborn care and resuscitation on 7-day (early) neonatal mortality rates for very low birth weight (VLBW) infants. The study was designed to test the hypothesis that these training programs would reduce neonatal mortality rates for VLBW infants. METHODS: Local instructors trained birth attendants from 96 rural communities in 6 developing countries in protocol and data collection, the World Health Organization Essential Newborn Care (ENC) course, and a modified version of the American Academy of Pediatrics Neonatal Resuscitation Program (NRP), by using a train-the-trainer model. To test the impact of ENC training, data on infants of 500 to 1499 g were collected by using a before/after, active baseline, controlled study design. A cluster-randomized, controlled trial design was used to test the impact of the NRP. RESULTS: A total of 1096 VLBW (500-1499 g) infants were enrolled, and 98.5% of live-born infants were monitored to 7 days. All-cause, 7-day neonatal mortality, stillbirth, and perinatal mortality rates were not affected by ENC or NRP training. CONCLUSIONS: Neither ENC nor NRP training of birth attendants decreased 7-day neonatal, stillbirth, or perinatal mortality rates for VLBW infants born at home or at first-level facilities. Encouragement of delivery in a facility where a higher level of care is available may be preferable when delivery of a VLBW infant is expected.

Original languageEnglish (US)
JournalPediatrics
Volume126
Issue number5
DOIs
StatePublished - Nov 1 2010

Fingerprint

Very Low Birth Weight Infant
Resuscitation
Developing Countries
Infant Mortality
Newborn Infant
Mortality
Stillbirth
Perinatal Mortality
Education
Parturition
Rural Population
Randomized Controlled Trials
Pediatrics

Keywords

  • Developing countries
  • Health care systems
  • Neonatal mortality
  • Perinatal mortality
  • Prematurity
  • Stillbirth
  • Very low birth weight

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Carlo, W. A., Goudar, S. S., Jehan, I., Chomba, E., Tshefu, A., Garces, A., ... Wright, L. L. (2010). High mortality rates for very low birth weight infants in developing countries despite training. Pediatrics, 126(5). https://doi.org/10.1542/peds.2010-1183

High mortality rates for very low birth weight infants in developing countries despite training. / Carlo, Waldemar A.; Goudar, Shivaprasad S.; Jehan, Imtiaz; Chomba, Elwyn; Tshefu, Antoinette; Garces, Ana; Parida, Sailajanandan; Althabe, Fernando; McClure, Elizabeth M.; Derman, Richard J.; Goldenberg, Robert L.; Bose, Carl; Hambidge, Michael; Panigrahi, Pinaki; Buekens, Pierre; Chakraborty, Hrishikesh; Hartwell, Tyler D.; Moore, Janet; Wright, Linda L.

In: Pediatrics, Vol. 126, No. 5, 01.11.2010.

Research output: Contribution to journalArticle

Carlo, WA, Goudar, SS, Jehan, I, Chomba, E, Tshefu, A, Garces, A, Parida, S, Althabe, F, McClure, EM, Derman, RJ, Goldenberg, RL, Bose, C, Hambidge, M, Panigrahi, P, Buekens, P, Chakraborty, H, Hartwell, TD, Moore, J & Wright, LL 2010, 'High mortality rates for very low birth weight infants in developing countries despite training', Pediatrics, vol. 126, no. 5. https://doi.org/10.1542/peds.2010-1183
Carlo, Waldemar A. ; Goudar, Shivaprasad S. ; Jehan, Imtiaz ; Chomba, Elwyn ; Tshefu, Antoinette ; Garces, Ana ; Parida, Sailajanandan ; Althabe, Fernando ; McClure, Elizabeth M. ; Derman, Richard J. ; Goldenberg, Robert L. ; Bose, Carl ; Hambidge, Michael ; Panigrahi, Pinaki ; Buekens, Pierre ; Chakraborty, Hrishikesh ; Hartwell, Tyler D. ; Moore, Janet ; Wright, Linda L. / High mortality rates for very low birth weight infants in developing countries despite training. In: Pediatrics. 2010 ; Vol. 126, No. 5.
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abstract = "OBJECTIVE: The goal was to determine the effect of training in newborn care and resuscitation on 7-day (early) neonatal mortality rates for very low birth weight (VLBW) infants. The study was designed to test the hypothesis that these training programs would reduce neonatal mortality rates for VLBW infants. METHODS: Local instructors trained birth attendants from 96 rural communities in 6 developing countries in protocol and data collection, the World Health Organization Essential Newborn Care (ENC) course, and a modified version of the American Academy of Pediatrics Neonatal Resuscitation Program (NRP), by using a train-the-trainer model. To test the impact of ENC training, data on infants of 500 to 1499 g were collected by using a before/after, active baseline, controlled study design. A cluster-randomized, controlled trial design was used to test the impact of the NRP. RESULTS: A total of 1096 VLBW (500-1499 g) infants were enrolled, and 98.5{\%} of live-born infants were monitored to 7 days. All-cause, 7-day neonatal mortality, stillbirth, and perinatal mortality rates were not affected by ENC or NRP training. CONCLUSIONS: Neither ENC nor NRP training of birth attendants decreased 7-day neonatal, stillbirth, or perinatal mortality rates for VLBW infants born at home or at first-level facilities. Encouragement of delivery in a facility where a higher level of care is available may be preferable when delivery of a VLBW infant is expected.",
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AU - Goudar, Shivaprasad S.

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AU - Chomba, Elwyn

AU - Tshefu, Antoinette

AU - Garces, Ana

AU - Parida, Sailajanandan

AU - Althabe, Fernando

AU - McClure, Elizabeth M.

AU - Derman, Richard J.

AU - Goldenberg, Robert L.

AU - Bose, Carl

AU - Hambidge, Michael

AU - Panigrahi, Pinaki

AU - Buekens, Pierre

AU - Chakraborty, Hrishikesh

AU - Hartwell, Tyler D.

AU - Moore, Janet

AU - Wright, Linda L.

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N2 - OBJECTIVE: The goal was to determine the effect of training in newborn care and resuscitation on 7-day (early) neonatal mortality rates for very low birth weight (VLBW) infants. The study was designed to test the hypothesis that these training programs would reduce neonatal mortality rates for VLBW infants. METHODS: Local instructors trained birth attendants from 96 rural communities in 6 developing countries in protocol and data collection, the World Health Organization Essential Newborn Care (ENC) course, and a modified version of the American Academy of Pediatrics Neonatal Resuscitation Program (NRP), by using a train-the-trainer model. To test the impact of ENC training, data on infants of 500 to 1499 g were collected by using a before/after, active baseline, controlled study design. A cluster-randomized, controlled trial design was used to test the impact of the NRP. RESULTS: A total of 1096 VLBW (500-1499 g) infants were enrolled, and 98.5% of live-born infants were monitored to 7 days. All-cause, 7-day neonatal mortality, stillbirth, and perinatal mortality rates were not affected by ENC or NRP training. CONCLUSIONS: Neither ENC nor NRP training of birth attendants decreased 7-day neonatal, stillbirth, or perinatal mortality rates for VLBW infants born at home or at first-level facilities. Encouragement of delivery in a facility where a higher level of care is available may be preferable when delivery of a VLBW infant is expected.

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KW - Developing countries

KW - Health care systems

KW - Neonatal mortality

KW - Perinatal mortality

KW - Prematurity

KW - Stillbirth

KW - Very low birth weight

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