The Experts below are selected from a list of 288 Experts worldwide ranked by ideXlab platform
Terhi J Lohela - One of the best experts on this subject based on the ideXlab platform.
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distance to care facility delivery and early Neonatal Mortality in malawi and zambia
PLOS ONE, 2012Co-Authors: Terhi J Lohela, Oona M R Campbell, Sabine GabryschAbstract:BACKGROUND: Globally, approximately 3 million babies die annually within their first month. Access to adequate care at birth is needed to reduce newborn as well as maternal deaths. We explore the influence of distance to delivery care and of level of care on early Neonatal Mortality in rural Zambia and Malawi, the influence of distance (and level of care) on facility delivery, and the influence of facility delivery on early Neonatal Mortality. METHODS AND FINDINGS: National Health Facility Censuses were used to classify the level of obstetric care for 1131 Zambian and 446 Malawian delivery facilities. Straight-line distances to facilities were calculated for 3771 newborns in the 2007 Zambia DHS and 8842 newborns in the 2004 Malawi DHS. There was no association between distance to care and early Neonatal Mortality in Malawi (OR 0.97, 95%CI 0.58-1.60), while in Zambia, further distance (per 10 km) was associated with lower Mortality (OR 0.55, 95%CI 0.35-0.87). The level of care provided in the closest facility showed no association with early Neonatal Mortality in either Malawi (OR 1.02, 95%CI 0.90-1.16) or Zambia (OR 1.02, 95%CI 0.82-1.26). In both countries, distance to care was strongly associated with facility use for delivery (Malawi: OR 0.35 per 10km, 95%CI 0.26-0.46). All results are adjusted for available confounders. Early Neonatal Mortality did not differ by frequency of facility delivery in the community. CONCLUSIONS: While better geographic access and higher level of care were associated with more frequent facility delivery, there was no association with lower early Neonatal Mortality. This could be due to low quality of care for newborns at health facilities, but differential underreporting of early Neonatal deaths in the DHS is an alternative explanation. Improved data sources are needed to monitor progress in the provision of obstetric and newborn care and its impact on Mortality.
Katherine S Laughon - One of the best experts on this subject based on the ideXlab platform.
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Neonatal Mortality by attempted route of delivery in early preterm birth
American Journal of Obstetrics and Gynecology, 2012Co-Authors: Uma M Reddy, Jun Zhang, Zhen Chen, Tonse N K Raju, Katherine S LaughonAbstract:Objective We sought to study Neonatal outcomes in early preterm births by delivery route. Study Design Delivery precursors were analyzed in 4352 singleton deliveries, 24 0/7 to 31 6/7 weeks' gestation. In a subset (n = 2906) eligible for a trial of labor, Neonatal Mortality in attempted vaginal delivery (VD) was compared to planned cesarean delivery stratified by presentation. Results Delivery precursors were classified as maternal or fetal conditions (45.7%), preterm premature rupture of membranes (37.7%), and preterm labor (16.6%). For vertex presentation, 79% attempted VD and 84% were successful. There was no difference in Neonatal Mortality. For breech presentation, at 24 0/7 to 27 6/7 weeks' gestation, 31.7% attempted VD and 27.6% were successful; Neonatal Mortality was increased (25.2% vs 13.2%, P = .003). At 28 0/7 to 31 6/7 weeks' gestation, 30.5% attempted VD and 17.2% were successful; Neonatal Mortality was increased (6.0% vs 1.5%, P = .016). Conclusion Attempted VD for vertex presentation has a high success rate with no difference in Neonatal Mortality unlike breech presentation.
Jun Zhang - One of the best experts on this subject based on the ideXlab platform.
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Neonatal Mortality by attempted route of delivery in early preterm birth
American Journal of Obstetrics and Gynecology, 2012Co-Authors: Uma M Reddy, Jun Zhang, Zhen Chen, Tonse N K Raju, Katherine S LaughonAbstract:Objective We sought to study Neonatal outcomes in early preterm births by delivery route. Study Design Delivery precursors were analyzed in 4352 singleton deliveries, 24 0/7 to 31 6/7 weeks' gestation. In a subset (n = 2906) eligible for a trial of labor, Neonatal Mortality in attempted vaginal delivery (VD) was compared to planned cesarean delivery stratified by presentation. Results Delivery precursors were classified as maternal or fetal conditions (45.7%), preterm premature rupture of membranes (37.7%), and preterm labor (16.6%). For vertex presentation, 79% attempted VD and 84% were successful. There was no difference in Neonatal Mortality. For breech presentation, at 24 0/7 to 27 6/7 weeks' gestation, 31.7% attempted VD and 27.6% were successful; Neonatal Mortality was increased (25.2% vs 13.2%, P = .003). At 28 0/7 to 31 6/7 weeks' gestation, 30.5% attempted VD and 17.2% were successful; Neonatal Mortality was increased (6.0% vs 1.5%, P = .016). Conclusion Attempted VD for vertex presentation has a high success rate with no difference in Neonatal Mortality unlike breech presentation.
Sabine Gabrysch - One of the best experts on this subject based on the ideXlab platform.
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distance to care facility delivery and early Neonatal Mortality in malawi and zambia
PLOS ONE, 2012Co-Authors: Terhi J Lohela, Oona M R Campbell, Sabine GabryschAbstract:BACKGROUND: Globally, approximately 3 million babies die annually within their first month. Access to adequate care at birth is needed to reduce newborn as well as maternal deaths. We explore the influence of distance to delivery care and of level of care on early Neonatal Mortality in rural Zambia and Malawi, the influence of distance (and level of care) on facility delivery, and the influence of facility delivery on early Neonatal Mortality. METHODS AND FINDINGS: National Health Facility Censuses were used to classify the level of obstetric care for 1131 Zambian and 446 Malawian delivery facilities. Straight-line distances to facilities were calculated for 3771 newborns in the 2007 Zambia DHS and 8842 newborns in the 2004 Malawi DHS. There was no association between distance to care and early Neonatal Mortality in Malawi (OR 0.97, 95%CI 0.58-1.60), while in Zambia, further distance (per 10 km) was associated with lower Mortality (OR 0.55, 95%CI 0.35-0.87). The level of care provided in the closest facility showed no association with early Neonatal Mortality in either Malawi (OR 1.02, 95%CI 0.90-1.16) or Zambia (OR 1.02, 95%CI 0.82-1.26). In both countries, distance to care was strongly associated with facility use for delivery (Malawi: OR 0.35 per 10km, 95%CI 0.26-0.46). All results are adjusted for available confounders. Early Neonatal Mortality did not differ by frequency of facility delivery in the community. CONCLUSIONS: While better geographic access and higher level of care were associated with more frequent facility delivery, there was no association with lower early Neonatal Mortality. This could be due to low quality of care for newborns at health facilities, but differential underreporting of early Neonatal deaths in the DHS is an alternative explanation. Improved data sources are needed to monitor progress in the provision of obstetric and newborn care and its impact on Mortality.
Uma M Reddy - One of the best experts on this subject based on the ideXlab platform.
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Neonatal Mortality by attempted route of delivery in early preterm birth
American Journal of Obstetrics and Gynecology, 2012Co-Authors: Uma M Reddy, Jun Zhang, Zhen Chen, Tonse N K Raju, Katherine S LaughonAbstract:Objective We sought to study Neonatal outcomes in early preterm births by delivery route. Study Design Delivery precursors were analyzed in 4352 singleton deliveries, 24 0/7 to 31 6/7 weeks' gestation. In a subset (n = 2906) eligible for a trial of labor, Neonatal Mortality in attempted vaginal delivery (VD) was compared to planned cesarean delivery stratified by presentation. Results Delivery precursors were classified as maternal or fetal conditions (45.7%), preterm premature rupture of membranes (37.7%), and preterm labor (16.6%). For vertex presentation, 79% attempted VD and 84% were successful. There was no difference in Neonatal Mortality. For breech presentation, at 24 0/7 to 27 6/7 weeks' gestation, 31.7% attempted VD and 27.6% were successful; Neonatal Mortality was increased (25.2% vs 13.2%, P = .003). At 28 0/7 to 31 6/7 weeks' gestation, 30.5% attempted VD and 17.2% were successful; Neonatal Mortality was increased (6.0% vs 1.5%, P = .016). Conclusion Attempted VD for vertex presentation has a high success rate with no difference in Neonatal Mortality unlike breech presentation.
