A multi-faceted intervention including antenatal corticosteroids to reduce neonatal mortality associated with preterm birth: a case study from the Guatemalan Western Highlands
Background The Global Network for Women’s and Children’s Health Research undertook a cluster-randomized trial to assess the impact of a multi-faceted intervention to identify women at high-risk of preterm birth at all levels of care, to administer corticosteroids to women and refer for facility deli...
Ausführliche Beschreibung
Autor*in: |
Garces, Ana [verfasserIn] |
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E-Artikel |
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Sprache: |
Englisch |
Erschienen: |
2016 |
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Anmerkung: |
© Garces et al. 2016 |
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Übergeordnetes Werk: |
Enthalten in: Reproductive health - London : BioMed Central, 2004, 13(2016), 1 vom: 24. Mai |
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Übergeordnetes Werk: |
volume:13 ; year:2016 ; number:1 ; day:24 ; month:05 |
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DOI / URN: |
10.1186/s12978-016-0178-0 |
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Katalog-ID: |
SPR029188148 |
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520 | |a Background The Global Network for Women’s and Children’s Health Research undertook a cluster-randomized trial to assess the impact of a multi-faceted intervention to identify women at high-risk of preterm birth at all levels of care, to administer corticosteroids to women and refer for facility delivery compared with standard care. Of the seven sites that participated in the ACT trial, only two sites had statistically significant reductions in the neonatal mortality among the target group of <5th percentile infants, and of the two, Guatemala’s improvement in neonatal mortality was by far the largest. Methods We used data available from the ACT trial as well as pretrial data in an attempt to understand why neonatal mortality may have decreased in the intervention clusters in <$ 5^{th} $ percentile infants in Chimaltenango, Guatemala. The intervention and control clusters were compared in regards to ACS use, the various types of medical care, outcomes in facility and community births and among births in various birth weight categories. Results Neonatal mortality decreased to a greater extent in the intervention compared to the control clusters in the <$ 5^{th} $ percentile infants in Guatemala during the ACT Trial. ACS use for the <$ 5^{th} $ percentile infants in the intervention clusters was 49.1 % compared to 13.8 % in the control clusters. Many measures of the quality of obstetric and neonatal care improved to a greater extent in the intervention compared to the control clusters during the trial. Births in facilities and births weighing 1500 to 2500 g had the greatest reduction in neonatal mortality. Conclusions The combination of improved care and greater ACS use may potentially account for the observed difference in neonatal mortality between the intervention and control clusters. Trial registration Clinicaltrials.gov: NCT01084096. | ||
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700 | 1 | |a Wallace, Dennis D. |4 aut | |
700 | 1 | |a Althabe, Fernando |4 aut | |
700 | 1 | |a Goldenberg, Robert L. |4 aut | |
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10.1186/s12978-016-0178-0 doi (DE-627)SPR029188148 (SPR)s12978-016-0178-0-e DE-627 ger DE-627 rakwb eng Garces, Ana verfasserin aut A multi-faceted intervention including antenatal corticosteroids to reduce neonatal mortality associated with preterm birth: a case study from the Guatemalan Western Highlands 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Garces et al. 2016 Background The Global Network for Women’s and Children’s Health Research undertook a cluster-randomized trial to assess the impact of a multi-faceted intervention to identify women at high-risk of preterm birth at all levels of care, to administer corticosteroids to women and refer for facility delivery compared with standard care. Of the seven sites that participated in the ACT trial, only two sites had statistically significant reductions in the neonatal mortality among the target group of <5th percentile infants, and of the two, Guatemala’s improvement in neonatal mortality was by far the largest. Methods We used data available from the ACT trial as well as pretrial data in an attempt to understand why neonatal mortality may have decreased in the intervention clusters in <$ 5^{th} $ percentile infants in Chimaltenango, Guatemala. The intervention and control clusters were compared in regards to ACS use, the various types of medical care, outcomes in facility and community births and among births in various birth weight categories. Results Neonatal mortality decreased to a greater extent in the intervention compared to the control clusters in the <$ 5^{th} $ percentile infants in Guatemala during the ACT Trial. ACS use for the <$ 5^{th} $ percentile infants in the intervention clusters was 49.1 % compared to 13.8 % in the control clusters. Many measures of the quality of obstetric and neonatal care improved to a greater extent in the intervention compared to the control clusters during the trial. Births in facilities and births weighing 1500 to 2500 g had the greatest reduction in neonatal mortality. Conclusions The combination of improved care and greater ACS use may potentially account for the observed difference in neonatal mortality between the intervention and control clusters. Trial registration Clinicaltrials.gov: NCT01084096. Preterm Birth (dpeaa)DE-He213 Neonatal Mortality (dpeaa)DE-He213 Intervention Cluster (dpeaa)DE-He213 Home Birth (dpeaa)DE-He213 Antenatal Corticosteroid (dpeaa)DE-He213 McClure, Elizabeth M. aut Figueroa, Lester aut Pineda, Sayury aut Hambidge, K. Michael aut Krebs, Nancy F. aut Thorsten, Vanessa R. aut Wallace, Dennis D. aut Althabe, Fernando aut Goldenberg, Robert L. aut Enthalten in Reproductive health London : BioMed Central, 2004 13(2016), 1 vom: 24. Mai (DE-627)389462543 (DE-600)2149029-6 1742-4755 nnns volume:13 year:2016 number:1 day:24 month:05 https://dx.doi.org/10.1186/s12978-016-0178-0 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2016 1 24 05 |
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10.1186/s12978-016-0178-0 doi (DE-627)SPR029188148 (SPR)s12978-016-0178-0-e DE-627 ger DE-627 rakwb eng Garces, Ana verfasserin aut A multi-faceted intervention including antenatal corticosteroids to reduce neonatal mortality associated with preterm birth: a case study from the Guatemalan Western Highlands 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Garces et al. 2016 Background The Global Network for Women’s and Children’s Health Research undertook a cluster-randomized trial to assess the impact of a multi-faceted intervention to identify women at high-risk of preterm birth at all levels of care, to administer corticosteroids to women and refer for facility delivery compared with standard care. Of the seven sites that participated in the ACT trial, only two sites had statistically significant reductions in the neonatal mortality among the target group of <5th percentile infants, and of the two, Guatemala’s improvement in neonatal mortality was by far the largest. Methods We used data available from the ACT trial as well as pretrial data in an attempt to understand why neonatal mortality may have decreased in the intervention clusters in <$ 5^{th} $ percentile infants in Chimaltenango, Guatemala. The intervention and control clusters were compared in regards to ACS use, the various types of medical care, outcomes in facility and community births and among births in various birth weight categories. Results Neonatal mortality decreased to a greater extent in the intervention compared to the control clusters in the <$ 5^{th} $ percentile infants in Guatemala during the ACT Trial. ACS use for the <$ 5^{th} $ percentile infants in the intervention clusters was 49.1 % compared to 13.8 % in the control clusters. Many measures of the quality of obstetric and neonatal care improved to a greater extent in the intervention compared to the control clusters during the trial. Births in facilities and births weighing 1500 to 2500 g had the greatest reduction in neonatal mortality. Conclusions The combination of improved care and greater ACS use may potentially account for the observed difference in neonatal mortality between the intervention and control clusters. Trial registration Clinicaltrials.gov: NCT01084096. Preterm Birth (dpeaa)DE-He213 Neonatal Mortality (dpeaa)DE-He213 Intervention Cluster (dpeaa)DE-He213 Home Birth (dpeaa)DE-He213 Antenatal Corticosteroid (dpeaa)DE-He213 McClure, Elizabeth M. aut Figueroa, Lester aut Pineda, Sayury aut Hambidge, K. Michael aut Krebs, Nancy F. aut Thorsten, Vanessa R. aut Wallace, Dennis D. aut Althabe, Fernando aut Goldenberg, Robert L. aut Enthalten in Reproductive health London : BioMed Central, 2004 13(2016), 1 vom: 24. Mai (DE-627)389462543 (DE-600)2149029-6 1742-4755 nnns volume:13 year:2016 number:1 day:24 month:05 https://dx.doi.org/10.1186/s12978-016-0178-0 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2016 1 24 05 |
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10.1186/s12978-016-0178-0 doi (DE-627)SPR029188148 (SPR)s12978-016-0178-0-e DE-627 ger DE-627 rakwb eng Garces, Ana verfasserin aut A multi-faceted intervention including antenatal corticosteroids to reduce neonatal mortality associated with preterm birth: a case study from the Guatemalan Western Highlands 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Garces et al. 2016 Background The Global Network for Women’s and Children’s Health Research undertook a cluster-randomized trial to assess the impact of a multi-faceted intervention to identify women at high-risk of preterm birth at all levels of care, to administer corticosteroids to women and refer for facility delivery compared with standard care. Of the seven sites that participated in the ACT trial, only two sites had statistically significant reductions in the neonatal mortality among the target group of <5th percentile infants, and of the two, Guatemala’s improvement in neonatal mortality was by far the largest. Methods We used data available from the ACT trial as well as pretrial data in an attempt to understand why neonatal mortality may have decreased in the intervention clusters in <$ 5^{th} $ percentile infants in Chimaltenango, Guatemala. The intervention and control clusters were compared in regards to ACS use, the various types of medical care, outcomes in facility and community births and among births in various birth weight categories. Results Neonatal mortality decreased to a greater extent in the intervention compared to the control clusters in the <$ 5^{th} $ percentile infants in Guatemala during the ACT Trial. ACS use for the <$ 5^{th} $ percentile infants in the intervention clusters was 49.1 % compared to 13.8 % in the control clusters. Many measures of the quality of obstetric and neonatal care improved to a greater extent in the intervention compared to the control clusters during the trial. Births in facilities and births weighing 1500 to 2500 g had the greatest reduction in neonatal mortality. Conclusions The combination of improved care and greater ACS use may potentially account for the observed difference in neonatal mortality between the intervention and control clusters. Trial registration Clinicaltrials.gov: NCT01084096. Preterm Birth (dpeaa)DE-He213 Neonatal Mortality (dpeaa)DE-He213 Intervention Cluster (dpeaa)DE-He213 Home Birth (dpeaa)DE-He213 Antenatal Corticosteroid (dpeaa)DE-He213 McClure, Elizabeth M. aut Figueroa, Lester aut Pineda, Sayury aut Hambidge, K. Michael aut Krebs, Nancy F. aut Thorsten, Vanessa R. aut Wallace, Dennis D. aut Althabe, Fernando aut Goldenberg, Robert L. aut Enthalten in Reproductive health London : BioMed Central, 2004 13(2016), 1 vom: 24. Mai (DE-627)389462543 (DE-600)2149029-6 1742-4755 nnns volume:13 year:2016 number:1 day:24 month:05 https://dx.doi.org/10.1186/s12978-016-0178-0 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2016 1 24 05 |
allfieldsGer |
10.1186/s12978-016-0178-0 doi (DE-627)SPR029188148 (SPR)s12978-016-0178-0-e DE-627 ger DE-627 rakwb eng Garces, Ana verfasserin aut A multi-faceted intervention including antenatal corticosteroids to reduce neonatal mortality associated with preterm birth: a case study from the Guatemalan Western Highlands 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Garces et al. 2016 Background The Global Network for Women’s and Children’s Health Research undertook a cluster-randomized trial to assess the impact of a multi-faceted intervention to identify women at high-risk of preterm birth at all levels of care, to administer corticosteroids to women and refer for facility delivery compared with standard care. Of the seven sites that participated in the ACT trial, only two sites had statistically significant reductions in the neonatal mortality among the target group of <5th percentile infants, and of the two, Guatemala’s improvement in neonatal mortality was by far the largest. Methods We used data available from the ACT trial as well as pretrial data in an attempt to understand why neonatal mortality may have decreased in the intervention clusters in <$ 5^{th} $ percentile infants in Chimaltenango, Guatemala. The intervention and control clusters were compared in regards to ACS use, the various types of medical care, outcomes in facility and community births and among births in various birth weight categories. Results Neonatal mortality decreased to a greater extent in the intervention compared to the control clusters in the <$ 5^{th} $ percentile infants in Guatemala during the ACT Trial. ACS use for the <$ 5^{th} $ percentile infants in the intervention clusters was 49.1 % compared to 13.8 % in the control clusters. Many measures of the quality of obstetric and neonatal care improved to a greater extent in the intervention compared to the control clusters during the trial. Births in facilities and births weighing 1500 to 2500 g had the greatest reduction in neonatal mortality. Conclusions The combination of improved care and greater ACS use may potentially account for the observed difference in neonatal mortality between the intervention and control clusters. Trial registration Clinicaltrials.gov: NCT01084096. Preterm Birth (dpeaa)DE-He213 Neonatal Mortality (dpeaa)DE-He213 Intervention Cluster (dpeaa)DE-He213 Home Birth (dpeaa)DE-He213 Antenatal Corticosteroid (dpeaa)DE-He213 McClure, Elizabeth M. aut Figueroa, Lester aut Pineda, Sayury aut Hambidge, K. Michael aut Krebs, Nancy F. aut Thorsten, Vanessa R. aut Wallace, Dennis D. aut Althabe, Fernando aut Goldenberg, Robert L. aut Enthalten in Reproductive health London : BioMed Central, 2004 13(2016), 1 vom: 24. Mai (DE-627)389462543 (DE-600)2149029-6 1742-4755 nnns volume:13 year:2016 number:1 day:24 month:05 https://dx.doi.org/10.1186/s12978-016-0178-0 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2016 1 24 05 |
allfieldsSound |
10.1186/s12978-016-0178-0 doi (DE-627)SPR029188148 (SPR)s12978-016-0178-0-e DE-627 ger DE-627 rakwb eng Garces, Ana verfasserin aut A multi-faceted intervention including antenatal corticosteroids to reduce neonatal mortality associated with preterm birth: a case study from the Guatemalan Western Highlands 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Garces et al. 2016 Background The Global Network for Women’s and Children’s Health Research undertook a cluster-randomized trial to assess the impact of a multi-faceted intervention to identify women at high-risk of preterm birth at all levels of care, to administer corticosteroids to women and refer for facility delivery compared with standard care. Of the seven sites that participated in the ACT trial, only two sites had statistically significant reductions in the neonatal mortality among the target group of <5th percentile infants, and of the two, Guatemala’s improvement in neonatal mortality was by far the largest. Methods We used data available from the ACT trial as well as pretrial data in an attempt to understand why neonatal mortality may have decreased in the intervention clusters in <$ 5^{th} $ percentile infants in Chimaltenango, Guatemala. The intervention and control clusters were compared in regards to ACS use, the various types of medical care, outcomes in facility and community births and among births in various birth weight categories. Results Neonatal mortality decreased to a greater extent in the intervention compared to the control clusters in the <$ 5^{th} $ percentile infants in Guatemala during the ACT Trial. ACS use for the <$ 5^{th} $ percentile infants in the intervention clusters was 49.1 % compared to 13.8 % in the control clusters. Many measures of the quality of obstetric and neonatal care improved to a greater extent in the intervention compared to the control clusters during the trial. Births in facilities and births weighing 1500 to 2500 g had the greatest reduction in neonatal mortality. Conclusions The combination of improved care and greater ACS use may potentially account for the observed difference in neonatal mortality between the intervention and control clusters. Trial registration Clinicaltrials.gov: NCT01084096. Preterm Birth (dpeaa)DE-He213 Neonatal Mortality (dpeaa)DE-He213 Intervention Cluster (dpeaa)DE-He213 Home Birth (dpeaa)DE-He213 Antenatal Corticosteroid (dpeaa)DE-He213 McClure, Elizabeth M. aut Figueroa, Lester aut Pineda, Sayury aut Hambidge, K. Michael aut Krebs, Nancy F. aut Thorsten, Vanessa R. aut Wallace, Dennis D. aut Althabe, Fernando aut Goldenberg, Robert L. aut Enthalten in Reproductive health London : BioMed Central, 2004 13(2016), 1 vom: 24. Mai (DE-627)389462543 (DE-600)2149029-6 1742-4755 nnns volume:13 year:2016 number:1 day:24 month:05 https://dx.doi.org/10.1186/s12978-016-0178-0 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 13 2016 1 24 05 |
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multi-faceted intervention including antenatal corticosteroids to reduce neonatal mortality associated with preterm birth: a case study from the guatemalan western highlands |
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A multi-faceted intervention including antenatal corticosteroids to reduce neonatal mortality associated with preterm birth: a case study from the Guatemalan Western Highlands |
abstract |
Background The Global Network for Women’s and Children’s Health Research undertook a cluster-randomized trial to assess the impact of a multi-faceted intervention to identify women at high-risk of preterm birth at all levels of care, to administer corticosteroids to women and refer for facility delivery compared with standard care. Of the seven sites that participated in the ACT trial, only two sites had statistically significant reductions in the neonatal mortality among the target group of <5th percentile infants, and of the two, Guatemala’s improvement in neonatal mortality was by far the largest. Methods We used data available from the ACT trial as well as pretrial data in an attempt to understand why neonatal mortality may have decreased in the intervention clusters in <$ 5^{th} $ percentile infants in Chimaltenango, Guatemala. The intervention and control clusters were compared in regards to ACS use, the various types of medical care, outcomes in facility and community births and among births in various birth weight categories. Results Neonatal mortality decreased to a greater extent in the intervention compared to the control clusters in the <$ 5^{th} $ percentile infants in Guatemala during the ACT Trial. ACS use for the <$ 5^{th} $ percentile infants in the intervention clusters was 49.1 % compared to 13.8 % in the control clusters. Many measures of the quality of obstetric and neonatal care improved to a greater extent in the intervention compared to the control clusters during the trial. Births in facilities and births weighing 1500 to 2500 g had the greatest reduction in neonatal mortality. Conclusions The combination of improved care and greater ACS use may potentially account for the observed difference in neonatal mortality between the intervention and control clusters. Trial registration Clinicaltrials.gov: NCT01084096. © Garces et al. 2016 |
abstractGer |
Background The Global Network for Women’s and Children’s Health Research undertook a cluster-randomized trial to assess the impact of a multi-faceted intervention to identify women at high-risk of preterm birth at all levels of care, to administer corticosteroids to women and refer for facility delivery compared with standard care. Of the seven sites that participated in the ACT trial, only two sites had statistically significant reductions in the neonatal mortality among the target group of <5th percentile infants, and of the two, Guatemala’s improvement in neonatal mortality was by far the largest. Methods We used data available from the ACT trial as well as pretrial data in an attempt to understand why neonatal mortality may have decreased in the intervention clusters in <$ 5^{th} $ percentile infants in Chimaltenango, Guatemala. The intervention and control clusters were compared in regards to ACS use, the various types of medical care, outcomes in facility and community births and among births in various birth weight categories. Results Neonatal mortality decreased to a greater extent in the intervention compared to the control clusters in the <$ 5^{th} $ percentile infants in Guatemala during the ACT Trial. ACS use for the <$ 5^{th} $ percentile infants in the intervention clusters was 49.1 % compared to 13.8 % in the control clusters. Many measures of the quality of obstetric and neonatal care improved to a greater extent in the intervention compared to the control clusters during the trial. Births in facilities and births weighing 1500 to 2500 g had the greatest reduction in neonatal mortality. Conclusions The combination of improved care and greater ACS use may potentially account for the observed difference in neonatal mortality between the intervention and control clusters. Trial registration Clinicaltrials.gov: NCT01084096. © Garces et al. 2016 |
abstract_unstemmed |
Background The Global Network for Women’s and Children’s Health Research undertook a cluster-randomized trial to assess the impact of a multi-faceted intervention to identify women at high-risk of preterm birth at all levels of care, to administer corticosteroids to women and refer for facility delivery compared with standard care. Of the seven sites that participated in the ACT trial, only two sites had statistically significant reductions in the neonatal mortality among the target group of <5th percentile infants, and of the two, Guatemala’s improvement in neonatal mortality was by far the largest. Methods We used data available from the ACT trial as well as pretrial data in an attempt to understand why neonatal mortality may have decreased in the intervention clusters in <$ 5^{th} $ percentile infants in Chimaltenango, Guatemala. The intervention and control clusters were compared in regards to ACS use, the various types of medical care, outcomes in facility and community births and among births in various birth weight categories. Results Neonatal mortality decreased to a greater extent in the intervention compared to the control clusters in the <$ 5^{th} $ percentile infants in Guatemala during the ACT Trial. ACS use for the <$ 5^{th} $ percentile infants in the intervention clusters was 49.1 % compared to 13.8 % in the control clusters. Many measures of the quality of obstetric and neonatal care improved to a greater extent in the intervention compared to the control clusters during the trial. Births in facilities and births weighing 1500 to 2500 g had the greatest reduction in neonatal mortality. Conclusions The combination of improved care and greater ACS use may potentially account for the observed difference in neonatal mortality between the intervention and control clusters. Trial registration Clinicaltrials.gov: NCT01084096. © Garces et al. 2016 |
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A multi-faceted intervention including antenatal corticosteroids to reduce neonatal mortality associated with preterm birth: a case study from the Guatemalan Western Highlands |
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<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">SPR029188148</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230519124120.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">201007s2016 xx |||||o 00| ||eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1186/s12978-016-0178-0</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)SPR029188148</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(SPR)s12978-016-0178-0-e</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Garces, Ana</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="2"><subfield code="a">A multi-faceted intervention including antenatal corticosteroids to reduce neonatal mortality associated with preterm birth: a case study from the Guatemalan Western Highlands</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2016</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="500" ind1=" " ind2=" "><subfield code="a">© Garces et al. 2016</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Background The Global Network for Women’s and Children’s Health Research undertook a cluster-randomized trial to assess the impact of a multi-faceted intervention to identify women at high-risk of preterm birth at all levels of care, to administer corticosteroids to women and refer for facility delivery compared with standard care. Of the seven sites that participated in the ACT trial, only two sites had statistically significant reductions in the neonatal mortality among the target group of <5th percentile infants, and of the two, Guatemala’s improvement in neonatal mortality was by far the largest. Methods We used data available from the ACT trial as well as pretrial data in an attempt to understand why neonatal mortality may have decreased in the intervention clusters in <$ 5^{th} $ percentile infants in Chimaltenango, Guatemala. The intervention and control clusters were compared in regards to ACS use, the various types of medical care, outcomes in facility and community births and among births in various birth weight categories. Results Neonatal mortality decreased to a greater extent in the intervention compared to the control clusters in the <$ 5^{th} $ percentile infants in Guatemala during the ACT Trial. ACS use for the <$ 5^{th} $ percentile infants in the intervention clusters was 49.1 % compared to 13.8 % in the control clusters. Many measures of the quality of obstetric and neonatal care improved to a greater extent in the intervention compared to the control clusters during the trial. Births in facilities and births weighing 1500 to 2500 g had the greatest reduction in neonatal mortality. Conclusions The combination of improved care and greater ACS use may potentially account for the observed difference in neonatal mortality between the intervention and control clusters. Trial registration Clinicaltrials.gov: NCT01084096.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Preterm Birth</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Neonatal Mortality</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Intervention Cluster</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Home Birth</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Antenatal Corticosteroid</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">McClure, Elizabeth M.</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Figueroa, Lester</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Pineda, Sayury</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Hambidge, K. 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