Albert Manasyan1,2, Elwyn Chomba1,3, Janet Moore4, Dennis Wallace4, Elizabeth M McClure4, Marion Koso-Thomas5, Waldemar A Carlo1. 1. University of Alabama at Birmingham, Birmingham, AL, USA. 2. Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia. 3. University of Zambia, Lusaka, Zambia. 4. RTI International, Durham, NC, USA. 5. Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, MD, USA.
Abstract
OBJECTIVE: To test the hypothesis that modified perinatal mortality, early neonatal mortality, and other measures of perinatal mortality are lower with facility births than with home births among deliveries conducted by traditional birth attendants (TBAs) or nurse-midwives. METHOD: This population-based observational study used data collected prospectively for home and facility deliveries conducted by TBAs and nurse-midwives in 13 rural communities in Zambia between September 1, 2009, and December 31, 2015. RESULTS: We enrolled 48 956 pregnant women. In adjusted analysis, modified perinatal mortality (adjusted odds ratio [aOR] 0.63, 95% confidence interval [CI] 0.45-0.88), early neonatal mortality (0.48, 0.33-0.69), and fresh stillbirth/day-1 neonatal mortality (0.55, 0.38-0.80) were lower among home deliveries than among facility deliveries conducted by TBAs, but did not differ among deliveries conducted by nurse-midwives. Rates of fresh stillbirth did not differ between home and facility delivery by either TBAs (aOR 1.03, 95% CI 0.64-1.66) or nurse-midwives (1.19, 0.67-2.10). CONCLUSION: Our findings show significant reductions in modified perinatal mortality, early neonatal mortality, and fresh stillbirth/day-1 neonatal mortality among home deliveries done by TBAs. This may be explained by robust community structures built by our program and referral bias of complicated cases.
OBJECTIVE: To test the hypothesis that modified perinatal mortality, early neonatal mortality, and other measures of perinatal mortality are lower with facility births than with home births among deliveries conducted by traditional birth attendants (TBAs) or nurse-midwives. METHOD: This population-based observational study used data collected prospectively for home and facility deliveries conducted by TBAs and nurse-midwives in 13 rural communities in Zambia between September 1, 2009, and December 31, 2015. RESULTS: We enrolled 48 956 pregnant women. In adjusted analysis, modified perinatal mortality (adjusted odds ratio [aOR] 0.63, 95% confidence interval [CI] 0.45-0.88), early neonatal mortality (0.48, 0.33-0.69), and fresh stillbirth/day-1 neonatal mortality (0.55, 0.38-0.80) were lower among home deliveries than among facility deliveries conducted by TBAs, but did not differ among deliveries conducted by nurse-midwives. Rates of fresh stillbirth did not differ between home and facility delivery by either TBAs (aOR 1.03, 95% CI 0.64-1.66) or nurse-midwives (1.19, 0.67-2.10). CONCLUSION: Our findings show significant reductions in modified perinatal mortality, early neonatal mortality, and fresh stillbirth/day-1 neonatal mortality among home deliveries done by TBAs. This may be explained by robust community structures built by our program and referral bias of complicated cases.
Authors: Stephen N Wall; Anne C C Lee; Waldemar Carlo; Robert Goldenberg; Susan Niermeyer; Gary L Darmstadt; William Keenan; Zulfiqar A Bhutta; Jeffrey Perlman; Joy E Lawn Journal: Semin Perinatol Date: 2010-12 Impact factor: 3.300
Authors: Gary L Darmstadt; Anne C C Lee; Simon Cousens; Lynn Sibley; Zulfiqar A Bhutta; France Donnay; Dave Osrin; Abhay Bang; Vishwajeet Kumar; Steven N Wall; Abdullah Baqui; Joy E Lawn Journal: Int J Gynaecol Obstet Date: 2009-10 Impact factor: 3.561
Authors: Joy E Lawn; Mary V Kinney; Robert E Black; Catherine Pitt; Simon Cousens; Kate Kerber; Erica Corbett; Allisyn C Moran; Claudia S Morrissey; Mikkel Z Oestergaard Journal: Health Policy Plan Date: 2012-07 Impact factor: 3.344
Authors: 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; Nancy F Krebs; Pinaki Panigrahi; Pierre Buekens; Hrishikesh Chakraborty; Tyler D Hartwell; Linda L Wright Journal: N Engl J Med Date: 2010-02-18 Impact factor: 91.245
Authors: Christiana R Titaley; Cynthia L Hunter; Michael J Dibley; Peter Heywood Journal: BMC Pregnancy Childbirth Date: 2010-08-11 Impact factor: 3.007
Authors: Christopher J Gill; Grace Phiri-Mazala; Nicholas G Guerina; Joshua Kasimba; Charity Mulenga; William B MacLeod; Nelson Waitolo; Anna B Knapp; Mark Mirochnick; Arthur Mazimba; Matthew P Fox; Lora Sabin; Philip Seidenberg; Jonathon L Simon; Davidson H Hamer Journal: BMJ Date: 2011-02-03
Authors: Margaret Kweku; Hubert Amu; Adam Awolu; Martin Adjuik; Martin Amogre Ayanore; Emmanuel Manu; Elvis Enowbeyang Tarkang; Joyce Komesuor; Geoffrey Adebayo Asalu; Fortress Yayra Aku; Nuworza Kugbey; Fidelis Anumu; Laud Ampomah Boateng; Justine Sefakor Alornyo; Roland Glover; Timothy Letsa; Ayaga A Bawah; Nicholas S Kanlisi; John Koku Awoonor-Williams; James F Phillips; John Owusu Gyapong Journal: PLoS One Date: 2020-01-08 Impact factor: 3.240
Authors: Iván Sarmiento; Sergio Paredes-Solís; Abraham de Jesús García; Nadia Maciel Paulino; Felipe René Serrano de Los Santos; José Legorreta-Soberanis; Germán Zuluaga; Anne Cockcroft; Neil Andersson Journal: BMC Pregnancy Childbirth Date: 2022-01-17 Impact factor: 3.007