Evidence map›Paper›PMID 30763454›Full record

Observational studyInternational journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics2019

Association between birth attendant type and delivery site and perinatal outcomes.

Albert Manasyan, Elwyn Chomba, Janet Moore, Dennis Wallace, Elizabeth M McClure, Marion Koso-Thomas, Waldemar A Carlo, NICHD Global Network for Women's and Children's Health Research

Abstract readComparative StudyObservational Study
In one paragraph

Observational study in International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Albert ManasyanUniversity of Alabama at Birmingham, Birmingham, AL, USA.
Elwyn ChombaUniversity of Alabama at Birmingham, Birmingham, AL, USA.
Janet MooreRTI International, Durham, NC, USA.
Dennis WallaceRTI International, Durham, NC, USA.
Elizabeth M McClureRTI International, Durham, NC, USA.
Marion Koso-ThomasEunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, MD, USA.
Waldemar A CarloUniversity of Alabama at Birmingham, Birmingham, AL, USA.
NICHD Global Network for Women's and Children's Health Research

Funding

Neonatal Resuscitation in Developing CountriesU01HD043464 · NICHD · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CARLO FONT, WALDEMAR A. · 2003 to 2012
$6.6M
Boston University/Lata Medical Research Foundation Global Network for Women's Children's Health Research UnitUG1HD078439 · NICHD · BOSTON UNIVERSITY MEDICAL CAMPUS · PI Patricia L Hibberd · 2018 to 2026
$5.5M
Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of HealthNICHD NIH HHS U01 HD043464
6 · The paper itself

Abstract

objectiveTo 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.

methodThis 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.

resultsWe 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).

conclusionOur 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.

Indexed as

Perinatal MortalityAdultFemaleHealth FacilitiesHome ChildbirthHumansInfantInfant, NewbornMidwiferyNurse MidwivesPopulation SurveillancePregnancyRegistriesRural PopulationStillbirthYoung AdultBirth attendantFacility deliveryHome deliveryNeonatal mortalityStillbirthTraditional birth attendant

Identifiers

PMID30763454
PMCPMC7868173

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.