Evidence map›Paper›PMID 33371038›Full record

ArticleBMJ open2020

Assessing the changes in childbirth care practices and neonatal outcomes in Western China: pre-comparison and post-comparison study on early essential newborn care interventions.

Wen Qu, Qing Yue, Yan Wang, Jin Liuxing Yang, Xi Jin, Xiaona Huang, Xiaobo Tian, Kathryn Martin, Anuradha Narayan, Tao Xu

Abstract readClinical Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 pooled it
–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

13 citing papers in PubMed, 1 synthesis or guideline pooled it.

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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

10 authors.

Wen QuChild Health Care Department, National Center for Women and Children's Heath China Center for Disease Control, Beijing, China.
Qing YueChild Health Care Department, National Center for Women and Children's Heath China Center for Disease Control, Beijing, China.
Yan WangChild Health Care Department, National Center for Women and Children's Heath China Center for Disease Control, Beijing, China.
Jin Liuxing YangChild Health Care Department, National Center for Women and Children's Heath China Center for Disease Control, Beijing, China.
Xi JinChild Health Care Department, National Center for Women and Children's Heath China Center for Disease Control, Beijing, China.
Xiaona HuangHealth, Nutrition & WASH Section of UNICEF China Office, Beijing, China.
Xiaobo TianHealth, Nutrition & WASH Section of UNICEF China Office, Beijing, China.
Kathryn MartinSchool of Community Medicine, The University of Oklahoma, Tulsa, Oklahoma, USA.
Anuradha NarayanHealth, Nutrition & WASH Section of UNICEF China Office, Beijing, China.
Tao XuChild Health Care Department, National Center for Women and Children's Heath China Center for Disease Control, Beijing, China xutao6622@163.com.ORCID 0000-0003-2076-9485

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo explore the changes in childbirth care practices and health outcomes of newborns after the introduction of early essential newborn care (EENC).

designA pre-comparison and post-comparison study.

settingThe study was conducted in December 2016 and December 2018 in 18 counties in four western provinces of China.

participants46 hospitals that provide delivery services participated in the study.

interventionsEENC practices were introduced and implemented in the 46 hospitals. OUTCOME MEASURES: The changes of hospital indicators such as incidence of birth asphyxia and neonatal mortality were compared in 2016 and 2018. EENC coverage indicators, such as skin-to-skin (STS) contact, and time of first breast feeding were also compared before and after the intervention via interview with 524 randomly selected postpartum mothers (320 in 2016 and 204 in 2018).

results54 335 newborns were delivered in the pre-EENC period (2016) and 58 057 delivered in the post-EENC period (2018). According to hospital records, the proportion of newborns receiving immediate STS contact increased from 32.6% to 51.2% (Risk Ratio (RR)=1.57,95% CI 1.55 to 1.59) and the percentage of newborns receiving prolonged STS contact for more than 90 min increased from 8.1% to 26.8% (RR=3.31, 95% CI 3.21 to 3.41). No statistically significant changes were found in neonatal mortality, although slight decreases in birth asphyxiate and neonatal intensive care unit admission rates were detected. Among the mothers interviewed, the proportion of newborns receiving immediate STS contact increased from 34.6% to 80.0% (RR=2.31, 95% CI 1.69 to 3.17). The exclusive breastfeeding rate increased from 43% to 73.4% (RR=1.71, 95% CI 1.43 to 2.04). The average length of the first breast feeding increased from 15.8 min to 17.1 min.

conclusionsThe introduction of EENC has yielded significant improvements in newborn care services at the pilot hospitals, including enhanced maternal and newborn care practices, improved STS contact quality and early breastfeeding performance. Further studies are needed to evaluate the long-term impact of EENC on newborn health outcomes.

Indexed as

Breast FeedingInfant MortalityChinaFemaleHumansInfantInfant, NewbornMothersParturitionPregnancyhealth & safetypaediatricsperinatologypublic healthquality in health care

Identifiers

PMID33371038
PMCPMC7757506

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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.