Does provision of antenatal care in Southern Asia improve neonatal survival? A systematic review and meta-analysis.



O'Dair, Millie A, Demetri, Andrew, Clayton, Gemma L, Caldwell, Deborah, Barnard, Katie, Burden, Christy, Fraser, Abigail and Merriel, Abi ORCID: 0000-0003-0352-2106
(2022) Does provision of antenatal care in Southern Asia improve neonatal survival? A systematic review and meta-analysis. AJOG global reports, 2 (4). 100128-.

Access the full-text of this item by clicking on the Open Access link.

Abstract

<h4>Background</h4>Southern Asia has one of the highest burdens of neonatal mortality worldwide (26/1000 live births). Ensuring that women receive antenatal care from a skilled provider may play an important role in reducing this burden.<h4>Objective</h4>This study aimed to determine whether antenatal care received from a skilled provider could reduce neonatal mortality in Southern Asia by systematically reviewing existing evidence.<h4>Study design</h4>Seven databases were searched (MEDLINE, Embase, Cochrane Library, CINAHL, PubMed, PsycINFO, and International Bibliography of the Social Sciences [IBSS]). The key words included: "neonatal mortality," "antenatal care," and "Southern Asia." Nonrandomized comparative studies conducted in Southern Asia reporting on neonatal mortality in women who received antenatal care compared with those who did not were included. Two authors carried out the screening and data extraction. The Risk of Bias Assessment tool for Non-randomized Studies (RoBANS) was used to assess quality of studies. Results were reported using a random-effects model based on odds ratios with 95% confidence intervals.<h4>Results</h4>Four studies were included in a meta-analysis of adjusted results. The pooled odds ratio was 0.46 (95% confidence interval, 0.24 to 0.86) for neonatal deaths among women having at least 1 antenatal care visit during pregnancy compared with women having none. In the final meta-analysis, 16 studies could not be included because of lack of adjustment for confounders, highlighting the need for further higher-quality studies to evaluate the true impact.<h4>Conclusion</h4>This review suggests that in Southern Asia, neonates born to women who received antenatal care have a lower risk of death in the neonatal period compared with neonates born to women who did not receive antenatal care. This should encourage health policy to strengthen antenatal care programs in Southern Asia.

Item Type: Article
Uncontrolled Keywords: Southern Asia, antenatal care, maternal health services, neonatal death, neonatal mortality, prenatal care
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 04 Jan 2023 09:48
Last Modified: 04 Jan 2023 09:48
DOI: 10.1016/j.xagr.2022.100128
Open Access URL: https://doi.org/10.1016/j.xagr.2022.100128
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3166822