Table 1.
Meta-analyses focusing on interventions to reduce perinatal mortality.
| Period of intervention | Intervention n name | Year of meta-analysis | Publication year of included studies | Number of studies included | Types of trials included | Number of participants | Effects studied & size (95% CI) |
|---|---|---|---|---|---|---|---|
| Antenatal | Antenatal care [25] | 2018 | 2009–2017 | 18 | Cross sectional & case-control studies | 94,118 neonates | NM RR = 0.66 (0.54–0.80) |
| Antenatal care, sub-Saharan Africa [26] | 2019 | 2009–2019 | 12 | Cohort & cross-sectional studies | 79,990 neonates | NM RR = 0.61 (0.43–0.86) | |
| Birth interval < 18 months [28] | 2013 | 1982–2004 | 5 | Cohort studies | 32,670 neonates | SGA OR = 1.51 (1.31–1.75) Prematurity OR = 1.58 (1.19–2.10) NM OR = 1.49 (0.93–2.37) IM OR = 1.83 (1.19–2.81) |
|
| Tetanus toxoid vaccination [29] | 2010 | 1966–1998 | 2 | RCT & cohort study | 2146 neonates | NM from tetanus infection RR = 0.06 (0.02–0.2) | |
| Nutrition education [34] | 2015 | 1973–2014 | 17 | RCT | 9030 women | Prematurity RR = 0.46 (0.21–0.98) LBW RR = 0.04 (0.01–0.14) |
|
| Iron supplementation [35] | 2015 | 1947–2012 | 61 | RCT & quasi-RCT | 43,274 women | LBW RR = 0.84 (0.69–1.03) Prematurity RR = 0.93 (0.84–1.03) NM RR = 0.91 (0.71–1.18) |
|
| Vitamin A supplementation [36] | 2015 | 1993–2011 | 19 | RCT, quasi-RCT, & cluster RCT | 310,000 women | PM RR = 1.01 (0.95–1.07) NM RR = 0.98 (0.94–1.01) |
|
| Vitamin C supplementation [37] | 2015 | 1966–2014 | 29 | RCT & quasi-RCT | 24,300 women | SB RR = 1.15 (0.89–1.49) PM RR = 1.07 (0.77–1.49) NM RR = 0.79 (0.58–1.08) |
|
| Vitamin D supplementation [38] | 2019 | 1980–2017 | 30 | RCT, quasi-RCT, & cluster RCT | 7033 women | Prematurity RR = 0.66 (0.34–1.34) LBW RR = 0.55 (0.35–0.87) |
|
| Multi-micronutrient supplementation [39] | 2019 | 1975–2014 | 21 | RCT | 142,496 women | Very preterm neonates RR = 0.81(0.71–0.93) SGA RR = 0.92 (0.88–0.97) LBW RR = 0.88 (0.85–0.91) Prematurity RR = 0.95 (0.90–1.01) SB RR = 0.95 (0.86–1.04) PM RR = 1.00 (0.90–1.11) NM RR = 1.00 (0.89–1.12) |
|
| Delivery | Basic neonatal resuscitation [42] | 2011 | 1985–2011 | 24 | Observational, quasi-experimental, & cluster RCT | 392,506 neonates | Intrapartum-related deaths RR = 0.70 (0.59–0.84) |
| Basic neonatal resuscitation [43] | 2017 | 1990–2016 | 20 | RCT, quasi-RCT, interrupted time series, & before–after studies | 1,653,805 neonates | SB RR = 0.79 (0.44–1.41) 7-day NM RR = 0.53 (0.38–0.73) 28-day NM RR = 0.50 (0.37–0.68) PM RR = 0.63 (0.42–0.94) |
|
| Skilled birth attendant [45] | 2011 | 1989–2008 | 21 | Pre-post cohort studies | Not mentioned | SB RR = 0.77 (0.69–0.85) | |
| Clean delivery practices [46] | 2011 | 1991–2010 | 38 | Case-control & cohort studies | Not mentioned | Provider handwashing & NM RR = 0.19 (0.01–0.34) Maternal handwashing & NM RR = 0.44 (0.18–0.62) |
|
| Health facility delivery [59] | 2013 | 1996–2012 | 19 | Cohort & cross-sectional studies | 1,606,805 neonates | NM RR = 0.71 (0.54–0.87) | |
| Health facility delivery [60] | 2019 | 2010–2017 | 19 | Cohort & cross-sectional studies | 1,046,362 neonates | NM OR = 0.48 (0.38–0.58) | |
| Post Delivery & Neonatal | Umbilical cord chlorhexidine application [61] | 2016 | 2006–2013 | 6 | RCT, quasi-RCT, & cluster RCT | 59,179 neonates | NM RR = 0.85 (0.76–0.95) Omphalitis RR = 0.71 (0.62–0.81) |
| Exclusive breastfeeding [62] | 2015 | 1982–2011 | 11 | Observational studies | 70,976 neonates | NM OR = 3.67 (2.04–6.61) | |
| Kangaroo mother care [63] | 2016 | 1988–2016 | 21 | RCT | 3041 neonates | NM RR = 0.60 (0.39–0.92) Sepsis RR = 0.35 (0.22–0.54) Hypothermia RR = 0.28 (0.16–0.49) |
|
| Kangaroo mother care [64] | 2016 | 1988–2014 | 124 | RCT & observational studies | Not mentioned | NM RR = 0.64 (0.46–0.89) Sepsis RR = 0.53 (0.34–0.83) Hypothermia RR = 0.22 (0.12–0.41) |
|
| Combined Antenatal &Postnatal | Education [65] | 2019 | 1995–2017 | 33 | RCT, quasi-RCT, & cluster RCT | Not mentioned | NM RR = 0.87 (0.78–0.96) Early NM RR = 0.74 (0.66–0.84) Late NM RR = 0.54 (0.40–0.74) PM RR = 0.83 (0.75–0.91) |
| Education [66] | 2011 | 2008–2011 | 4 | RCT | 57270 neonates | NM OR = 0.81 (0.75–0.88) Early NM OR = 0.80 (0.70–0.91) Late NM OR = 0.79 (0.63–0.99) |
|
| Education [67] | 2017 | 2001–2017 | 17 | Cluster-RCT | Not mentioned | NM RR = 0.75 (0.69–0.80) | |
| Home based antenatal & neonatal care [69] | 2016 | 2008–2012 | 5 | Cluster-RCT | 101,655 neonates | NM RR = 0.75 (0.61–0.92) PM RR = 0.78 (0.64–0.94) |
SGA = small for gestational age, LBW = low birth weight, SB = stillbirth, PM = perinatal mortality, NM = neonatal mortality, IM = infant mortality, OR = odds ratio, RR = risk ratio.