Moldova

Newborn care program promises great success in reducing stillborn births

February 20, 2010

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By Jessica Berman

A pilot program promoting newborn care promises to dramatically reduce the number of stillborn births worldwide.

The study by U.S. researchers looked at the effectiveness of a newborn care program developed by the World Health Organization (WHO), and found that it reduced by more than one-third the number of newborn stillbirths in six countries where it was tried.

A baby that dies immediately after birth or within the first week is considered stillborn.

The WHO estimates there are three million stillbirths globally each year, while an additional four million infants die within the first month of life.

Experts say training nurses and birth attendants in techniques of the program, called Essential Newborn Care, could save one million lives each year.

The leading cause of newborn death is the failure of the infants to begin breathing on their own immediately following birth, according to Waldemar Carlo, a neonatologist at the University of Alabama in Birmingham.

Carlo says the newborn care program teaches resuscitation techniques using hand-held pumps and masks to fill the babies' lungs with oxygen.

"We have trained them to help babies breathe at birth," he said. "And then we have trained them in other very essential care including keeping them [newborns] warm right after birth in the first few hours, starting breastfeeding early, special care for small babies and other aspects that are considered essential."

For the study, India, Pakistan, the Democratic Republic of the Congo, Guatemala, Argentina and Zambia each sent a health care worker to the United States to be trained in the Essential Newborn Care regimen.

Upon completion of the training, the workers returned to their countries to teach the techniques to 3,600 birth-care personnel in rural communities.

A study of the effectiveness birth techniques, involving 120,000 births, showed the rate of stillbirths dropped from 23 per 1,000 deliveries to just under 16 stillborn babies per 1,000 births.

Carlo said the Essential Newborn Care regimen could significantly reduce newborn mortality if applied on a global scale.

"The training is very basic," he said. "That it has the potential to substantially decrease the mortality maybe by as many as one million babies per year."

The study by Waldemar Carlo and colleagues was published in this week's New England Journal of Medicine.

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