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Malherbe HL, Modell B, Blencowe H, Strong KL, Aldous C. A review of key terminology and definitions used for birth defects globally. J Community Genet 2023; 14:241-262. [PMID: 37093545 PMCID: PMC10272040 DOI: 10.1007/s12687-023-00642-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/08/2023] [Indexed: 04/25/2023] Open
Abstract
Birth defects, also known as congenital disorders, are a significant health issue impacting at least five million births annually worldwide. For policymakers to mount a relevant healthcare response to care for those affected, the burden of disease of these conditions must be quantified. Estimates of the contribution of birth defects to under-5 child mortality and morbidity are generated by several groups globally. These estimates often differ, causing confusion for policymakers. While some differences may be attributed to the data sources and methods used, much is due to a lack of clarity in the terminology used for the group of disorders classed as "congenital". This study aimed to gain insight into the diversity of terms and definitions for birth defects, including those used routinely by relevant international/national organisations and in the peer-reviewed literature. This two-part study included (1) scoping review of peer-reviewed literature to identify terms and definitions in use for birth defects and (2) review of key websites and grey literature to identify terms and definitions used. The results of this study indicate a wide variety of terms being used, often interchangeably and undefined, in peer-reviewed publications, on institutional websites and related literature. This suggests a lack of clarity related to terminology and sets the scene for further discussion, recommending that the community of practice working on birth defects comes to a consensus on standard terminology and definitions for global uptake and implementation. Such standardisation will facilitate a common understanding of the burden of these disorders globally, regionally and within countries so that action can be taken to support affected children and their families.
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Affiliation(s)
- H L Malherbe
- Centre for Human Metabolomics, North-West University, North-West Province, Potchefstroom, South Africa.
- Rare Diseases South Africa NPC, The Station, 63 Peter Place, Bryanston, Johannesburg, 2021, Gauteng, South Africa.
| | - B Modell
- University College London, London, UK
| | - H Blencowe
- Centre for Maternal, Adolescent, Reproductive and Child Health, London School of Hygiene and Tropical Medicine, London, UK
| | - K L Strong
- Department of Maternal, Newborn, Child and Adolescent Health and Aging, Health, World Health Organization, Geneva, Switzerland
| | - C Aldous
- School of Clinical Medicine, University of Kwa-Zulu Natal, Durban, South Africa
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2
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Shakespeare C, Merriel A, Bakhbakhi D, Baneszova R, Barnard K, Lynch M, Storey C, Blencowe H, Boyle F, Flenady V, Gold K, Horey D, Mills T, Siassakos D. Parents' and healthcare professionals' experiences of care after stillbirth in low- and middle-income countries: a systematic review and meta-summary. BJOG 2018; 126:12-21. [PMID: 30099831 DOI: 10.1111/1471-0528.15430] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Stillbirth has a profound impact on women, families, and healthcare workers. The burden is highest in low- and middle-income countries (LMICs). There is need for respectful and supportive care for women, partners, and families after bereavement. OBJECTIVE To perform a qualitative meta-summary of parents' and healthcare professionals' experiences of care after stillbirth in LMICs. SEARCH STRATEGY Search terms were formulated by identifying all synonyms, thesaurus terms, and variations for stillbirth. Databases searched were AMED, EMBASE, MEDLINE, PsychINFO, BNI, CINAHL. SELECTION CRITERIA Qualitative, quantitative, and mixed method studies that addressed parents' or healthcare professionals' experience of care after stillbirth in LMICs. DATA COLLECTION AND ANALYSIS Studies were screened, and data extracted in duplicate. Data were analysed using the Sandelowski meta-summary technique that calculates frequency and intensity effect sizes (FES/IES). MAIN RESULTS In all, 118 full texts were screened, and 34 studies from 17 countries were included. FES range was 15-68%. Most studies had IES 1.5-4.5. Women experience a broad range of manifestations of grief following stillbirth, which may not be recognised by healthcare workers or in their communities. Lack of recognition exacerbates negative experiences of stigmatisation, blame, devaluation, and loss of social status. Adequately developed health systems, with trained and supported staff, are best equipped to provide the support and information that women want after stillbirth. CONCLUSIONS Basic interventions could have an immediate impact on the experiences of women and their families after stillbirth. Examples include public education to reduce stigma, promoting the respectful maternity care agenda, and investigating stillbirth appropriately. TWEETABLE ABSTRACT Reducing stigma, promoting respectful care and investigating stillbirth have a positive impact after stillbirth for women and families in LMICs.
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Affiliation(s)
- C Shakespeare
- School of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Department of Women and Children's Health, The Chilterns, Southmead Hospital, Bristol, UK
| | - A Merriel
- School of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Department of Women and Children's Health, The Chilterns, Southmead Hospital, Bristol, UK
| | - D Bakhbakhi
- School of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Department of Women and Children's Health, The Chilterns, Southmead Hospital, Bristol, UK
| | - R Baneszova
- 2nd Department of Obstetrics and Gynaecology, Faculty of Medicine, University Hospital Bratislava, Comenius University, Bratislava, Slovakia
| | - K Barnard
- Library and Knowledge Service, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - M Lynch
- Department of Women and Children's Health, The Chilterns, Southmead Hospital, Bristol, UK
| | - C Storey
- International Stillbirth Alliance, Bristol, UK
| | - H Blencowe
- London School of Hygiene and Tropical Medicine, London, UK
| | - F Boyle
- Centre of Research Excellence in Stillbirth, Mater Research Institute, University of Queensland, South Brisbane, Qld, Australia
| | - V Flenady
- Centre of Research Excellence in Stillbirth, Mater Research Institute, University of Queensland, South Brisbane, Qld, Australia
| | - K Gold
- Department of Medicine, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - D Horey
- La Trobe University, Bundoora, Vic., Australia
| | - T Mills
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
| | - D Siassakos
- School of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,Department of Women and Children's Health, The Chilterns, Southmead Hospital, Bristol, UK
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Moorthie S, Blencowe H, Darlison MW, Lawn J, Morris JK, Modell B, Bittles AH, Blencowe H, Christianson A, Cousens S, Darlison MW, Gibbons S, Hamamy H, Khoshnood B, Howson CP, Lawn J, Mastroiacovo P, Modell B, Moorthie S, Morris JK, Mossey PA, Neville AJ, Petrou M, Povey S, Rankin J, Schuler-Faccini L, Wren C, Yunnis KA. Estimating the birth prevalence and pregnancy outcomes of congenital malformations worldwide. J Community Genet 2018; 9:387-396. [PMID: 30218347 PMCID: PMC6167261 DOI: 10.1007/s12687-018-0384-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 08/29/2018] [Indexed: 12/22/2022] Open
Abstract
Congenital anomaly registries have two main surveillance aims: firstly to define baseline epidemiology of important congenital anomalies to facilitate programme, policy and resource planning, and secondly to identify clusters of cases and any other epidemiological changes that could give early warning of environmental or infectious hazards. However, setting up a sustainable registry and surveillance system is resource-intensive requiring national infrastructure for recording all cases and diagnostic facilities to identify those malformations that that are not externally visible. Consequently, not all countries have yet established robust surveillance systems. For these countries, methods are needed to generate estimates of prevalence of these disorders which can act as a starting point for assessing disease burden and service implications. Here, we describe how registry data from high-income settings can be used for generating reference rates that can be used as provisional estimates for countries with little or no observational data on non-syndromic congenital malformations.
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Affiliation(s)
| | - Hannah Blencowe
- Centre for Maternal, Adolescent, Reproductive, and Child Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Matthew W Darlison
- Centre for Health Informatics and Multiprofessional Education (CHIME), University College London, London, UK.
| | - Joy Lawn
- Centre for Maternal, Adolescent, Reproductive, and Child Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Joan K Morris
- Centre for Environmental and Preventive Medicine, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Bernadette Modell
- Centre for Health Informatics and Multiprofessional Education (CHIME), University College London, London, UK
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Ateva E, Blencowe H, Castillo T, Dev A, Farmer M, Kinney M, Mishra SK, Hopkins Leisher S, Maloney S, Ponce Hardy V, Quigley P, Ruidiaz J, Siassakos D, Stoner JE, Storey C, Tejada de Rivero Sawers ML. Every Woman, Every Child's 'Progress in Partnership' for stillbirths: a commentary by the stillbirth advocacy working group. BJOG 2018; 125:1058-1060. [PMID: 29285881 DOI: 10.1111/1471-0528.15113] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2017] [Indexed: 11/26/2022]
Affiliation(s)
- E Ateva
- White Ribbon Alliance, Washington, DC, USA
| | - H Blencowe
- MARCH Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - T Castillo
- HealthRight International, New York, NY, USA
| | - A Dev
- Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - M Farmer
- NCD Child, Elk Grove Village, IL, USA
| | - M Kinney
- Save the Children, Cape Town, South Africa
| | - S K Mishra
- AIHMS Ansul-India Health & Management Services, New Delhi, India
| | | | - S Maloney
- UNMC College of Public Health, Omaha, NE, USA
| | - V Ponce Hardy
- MARCH Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - P Quigley
- Health Partners International, Lewes, UK
| | - J Ruidiaz
- Fundación Era en Abril, Buenos Aires, Argentina
| | - D Siassakos
- International Stillbirth Alliance, Bristol, UK.,University of Bristol and Southmead Hospital, Bristol, UK
| | - J E Stoner
- Eastern Virginia Medical School, Brock Institute for Global and Community Health, Norfolk, VA, USA
| | - C Storey
- International Stillbirth Alliance, Bristol, UK
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Reinebrant HE, Leisher SH, Coory M, Henry S, Wojcieszek AM, Gardener G, Lourie R, Ellwood D, Teoh Z, Allanson E, Blencowe H, Draper ES, Erwich JJ, Frøen JF, Gardosi J, Gold K, Gordijn S, Gordon A, Heazell A, Khong TY, Korteweg F, Lawn JE, McClure EM, Oats J, Pattinson R, Pettersson K, Siassakos D, Silver RM, Smith G, Tunçalp Ö, Flenady V. Making stillbirths visible: a systematic review of globally reported causes of stillbirth. BJOG 2017; 125:212-224. [PMID: 29193794 DOI: 10.1111/1471-0528.14971] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND Stillbirth is a global health problem. The World Health Organization (WHO) application of the International Classification of Diseases for perinatal mortality (ICD-PM) aims to improve data on stillbirth to enable prevention. OBJECTIVES To identify globally reported causes of stillbirth, classification systems, and alignment with the ICD-PM. SEARCH STRATEGY We searched CINAHL, EMBASE, Medline, Global Health, and Pubmed from 2009 to 2016. SELECTION CRITERIA Reports of stillbirth causes in unselective cohorts. DATA COLLECTION AND ANALYSIS Pooled estimates of causes were derived for country representative reports. Systems and causes were assessed for alignment with the ICD-PM. Data are presented by income setting (low, middle, and high income countries; LIC, MIC, HIC). MAIN RESULTS Eighty-five reports from 50 countries (489 089 stillbirths) were included. The most frequent categories were Unexplained, Antepartum haemorrhage, and Other (all settings); Infection and Hypoxic peripartum (LIC), and Placental (MIC, HIC). Overall report quality was low. Only one classification system fully aligned with ICD-PM. All stillbirth causes mapped to ICD-PM. In a subset from HIC, mapping obscured major causes. CONCLUSIONS There is a paucity of quality information on causes of stillbirth globally. Improving investigation of stillbirths and standardisation of audit and classification is urgently needed and should be achievable in all well-resourced settings. Implementation of the WHO Perinatal Mortality Audit and Review guide is needed, particularly across high burden settings. FUNDING HR, SH, SHL, and AW were supported by an NHMRC-CRE grant (APP1116640). VF was funded by an NHMRC-CDF (APP1123611). TWEETABLE ABSTRACT Urgent need to improve data on causes of stillbirths across all settings to meet global targets. PLAIN LANGUAGE SUMMARY Background and methods Nearly three million babies are stillborn every year. These deaths have deep and long-lasting effects on parents, healthcare providers, and the society. One of the major challenges to preventing stillbirths is the lack of information about why they happen. In this study, we collected reports on the causes of stillbirth from high-, middle-, and low-income countries to: (1) Understand the causes of stillbirth, and (2) Understand how to improve reporting of stillbirths. Findings We found 85 reports from 50 different countries. The information available from the reports was inconsistent and often of poor quality, so it was hard to get a clear picture about what are the causes of stillbirth across the world. Many different definitions of stillbirth were used. There was also wide variation in what investigations of the mother and baby were undertaken to identify the cause of stillbirth. Stillbirths in all income settings (low-, middle-, and high-income countries) were most frequently reported as Unexplained, Other, and Haemorrhage (bleeding). Unexplained and Other are not helpful in understanding why a baby was stillborn. In low-income countries, stillbirths were often attributed to Infection and Complications during labour and birth. In middle- and high-income countries, stillbirths were often reported as Placental complications. Limitations We may have missed some reports as searches were carried out in English only. The available reports were of poor quality. Implications Many countries, particularly those where the majority of stillbirths occur, do not report any information about these deaths. Where there are reports, the quality is often poor. It is important to improve the investigation and reporting of stillbirth using a standardised system so that policy makers and healthcare workers can develop effective stillbirth prevention programs. All stillbirths should be investigated and reported in line with the World Health Organization standards.
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Affiliation(s)
- H E Reinebrant
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland (MRI-UQ), Brisbane, QLD, Australia.,International Stillbirth Alliance, Bristol, UK
| | - S H Leisher
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland (MRI-UQ), Brisbane, QLD, Australia.,International Stillbirth Alliance, Bristol, UK
| | - M Coory
- Murdoch Childrens Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia
| | - S Henry
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland (MRI-UQ), Brisbane, QLD, Australia.,International Stillbirth Alliance, Bristol, UK
| | - A M Wojcieszek
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland (MRI-UQ), Brisbane, QLD, Australia.,International Stillbirth Alliance, Bristol, UK
| | - G Gardener
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland (MRI-UQ), Brisbane, QLD, Australia.,International Stillbirth Alliance, Bristol, UK
| | - R Lourie
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland (MRI-UQ), Brisbane, QLD, Australia.,Translational Research Institute, Brisbane, QLD, Australia
| | - D Ellwood
- Griffith University School of Medicine, Gold Coast, QLD, Australia.,Gold Coast University Hospital, Gold Coast, QLD, Australia
| | - Z Teoh
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland (MRI-UQ), Brisbane, QLD, Australia.,Department of Medicine-Pediatrics, University of Louisville, Louisville, KY, USA
| | - E Allanson
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland.,School of Women's and Infants' Health, Faculty of Medicine, Dentistry and Health Sciences, University of Western Australia, Perth, WA, Australia
| | - H Blencowe
- London School of Hygiene & Tropical Medicine, London, UK
| | - E S Draper
- MBRRACE-UK, Department of Health Sciences, University of Leicester Centre for Medicine, Leicester, UK
| | - J J Erwich
- International Stillbirth Alliance, Bristol, UK.,University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - J F Frøen
- Norwegian Institute of Public Health, Oslo, Norway.,Centre for Intervention Science in Maternal and Child Health (CISMAC), University of Bergen, Bergen, Norway
| | | | - K Gold
- International Stillbirth Alliance, Bristol, UK.,Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA.,Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - S Gordijn
- International Stillbirth Alliance, Bristol, UK.,University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - A Gordon
- University of Sydney, Sydney, NSW, Australia
| | - Aep Heazell
- Division of Developmental Biomedicine, Faculty of Medical and Human Sciences, University of Manchester, Manchester, UK.,St Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - T Y Khong
- SA Pathology, Women's and Children's Hospital, North Adelaide, SA, Australia
| | - F Korteweg
- Department of Obstetrics and Gynecology, Martini Hospital, Groningen, the Netherlands
| | - J E Lawn
- London School of Hygiene & Tropical Medicine, London, UK
| | - E M McClure
- International Stillbirth Alliance, Bristol, UK.,Department of Social, Statistical and Environmental Health Sciences, Research Triangle Institute, Research Triangle Park, NC, USA
| | - J Oats
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic., Australia.,Consultative Council on Obstetric and Paediatric Mortality and Morbidity (CCOPMM), Melbourne, Vic., Australia
| | - R Pattinson
- Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria, South Africa
| | - K Pettersson
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - D Siassakos
- International Stillbirth Alliance, Bristol, UK.,Obstetrics and Gynaecology, School of Social and Community Medicine, Southmead Hospital, University of Bristol, Bristol, UK
| | - R M Silver
- University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Gcs Smith
- Department of Obstetrics and Gynaecology, NIHR Cambridge Comprehensive Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - Ö Tunçalp
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - V Flenady
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland (MRI-UQ), Brisbane, QLD, Australia.,International Stillbirth Alliance, Bristol, UK
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Oatley HK, Blencowe H, Lawn JE. The effect of coverings, including plastic bags and wraps, on mortality and morbidity in preterm and full-term neonates. J Perinatol 2016; 36 Suppl 1:S83-9. [PMID: 27109095 PMCID: PMC4848741 DOI: 10.1038/jp.2016.35] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 11/24/2015] [Indexed: 01/21/2023]
Abstract
Neonatal hypothermia is an important risk factor for mortality and morbidity, and is common even in temperate climates. We conducted a systematic review to determine whether plastic coverings, used immediately following delivery, were effective in reducing the incidence of mortality, hypothermia and morbidity. A total of 26 studies (2271 preterm and 1003 term neonates) were included. Meta-analyses were conducted as appropriate. Plastic wraps were associated with a reduction in hypothermia in preterm (⩽29 weeks; risk ratio (RR)=0.57; 95% confidence interval (CI) 0.46 to 0.71) and term neonates (RR=0.76; 95% CI 0.60 to 0.96). No significant reduction in neonatal mortality or morbidity was found; however, the studies were underpowered for these outcomes. For neonates, especially preterm, plastic wraps combined with other environmental heat sources are effective in reducing hypothermia during stabilization and transfer within hospital. Further research is needed to quantify the effects on mortality or morbidity, and investigate the use of plastic coverings outside hospital settings or without additional heat sources.
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Affiliation(s)
- H K Oatley
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - H Blencowe
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
- Centre for Maternal, Reproductive & Child Health, London School of Hygiene & Tropical Medicine, London, UK
| | - J E Lawn
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
- Centre for Maternal, Reproductive & Child Health, London School of Hygiene & Tropical Medicine, London, UK
- Saving Newborn Lives, Save the Children, Washington, DC, USA
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Abstract
Reducing neonatal mortality remains a challenge with an estimated 3.0 million neonatal deaths in 2011, three-quarters of these in sub-Saharan Africa and Southern Asia. The leading causes of neonatal death globally are complications of preterm birth, intrapartum-related causes and infections. While post-neonatal, under-5 deaths fell by 47% between 1990 and 2011, neonatal deaths only fell by 32% and they now account for 43% of all under-5 child deaths. This article reviews the progress in reducing neonatal deaths in high-burden countries and presents an overview of known effective interventions to reduce neonatal mortality and the challenges faced in implementing these in high-burden settings. Effective action is possible to reduce neonatal mortality, but innovative approaches to implementation will be required if these preventable deaths are to be avoided.
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Affiliation(s)
- H Blencowe
- London School of Hygiene and Tropical Medicine, London, UK.
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van den Heuvel M, Blencowe H, Mittermayer K, Rylance S, Couperus A, Heikens GT, Bandsma RHJ. Introduction of bubble CPAP in a teaching hospital in Malawi. ACTA ACUST UNITED AC 2011; 31:59-65. [PMID: 21262111 DOI: 10.1179/1465328110y.0000000001] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Continuous positive airway pressure (CPAP) is relatively inexpensive and can be easily taught; it therefore has the potential to be the optimal respiratory support device for neonates in developing countries. OBJECTIVE The possibility of implementing bubble CPAP in a teaching hospital with a large neonatology unit but very limited resources was investigated. METHODS A CPAP system was developed consisting of a compressor, oxygen concentrator, water bottle to control the pressure and binasal prongs. Neonates with birthweights between 1 and 2·5 kg with persistent respiratory distress 4 hours after birth were eligible for bubble CPAP. RESULTS In the 7-week introduction period from 11 March until 27 April 2008, 11 neonates were treated with CPAP. Five of these neonates met the inclusion criteria and six neonates did not meet these criteria. Of the five neonates who received CPAP and met the inclusion criteria, three survived. The six infants who did not meet the inclusion criteria included three preterm infants with apnoea (all died), two with birthweights <1 kg (both died) and a firstborn twin (1.2 kg) who survived. No major complications of CPAP occurred. Bubble CPAP could be used independently by nurses after a short training period. CONCLUSION Successful long-term implementation of CPAP depends on the availability of sufficient trained nursing staff.
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Blencowe H, Molyneux EM. Setting up kangaroo mother care at Queen Elizabeth Central Hospital, Blantyre - a practical approach. Malawi Med J 2005. [DOI: 10.4314/mmj.v17i2.10873] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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