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首页> 美国卫生研究院文献>British Medical Journal >Effectiveness of strategies incorporating training and support of traditional birth attendants on perinatal and maternal mortality: meta-analysis
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Effectiveness of strategies incorporating training and support of traditional birth attendants on perinatal and maternal mortality: meta-analysis

机译：结合传统助产士围产期和产妇死亡率的培训和支持的策略的有效性：荟萃分析

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>Objective To assess the effectiveness of strategies incorporating training and support of traditional birth attendants on the outcomes of perinatal, neonatal, and maternal death in developing countries.>Design Systematic review with meta-analysis.>Data sources Medline, Embase, the Allied and Complementary Medicine database, British Nursing Index, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, BioMed Central, PsycINFO, Latin American and Caribbean Health Sciences Literature database, African Index Medicus, Web of Science, Reproductive Health Library, and Science Citation Index (from inception to April 2011), without language restrictions. Search terms were “birth attend*”, “traditional midwife”, “lay birth attendant”, “dais”, and “comadronas”. >Review methods We selected randomised and non-randomised controlled studies with outcomes of perinatal, neonatal, and maternal mortality. Two independent reviewers undertook data extraction. We pooled relative risks separately for the randomised and non-randomised controlled studies, using a random effects model.>Results We identified six cluster randomised controlled trials (n=138 549) and seven non-randomised controlled studies (n=72 225) that investigated strategies incorporating training and support of traditional birth attendants. All six randomised controlled trials found a reduction in adverse perinatal outcomes; our meta-analysis showed significant reductions in perinatal death (relative risk 0.76, 95% confidence interval 0.64 to 0.88, P<0.001; number needed to treat 35, 24 to 70) and neonatal death (0.79, 0.69 to 0.88, P<0.001; 98, 66 to 170). Meta-analysis of the non-randomised studies also showed a significant reduction in perinatal mortality (0.70, 0.57 to 0.84, p<0.001; 48, 32 to 96) and neonatal mortality (0.61, 0.48 to 0.75, P<0.001; 96, 65 to 168). Six studies reported on maternal mortality and our meta-analysis showed a non-significant reduction (three randomised trials, relative risk 0.79, 0.53 to 1.05, P=0.12; three non-randomised studies, 0.80, 0.44 to 1.15, P=0.26).>Conclusion Perinatal and neonatal deaths are significantly reduced with strategies incorporating training and support of traditional birth attendants.
机译：>目的，评估在发展中国家对传统接生员进行围产期，新生儿和孕产妇死亡结局培训和支持的策略的有效性。>设计系统评价，采用了分析。>数据来源：Medline，Embase，联合和补充医学数据库，英国护理指数，Cochrane图书馆，护理和联合健康文献累计索引，BioMed Central，PsycINFO，拉丁美洲和加勒比海健康科学文献数据库，Africa Index Medicus，Web of Science，生殖健康图书馆和Science Citation Index（从成立到2011年4月），没有语言限制。搜索词为“接生*”，“传统助产士”，“接生员”，“雏菊”和“ comadronas”。 >审查方法我们选择了围产期，新生儿和孕产妇死亡率结果的随机和非随机对照研究。两名独立的审稿人进行了数据提取。我们使用随机效应模型分别汇总了随机和非随机对照研究的相对风险。>结果我们确定了6项群集随机对照试验（n = 138 549）和7项非随机对照研究（ （n = 72 225）研究了结合传统接生员培训和支持的策略。所有六项随机对照试验均发现围产期不良结局有所减少。我们的荟萃分析显示围产期死亡（相对风险0.76，95％置信区间0.64至0.88，P <0.001；治疗35、24至70所需的数字）和新生儿死亡（0.79，0.69至0.88，P <0.001）显着降低; 98，66 to 170）。对非随机研究的荟萃分析还显示围产期死亡率（0.70，0.57至0.84，p <0.001; 48，32至96）和新生儿死亡率（0.61，0.48至0.75，P <0.001; 96， 65至168）。六项关于孕产妇死亡率的研究和我们的荟萃分析显示无显着降低（三项随机试验，相对风险0.79，0.53至1.05，P = 0.12；三项非随机研究，0.80，0.44至1.15，P = 0.26） 。>结论通过结合培训和支持传统接生员的策略，围产期和新生儿死亡显着减少。

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