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Hospital Births More Than Halve Neonatal Deaths in China

Proportion of neonatal deaths prevented by birth in hospital ranged from 48 to 70 percent

FRIDAY, Sept. 16 (HealthDay News) -- The implementation of a large-scale, facility-based strategy of intrapartum care and hospital births significantly reduced neonatal mortality in China between 1996 and 2008, according to a study published online Sept. 16 in The Lancet.

Xing Lin Feng, Ph.D., from the Peking University in Beijing, and colleagues examined the effect of an institutional strategy of intrapartum care on neonatal mortality in urban and rural China. Data from 1996 to 2008 were collected from 116 surveillance sites in China (37 urban districts and 79 rural counties), and used to calculate the relative risk of neonatal mortality by cause, socioeconomic region, and place of birth. Rural counties were categorized into four types (type 1 to 4, from most to least developed). The attributable risks and preventable fractions were compared for hospital and home births.

The investigators identified a decrease of 62 percent in neonatal mortality between 1996 and 2008. Hospital births had much lower rates of neonatal mortality than home births in all regions, with relative risks (RRs) ranging from 0.30 (type 2 rural) to 0.52 (type 4) in rural counties. Hospital births were associated with 48 to 70 percent fewer neonatal deaths. The neonatal mortality rate was lower in babies born in urban hospitals (5.7 per 1,000 live births), and almost four times higher among those born in type 4 rural hospitals (RR, 3.80).

"The major effect of China's facility-based strategy on neonatal mortality is much greater than that reported for community-based interventions," the authors write.

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