scholarly journals The impact of implementing the 2016 WHO Recommendations on Antenatal Care for a Positive Pregnancy Experience on perinatal deaths: an interrupted time-series analysis in Mpumalanga province, South Africa

2020 ◽  
Vol 5 (12) ◽  
pp. e002965
Author(s):  
Tina Lavin ◽  
Robert Clive Pattinson ◽  
Erin Kelty ◽  
Yogan Pillay ◽  
David Brian Preen
Keyword(s):  
Time Series ◽  
Time Series Analysis ◽  
Perinatal Mortality ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Neonatal Deaths ◽  
Series Analysis ◽  
Before And After ◽  
Implementation Period ◽  
Early Neonatal Deaths

ObjectivesTo investigate if the implementation of the 2016 WHO Recommendations for a Positive Pregnancy Experience reduced perinatal mortality in a South African province. The recommendations were implemented which included increasing the number of contacts and also the content of the contacts.MethodsRetrospective interrupted time-series analysis was conducted for all women accessing a minimum of one antenatal care contact from April 2014 to September 2019 in Mpumalanga province, South Africa. Retrospective interrupted time-series analysis of province level perinatal mortality and birth data comparing the pre-implementation period (April 2014–March 2017) and post-implementation period (April 2018–September 2019). The main outcome measure was unadjusted prevalence ratio (PR) for perinatal deaths before and after implementation; interrupted time-series analyses for trends in perinatal mortality before and after implementation; stillbirth risk by gestational age; primary cause of deaths (and maternal condition) before and after implementation.ResultsOverall, there was a 5.8% absolute decrease in stillbirths after implementation of the recommendations, however this was not statistically significant (PR 0.95, 95% CI 0.90% to 1.05%; p=0.073). Fresh stillbirths decreased by 16.6% (PR 0.86, 95% CI 0.77% to 0.95%; p=0.003) while macerated stillbirths (p=0.899) and early neonatal deaths remained unchanged (p=0.499). When stratified by weight fresh stillbirths >2500 g decreased by 17.2% (PR 0.81, 95% CI 0.70% to 0.94%; p=0.007) and early neonatal deaths decreased by 12.8% (PR 0.88, 95% CI 0.77% to 0.99%; p=0.041). The interrupted time-series analysis confirmed a trend for decreasing stillbirths at 0.09/1000 births per month (−0.09, 95% CI −1.18 to 0.01; p=0.059), early neonatal deaths (−0.09, 95% CI −0.14 to 0.04; p=<0.001) and perinatal mortality (−1.18, 95% CI −0.27 to −0.09; p<0.001) in the post-implementation period. A decrease in stillbirths, early neonatal deaths or perinatal mortality was not observed in the pre-implementation period. During the period when additional antenatal care contacts were implemented (34–38 weeks), there was a decrease in stillbirths of 18.4% (risk ratio (RR) 0.82, 95% CI 0.73% to 0.91%, p=0.0003). In hypertensive disorders of pregnancy, the risk of stillbirth decreased in the post-period by 15.1% (RR 0.85; 95% CI 0.76% to 0.94%; p=0.002).ConclusionThe implementation of the 2016 WHO Recommendations for a Positive Pregnancy Experience may be an effective public health strategy to reduce stillbirths in South African provinces.

scholarly journals England's Lockdown vs. Sweden's Herd Immunity: A Comparison of the Daily New COVID-19 Cases and Related Deaths Using Comparative Interrupted Time Series Analysis

2020 ◽  
Author(s):  
Moaath Mustafa Ali ◽  
Yazan Samhouri ◽  
Marwa Sabha ◽  
Lynna Alnimer
Keyword(s):  
Time Series ◽  
Time Series Analysis ◽  
Herd Immunity ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Post Intervention ◽  
Series Analysis ◽  
Before And After ◽  
Rebound Increase ◽  
Related Mortality

Background: There is a lack of empirical evidence that lockdowns decrease daily cases of COVID-19 and related mortality compared to herd immunity. England implemented a delayed lockdown on March 23, 2020, but Sweden did not. We aim to examine the effect of lockdown on daily COVID-19 cases and related deaths during the first 100 days post-lockdown. Methods: We compared daily cases of COVID-19 infection and related mortality in England and Sweden before and after lockdown intervention using a comparative-interrupted time series analysis. The period included was from COVID-19 pandemic onset till June 30, 2020. Results: The adjusted-rate of daily COVID-19 infections was eight cases/10,000,000 person higher in England than Sweden before lockdown order (95% CI: 2-14, P=0.01). On the day of intervention (lagged lockdown), England had 693 more COVID-19 cases/10,000,000 person compared to Sweden (95% CI: 467-920, P<0.001). Compared to the pre-intervention period, the adjusted daily confirmed cases rate decreased by 19 cases/ 10,000,000 person compared to Sweden (95% CI: 13-26, P<0.001). There was a rate excess of 1.5 daily deaths/ 10,000,000 person in England compared to Sweden pre-intervention (95% CI: 1-2, P<0.001). The increased mortality rate resulted in 50 excess deaths/ 10,000,000 person related to COVID-19 in England compared to Sweden on the day of lockdown (95% CI: 30-71, P<0.001). Post-intervention, the rate of daily deaths in England decreased by two deaths/ 10,000,000 person compared to Sweden (95% CI: 1-3, P<0.001). During phases one and two of lockdown lifting in England, there was no rebound increase in daily cases or deaths compared to Sweden. Conclusion: The lockdown order implemented in England on March 23, 2020, effectively decreased the daily new cases rate and related mortality compared to Sweden. There was no short-term increase in COVID-19 cases and related-deaths after the phases one and two of the lifting of restrictions in England compared to Sweden. This study provides empirical, comparative evidence that lockdowns slow the spread of COVID-19 in communities compared to herd immunity.

Introduction to ITSA

2019 ◽  
pp. 1-10
Author(s):  
David McDowall ◽  
Richard McCleary ◽  
Bradley J. Bartos
Keyword(s):  
Time Series ◽  
Time Series Analysis ◽  
Causal Inference ◽  
Essential Role ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Series Analysis ◽  
Before And After

Chapter 1 introduces Interrupted Time Series Analysis (ITSA) as a toolbox for researchers whose data consist of a long sequence of observations | say, N ≥15 observations | measured before and after a treatment or intervention. Sometimes the treatment or intervention is implemented by the researcher, other times it occurs naturally or by accident. The chapter also describes a family of impact types, characterized by their onset (abrupt or gradual) and duration (permanent or temporary); and the essential role of counterfactual controls in causal inference. The chapter concludes with an outline and summary of the book's subsequent chapters.

scholarly journals Interrupted Time Series Analysis of Changes in Zolpidem Use Due to Media Broadcasts

2021 ◽  
Vol 18 (10) ◽  
pp. 5114
Author(s):  
Bo-Ram Yang ◽  
Kyu-Nam Heo ◽  
Yun Mi Yu ◽  
Ga-Bin Yeom ◽  
Hye Duck Choi ◽  
...  
Keyword(s):  
Time Series ◽  
Time Series Analysis ◽  
Suicide Risk ◽  
Interrupted Time Series ◽  
Prescription Rate ◽  
Interrupted Time Series Analysis ◽  
Series Analysis ◽  
Public Media ◽  
Before And After ◽  
National Patient

Media has become a major source of information on health and plays a role in the decision-making process on health topics. We aimed to evaluate the association between zolpidem use and media broadcasts that reported the suicide risk. We obtained the data of adult outpatients who have been prescribed zolpidem or other hypnotics from the National Patient Sample database (2015–2017). We evaluated the change in zolpidem or other hypnotic prescription trends based on the prescription rate and average daily prescribed dose before and after July 2016, using interrupted time series analysis. A total of 129,787 adult patients had at least one zolpidem prescription in 3 years. The prescription rate of zolpidem after the broadcast decreased significantly by 0.178% (95% confidence interval (CI): −0.214, −0.142), whereas that of other hypnotic users did not differ from that before the broadcast (−0.020%, 95% CI: −0.088, 0.047). However, the trends in the prescription rate before and after the broadcast did not differ for zolpidem and other hypnotics. Broadcasting medication safety through major public media could have an effect on medication use. After broadcasting about the suicide risk of zolpidem, its overall prescription rate decreased immediately, but the trend was not changed.

Cesarean section rates before and after the Implementation of Health Sector Evolution Plan in Iran: an interrupted time series analysis

2021 ◽  
Vol 17 ◽  
Author(s):  
Abbas Alipour ◽  
Leyla Khazaei ◽  
Soheila Khodakarim
Keyword(s):  
Time Series ◽  
Retrospective Study ◽  
Time Series Analysis ◽  
Health Sector ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Series Analysis ◽  
The World ◽  
Before And After ◽  
Iranian Health System

Background: Today, the issue challenging cesarean delivery is its overuse as the conventional method of birth in the world, especially in developing countries. The Iranian health system implemented the Health Sector Evolution Plan (HSEP) in 2014 to reduce CS rates. Objective: To evaluate the effect of the implementation of the HSEP on the rate of CS in an Iranian subpopulation (Qom province) in 13 years. Methods: In this longitudinal retrospective study, the trend of CS rate over 13 years (2005-2017) in Qom province has been studied by using an interrupted time series analysis. Results: In the period after implementing the HSEP, the rate of CS decreases by 0.1% monthly slope compared to the previous period, which was not statistically significant. This trend is more definite among governmental hospitals. In contrast, the pattern observed in non-governmental hospitals has a monthly increased trend. Conclusion : After more than four years of implementation of the HSEP, it has not been able to significantly reduce the overall CSs during this period in Qom province and has failed to reach the plan's goals.

Educating Neonatal Nurses in Brazil: A Before-and-After Study with Interrupted Time Series Analysis

Neonatology ◽  
2014 ◽  
Vol 106 (3) ◽  
pp. 201-208 ◽  
Author(s):  
Clare Gilbert ◽  
Brian Darlow ◽  
Andrea Zin ◽  
Selvaraj Sivasubramaniam ◽  
Shaheen Shah ◽  
...  
Keyword(s):  
Time Series ◽  
Time Series Analysis ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Neonatal Nurses ◽  
Series Analysis ◽  
Before And After ◽  
Before And After Study

scholarly journals England's Lockdown vs. Sweden's Herd Immunity: A Comparison of the Daily New COVID-19 Cases and Related Deaths Using Comparative Interrupted Time Series Analysis

2020 ◽  
Author(s):  
Moaath K. Mustafa Ali ◽  
Yazan Samhouri ◽  
Marwa Sabha ◽  
Lynna Alnimer
Keyword(s):  
Time Series ◽  
Time Series Analysis ◽  
Herd Immunity ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Post Intervention ◽  
Series Analysis ◽  
Before And After ◽  
Rebound Increase ◽  
Related Mortality

Abstract Background: There is a lack of empirical evidence that lockdowns decrease daily cases of COVID-19 and related mortality compared to herd immunity. England implemented a delayed lockdown on March 23, 2020, but Sweden did not. We aim to examine the effect of lockdown on daily COVID-19 cases and related deaths during the first 100 days post-lockdown.Methods: We compared daily cases of COVID-19 infection and related mortality in England and Sweden before and after lockdown intervention using a comparative-interrupted time series analysis. The period included was from COVID-19 pandemic onset till June 30, 2020.Results: The adjusted-rate of daily COVID-19 infections was eight cases/10,000,000 person higher in England than Sweden before lockdown order (95% CI: 2-14, P=0.01). On the day of intervention (lagged lockdown), England had 693 more COVID-19 cases/10,000,000 person compared to Sweden (95% CI: 467-920, P<0.001). Compared to the pre-intervention period, the adjusted daily confirmed cases rate decreased by 19 cases/ 10,000,000 person compared to Sweden (95% CI: 13-26, P<0.001). There was a rate excess of 1.5 daily deaths/ 10,000,000 person in England compared to Sweden pre-intervention (95% CI: 1-2, P<0.001). The increased mortality rate resulted in 50 excess deaths/ 10,000,000 person related to COVID-19 in England compared to Sweden on the day of lockdown (95% CI: 30-71, P<0.001). Post-intervention, the rate of daily deaths in England decreased by two deaths/ 10,000,000 person compared to Sweden (95% CI: 1-3, P<0.001). During phases one and two of lockdown lifting in England, there was no rebound increase in daily cases or deaths compared to Sweden. Conclusion: The lockdown order implemented in England on March 23, 2020, effectively decreased the daily new cases rate and related mortality compared to Sweden. There was no short-term increase in COVID-19 cases and related-deaths after the phases one and two of the lifting of restrictions in England compared to Sweden. This study provides empirical, comparative evidence that lockdowns slow the spread of COVID-19 in communities compared to herd immunity.

Sign in / Sign up

Export Citation Format

Share Document