scholarly journals Effect of Caesarean Section on Neonatal Health in Bangladesh after Controlling Selection Bias: Propensity Score Based Analysis

2021 ◽  
Vol 69 (1) ◽  
pp. 23-29
Author(s):  
Md Mahmudur Rahman ◽  
Sabina Sharmin ◽  
Taslim Sazzad Mallick

The paper examines the effect of caesarean section (C-section) on early neonatal mortality, neonatal mortality, and early initiation of breastfeeding using Bangladesh Demographic and Health Survey (BDHS), 2014 data. Propensity score matching and weighting methods were used to estimate unbiased estimate of treatment effect. The study demonstrates how conclusion about treatment effect varies with and without having balance in the treatment groups. Standard analysis, without caring about balance, reveals that C-section has no significant impact on early neonatal mortality and neonatal mortality. After applying propensity score adjusted methods, balance was achieved in the treatment groups and it was found that C-section has significant effect on early neonatal mortality and neonatal mortality. However, there was no difference between standard and PS adjusted methods in estimating the effect of C-section on early initiation of breastfeeding. It is concluded that children who were delivered by C-section have significantly lower odds of early neonatal mortality, neonatal mortality, and early initiation of breastfeeding as compared to the children who were not delivered by C-section. Dhaka Univ. J. Sci. 69(1): 23-29, 2021 (January)

Author(s):  
Precious A Duodu ◽  
Henry O Duah ◽  
Veronica M Dzomeku ◽  
Adwoa B Boamah Mensah ◽  
Josephine Aboagye Mensah ◽  
...  

Abstract Background Early initiation of breastfeeding (EIBF) is a key strategy in averting neonatal deaths. However, studies on the facilitators and risk factors for EIBF are rare in Ghana. We examined trends in EIBF and its major facilitators and risk factors in Ghana using data from Demographic and Health Surveys from 1998 to 2014. Methods We used complete weighted data of 3194, 3639, 2909 and 5695 pairs of mothers ages 15–49 y and their children ages 0–5 y in the 1998, 2003, 2008 and 2014 surveys, respectively. We accounted for the complex sampling used in the surveys for both descriptive statistics and multiple variable risk ratio analysis. Results The proportion of children who achieved EIBF increased by about 2.5 times from 1998 to 2003 and there was a marginal increase in the proportion of children who achieved EIBF between 2003 and 2014. Children born by caesarean section were at higher risk of being breastfed later than 1 h across all four surveys. Being born in the Upper East Region (compared with the Western Region) of Ghana facilitated EIBF in 2003 and 2008. Conclusions The study revealed that the current estimate of the proportion of children achieving EIBF in Ghana was 55.1%, and delivery by caesarean section and region of residence consistently predicted the practice of EIBF in Ghana.


2021 ◽  
pp. 1-18
Author(s):  
Jeetendra Yadav ◽  
Chander Shekhar ◽  
Kusum Bharati

Abstract Early initiation of breastfeeding (EIBF) is considered one of the most cost-effective interventions for infant survival and well-being. This study aimed to examine the variations in, and determinants of, early initiation of breastfeeding among women in high and low neonatal mortality rate (NMR) settings in India using data from the fourth round of the National Family Health Survey conducted in 2015–16. At 35%, EIBF was found to be disproportionately low in the high NMR group of states compared with 52% in the low NMR group, with the national average being 44%. The chance of EIBF significantly increased if childbirth was vaginal, delivery took place in a health institution, the mother received breastfeeding advice and the birth was a planned one in both high and low NMR settings. In the high NMR group of states, the probability of initiating breastfeeding immediately after birth improved to a great extent if childbirth was assisted by a trained person and if the mother was exposed to any type of mass media. There is an urgent need to increase the access of mothers to breastfeeding advice during pregnancy and to increase their exposure to mass media, particularly in high NMR states. In addition, achieving universal access to institutional deliveries and deliveries assisted by a skilled birth attendant, especially in high NMR settings, and promoting early breastfeeding, especially in the case of Caesarean deliveries, would further improve the level of EIBF in the country as a whole. These interventions can potentially increase the prevalence of early initiation of breastfeeding and help India attain the neonatal mortality rate target of Sustainable Development Goal 3.


2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Satrinawati Berkat ◽  
Rosnah Sutan

Background. Early initiation of breastfeeding is the breastfeed that is received by the baby within the first hour of birth. It is recommended to reduce infant mortality and illness. Objective. To assess the effect of early initiation of breastfeeding on neonatal mortality for low birth weight in Aceh province, Indonesia. Method. In this qualitative study unmatched case controls were used as the design. Data was collected in 8 districts in Aceh province, Indonesia, between January and December 2012. The total sample for this study was 500 LBW who were born between 2010 and 2012, subdivided into 250 LBW who died in neonatal period and 250 LBW who survived during neonatal period. Result. Thermal care and hygienic practice were not significantly associated with neonatal mortality among LBW. Feeding and early initiation of breastfeeding were associated. Discussion. Early initiation of breastfeeding had an effect on neonatal mortality for the low birth weight in Aceh province, Indonesia. The risk of mortality was decreased for those neonates who accepted breast milk within the first hour after birth. Therefore it is concluded that a new strategy to promote and improve the coverage of the initiation of breastfeeding is needed.


Author(s):  
Harish Chand ◽  
Jyoti Sharma

Background: The SDG-3 goal suggests to reduce the neonatal mortality to below 12 per 1000 live births. New-born who are breastfed after 1 hour of birth are at 33% greater risk of neonatal mortality. To ascertain early initiation of breastfeeding (EIBF) knowledge, practices and its underlying determinants, a cross-sectional study was conducted with mothers of children below 3 years of age.Methods: Sample of 400 mothers of children under 3 years of age was collected. The data was analysed using statistical software SPSS version 23.0. All characteristics were summarized descriptively. Chi-square (χ2) test was performed to study the association between two categorical variables. Multivariable analysis was done using logistic regression model to determine the association of EIBF with socio-demographic and maternal factors.   Results: 75.8% mothers initiated early breastfeeding within 1 hour of birth whereas only 34.3% mothers had knowledge on early initiation of breastfeeding. 95% mothers fed colostrum to the new-born. Mothers with 25 years of age or more (AOR 1, 95% CI 0.52, 1.57; p value <0.73) were less likely to breastfeed new-born within 1 hour of birth as compared to the mothers who were <25 years of age.Conclusions: Timely initiation of breastfeeding within 1 hour of birth is a critical intervention to avert a considerable number of neonatal deaths to achieve SDG-3 goal, which to reduce neonatal mortality rate <12 per 1000 livebirths.  after delivery could sustain the breastfeeding practice for lo. Intensifying home visits in 3rd trimester to disseminate messages on EIBF and colostrum feeding may improve the coverage of EIBF.


2021 ◽  
Author(s):  
Loyce Kusasira ◽  
David Mukunya ◽  
Obakiro Samuel ◽  
Kiyimba Kenedy ◽  
Nekaka Rebecca ◽  
...  

Abstract BackgroundThe rates for the delayed initiation of breastfeeding in Uganda remain unacceptably high and reasons for this are not well understood. We aimed to determine the prevalence and predictors for the delayed initiation of breastfeeding in Eastern Uganda. MethodsThis study employed a cross-sectional study design. A total of 404 mother-infant pairs were enrolled onto the study between July and November, 2020 at Mbale regional referral hospital (MRRH). They were interviewed on socio-demographic related, infant-related, labour and delivery characteristics using a structured questionnaire. We estimated adjusted odds ratios using multivariable logistic regression models.Results. The rate of delayed initiation of breastfeeding was 70% (n=283/404, 95% CI: 65.3% – 74.4%). The factors that were associated with delayed initiation of breastfeeding were maternal charateristics including: being single (AOR=0.37; 95%CI: 0.19 – 0.74), receiving antenatal care for less than 3 times while pregnant (AOR=1.85, 95%CI: 1.07 – 3.19) undergoing a caesarean section (AOR= 2.07; 95%CI: 1.3 – 3.19) and having a difficult labour (AOR=2.05; 95%CI: 1.25 – 3.35). Infant characteristics included: having a health issue at birth (AOR=9.8; 95%CI: 2.94 – 32.98).Conclusions:The proportion of infants that do not achieve early initiation of breastfeeding in this setting remains high. Women at high risk of delaying the initiation of breastfeeding include those who: deliver by caesarean section, do not receive antenatal care and have labour difficulties. Infants at risk of not achieving early initiation of breastfeeding include those that have a health issue at birth. We recommend increased support for women who undergo caesarean section in the early initiation of breastfeeding. Breastfeeding support can be initiated in the recovery room after caesarean delivery or in the operating theatre. The importance of antenatal care attendance should be emphasized during health education classes.


BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e027497
Author(s):  
Engida Yisma ◽  
Ben W Mol ◽  
John W Lynch ◽  
Lisa G Smithers

ObjectiveTo examine the impact of caesarean section on breastfeeding indicators—early initiation of breastfeeding, exclusive breastfeeding under 6 months and children ever breastfed (at least once)—in sub-Saharan Africa.DesignSecondary analysis of Demographic and Health Surveys (DHS).SettingThirty-three low-income and middle-income countries with a survey conducted between 2010 and 2017/2018.ParticipantsWomen aged 15–49 years with a singleton live last birth during the 2 years preceding the survey.Main outcome measuresWe analysed the DHS data to examine the impact of caesarean section on breastfeeding indicators using the modified Poisson regression models for each country adjusted for potential confounders. For each breastfeeding indicator, the within-country adjusted prevalence ratios (aPR) were pooled in random-effects meta-analysis.ResultsThe within-country analyses showed, compared with vaginal birth, caesarean section was associated with aPR for early initiation of breastfeeding that ranged from 0.24 (95% CI 0.17 to 0.33) in Tanzania to 0.89 (95% CI 0.78 to 1.00) in South Africa. The aPR for exclusive breastfeeding under 6 months ranged from 0.58 (95% CI 0.34 to 0.98) in Angola to 1.93 (95% CI 0.46 to 8.10) in Cote d'Ivoire, while the aPR for children ever breastfed ranged from 0.91 (95% CI 0.82 to 1.02) in Gabon to 1.02 (95% CI 0.99 to 1.04) in Gambia. The meta-analysis showed caesarean section was associated with a 46% lower prevalence of early initiation of breastfeeding (pooled aPR, 0.54 (95% CI 0.48 to 0.60)). However, meta-analysis indicated little association with exclusive breastfeeding under 6 months (pooled aPR, 0.94 (95% CI 0.88 to 1.01)) and children ever breastfed (pooled aPR, 0.98 (95% CI 0.98 to 0.99)) among caesarean versus vaginally born children.ConclusionsCaesarean section had a negative influence on early initiation of breastfeeding but showed little difference in exclusive breastfeeding under 6 months and children ever breastfed in sub-Saharan Africa.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ofelia P. Saniel ◽  
Veincent Christian F. Pepito ◽  
Arianna Maever L. Amit

Abstract Background The prevalence of early initiation of breastfeeding and exclusive breastfeeding (EBF) at 6 months remain low in the Philippines. To help meet the 90% early initiation of breastfeeding target and to improve infant and young child feeding practices in the Philippines, the Millennium Development Goals - Fund 2030 Joint Programme (JP) on Ensuring Food Security and Nutrition for Children 0–24 months old was implemented. We aimed to determine the effectiveness of visits by peer counselors during pregnancy and after delivery, and membership in breastfeeding support groups in promoting these optimal breastfeeding practices. Methods We used data from the Endline Survey of the JP to study the effects of prenatal and postnatal peer counselor visits, and membership in breastfeeding support groups, and their possible interactions with initiation of breastfeeding within 1 hour of birth among children aged 0 to 24 months and EBF at 6 months among children aged 6 to 24 months, while adjusting for confounding. We used logistic regression methods for survey data to assess these associations. Results Of the 2343 mother-infant pairs, only 1500 (63.1%) practiced early initiation of breastfeeding. Of the 1865 children aged 6 months or older, only 621 (34.7%) were exclusively breastfed at 6 months. After adjusting for confounding variables, there was no strong evidence that peer counselor visits were associated with early initiation or EBF at 6 months. However, members of breastfeeding support groups had 1.49 times higher odds of early initiation of breastfeeding (95% CI [Confidence Interval] 1.12, 1.98) and 1.65 times higher odds of EBF (95% CI 1.20, 2.24) compared to those who were not members of breastfeeding support groups. There was no interaction between the different exposure variables and early initiation and EBF at 6 months. Conclusions Our findings suggest breastfeeding support groups may be institutionalized to promote both early initiation of breastfeeding and EBF in the Philippines, while the role of peer counselors in promoting optimal breastfeeding behaviors should be further reviewed. Our suggestion to integrate non-healthcare professionals to promote early initiation of breastfeeding and EBF could be tested in future intervention studies.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Vasanthakumar Namasivayam ◽  
Bidyadhar Dehury ◽  
Ravi Prakash ◽  
Marissa Becker ◽  
Lisa Avery ◽  
...  

Abstract Background Timely initiation of breastfeeding, also known as early initiation of breastfeeding, is a well-recognized life-saving intervention to reduce neonatal mortality. However, only one quarter of newborns in Uttar Pradesh, India were breastfed in the first hour of life. This paper aims to understand the association of community-based prenatal counselling and postnatal support at place of delivery with early initiation of breastfeeding in Uttar Pradesh, India. Methods Data from a cross-sectional survey of 9124 eligible women (who had a live birth in 59 days preceding the survey) conducted in 25 districts of Uttar Pradesh, India, in 2018, were used. Simple random sampling was used to randomly select 40 Community Development Blocks (sub district administrative units) in 25 districts. The Primary Sampling Units (PSUs), health service delivery unit for frontline workers, were selected randomly from a linelisting of PSUs in each selected Community Development Block. Bivariate and multivariate logistic regression analyses were performed to assess the association of prenatal counselling and postnatal support on early initiation of breastfeeding in public, private and home deliveries. Results Overall 48.1% of mothers initiated breastfeeding within an hour, with major variation by place of delivery (61.2% public, 23.6% private and 32.6% home). The adjusted odds ratio (aOR) of early initiation of breastfeeding was highest among mothers who received both counselling and support (aOR 2.67; 95% CI 2.30, 3.11), followed by those who received only support (aOR 1.99; 95% CI 1.73, 2.28), and only counselling (aOR 1.40; 95% CI 1.18, 1.67) compared to mothers who received none. The odds of early initiation of breastfeeding was highest among mothers who received both prenatal counselling and postnatal support irrespective of delivery at public health facilities (aOR 2.49; 95% CI 2.07, 3.01), private health facilities (aOR 3.50; 95% CI 2.25, 5.44), or home (aOR 2.84; 95% CI 2.02, 3.98). Conclusions A significant association of prenatal counselling and postnatal support immediately after birth on improving early initiation of breastfeeding, irrespective of place of delivery, indicates the importance of enhancing coverage of both the interventions through community and facility-based programs in Uttar Pradesh.


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