A little training slashes stillbirths: U.S. study

WASHINGTON (Reuters) - Simple training in how to help a newborn start breathing and to keep it warm and clean can slash the rate of stillbirths by a third in poor, rural areas of the world, U.S. researchers reported on Wednesday.

The rate of stillbirths in rural parts of six developing countries fell by more than 30 percent after midwives, nurses, doctors and other traditional birth attendants were trained, the researchers reported in the New England Journal of Medicine.

After the training program, the number of stillbirths fell from 23 per 1,000 newborns to 16 per 1,000, the researchers found. "This is a very large reduction in mortality," said Dr. Waldemar Carlo of the University of Alabama at Birmingham, who led the study.

He said many of the babies who survived probably did not breathe on their own at first. "Many babies don't start breathing at birth," Carlo told reporters in a telephone briefing.

The research team gave their trainees hand-held pumps and masks to fill babies' lungs with air if they were not breathing at birth, clean-delivery kits to prevent infection and scales to measure their weight.

Every year, 3.7 million newborns die and 3.3 million babies are born dead -- so-called stillbirths -- according to the World Health Organization.

"Approximately 38 percent of deaths among children younger than 5 years of age occur during the first 28 days of life, and 75 percent of the neonatal deaths occur within the first seven days," Carlo's team wrote.

They sent out a team of training experts in rural, poor areas of Argentina, the Democratic Republic of Congo, Guatemala, India, Pakistan, and Zambia.

"We trained all birth attendants," said Carlo -- including physicians. Not only were they given kits to help babies start breathing, but they were told about the need to keep a baby warm by placing it bare-skinned on the mother's bare skin, cleaning the baby and putting the mother on a clean surface.

The attendants were taught how to weigh low-weight babies, who are vulnerable, and ensure they fed properly in the first days after delivery.

The program, which covered 62,000 births, did not affect how many live-born babies died in the first week but it slashed the rate of stillbirths.

"We think this is a major breakthrough because up to now it had been thought it would be extremely difficult to train so many healthcare providers," Carlo said.

"If implemented worldwide, such an intervention could markedly reduce perinatal mortality."

The international research team was funded by the U.S. National Institute of Child Health and Human Development and the Bill and Melinda Gates Foundation.

(Editing by Eric Walsh)