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Table 2 Effect and affected fraction estimates for interventions to reduce stillbirths and maternal and neonatal deaths

From: Triple return on investment: the cost and impact of 13 interventions that could prevent stillbirths and save the lives of mothers and babies in South Africa

 

Stillbirths

Maternal deaths

Neonatal deaths

 

Effect

AF

Effect

AF

Effect

AF

Interventions for stillbirth prevention

      

Syphilis detection and treatment

0.82 for antepartum stillbirths*

0.21*

Minimal effect

-

0.03 for sepsis

1

Hypertensive disease case management

0.20 for antepartum and intrapartum stillbirths

1

0.59 for hypertensive disease

1*

Effect calculated as part of BEmOC and CEmOC

 

Diabetes case management

0.10 for antepartum and intrapartum stillbirths*

0.106*

Unknown effect

-

Unknown effect

-

MgSO4 Management of pre-eclampsia

0.20 for antepartum and intrapartum stillbirths*

0.213*

0.59 for hypertensive disease*

1*

Unknown effect

-

Fetal growth restriction detection and management

0.20 for antepartum and intrapartum stillbirths*

0.202*

Unknown effect

-

Unknown effect

-

Labor and delivery management: Essential obstetric care

0.23 for intrapartum stillbirths

1*

0.10 for sepsis

1*

0.25 for asphyxia*; 0.10 for prematurity*; 0.25 for sepsis; 0.36 for tetanus

1*

Labor and delivery management: Basic emergency obstetric care (BEmOC)

0.45 for intrapartum stillbirths

1*

0.08 for obstructed labor; 0.20 for antepartum hemorrhage*; 0.65 for postpartum hemorrhage; 0.50 for sepsis

1*

0.40 for asphyxia*; 0.10 for prematurity*; 0.25 for sepsis; 0.36 for tetanus

1*

Labor and delivery management: Comprehensive emergency obstetric care (CEmOC)

0.75 for intrapartum stillbirths

1*

0.99 for obstructed labor; 0.80 for antepartum hemorrhage*; 0.95 for postpartum hemorrhage; 0.99 for hypertensive disease of pregnancy; 0.70 for sepsis

1*

0.80 for asphyxia*; 0.10 for prematurity*; 0.25 for sepsis; 0.36 for tetanus

1*

Induction of labor for pregnancies lasting 41+ weeks (CEmOC only)

0.69 for antepartum and intrapartum stillbirths*

0.036*

No effect

-

Unknown effect

-

Interventions for maternal and newborn health

      

Early detection and treatment of HIV in pregnant women

Unknown effect

-

0.90 for other indirect causes

0.8

Unknown effect

-

Tetanus toxoid immunization during pregnancy

No effect

-

0.98*

0.005*

0.94 for tetanus*

1*

Antibiotics for preterm premature rupture of membranes

Unknown effect

-

0.26 for sepsis

0.1

0.12 for prematurity*; 0.08 for sepsis

1 for both

Antenatal corticosteroids for preterm labor

No effect

-

No effect

-

0.53 for prematurity*

1

Active management of the third stage of labor

No effect

-

0.27 for postpartum hemorrhage

1*

No effect

-

Neonatal resuscitation

No effect

-

No effect

-

0.3 for asphyxia*; 0.1 for prematurity*

1 for both*

  1. AF = Affected fraction; *Default LiST value in Spectrum V5.04. Sources: Adapted from Bhutta [31,32,36].