TABLE 2.

Summary of Impact of Antenatal, Intrapartum, and Postnatal Interventions on Perinatal and Neonatal Health Status Outcomes

InterventionEvidence of No or Negative Impact (Leave out of Programs)Uncertain Evidence (Need for Additional Research Before Including in Programs)Some Evidence (May Include in Programs, but Additional Evaluation Is Warranted)Clear Evidence (Merits Inclusion in Programs)
Antenatal interventions
        Maternal schooling/health educationX
        Antenatal care package(s)*X
    Nutrition-related interventions
        Protein supplementationX
        Balanced protein-energy supplementationX
        Iron supplementationX
        Periconceptional folate supplementationX
        Antenatal folate supplementationX
        Iodine supplementationX
        Antenatal vitamin A supplementationX
        Zinc supplementationX
        Multiple micronutrient supplementationX
    Infection-related interventions
        Malaria
            Malaria chemoprophylaxis or IPTX
            ITNsX
        DewormingX
    UTIs and reproductive tract infections
        Syphilis screening and treatmentX§
        Antibiotics for asymptomatic bacteriuriaX
        Antibiotics for bacterial vaginosisX
        Antibiotics for preterm laborX
        Antibiotics for PPROMX
    Tetanus
        TT immunizationX
        Clean delivery practicesX
    Maternal pneumococcal immunizationX
    Others
        Promotion of smoking cessation in pregnancyX
        Maternal care packagesX
Intrapartum interventions
    Maternal vaginal and newborn skin antisepsisX
Postnatal interventions
    Newborn resuscitationX
    Delayed umbilical cord clampingX
    Umbilical cord antisepsisX
    Hypothermia prevention and managementX
    Hypoglycemia prevention and managementX
    BreastfeedingX
    Prevention of ophthalmia neonatorumX
    Vitamin K prophylaxisX
    Hepatitis B vaccinationX
    Neonatal vitamin A supplementationX
    KMCX
    Topical emollient therapyX
    Hyperbilirubinemia screeningX
    TBA/CHW trainingX
    Pneumonia case managementX
    Neonatal care packagesX
    Care in peripheral health facilitiesX
  • * Priority interventions include TT immunization, iron-folate supplementation, detection and treatment of pre-eclampsia, and, where appropriate, detection and management of syphilis and malaria.

  • Inclusion in programs may be warranted despite lack of evidence, which is due in part to ethical constraints in conducting RCTs of iron supplementation.

  • Inclusion is indicated in endemic areas for reduction of maternal anemia and parasitemia and to improve birth weight; impact on mortality needs additional assessment.

  • § Benefits of diagnosis and treatment are clear, but additional research is needed on cost-effective means of providing accessible and quality diagnosis and treatment at the community level.

  • Appropriate at referral-level health facilities.

  • Assessment based on health indicators other than neonatal health status outcomes.