SynthesisNeonatology2025
The Effectiveness of Regionalization of Perinatal Care and Specific Facility-Based Interventions: A Systematic Review.
Synthesis in Neonatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed.
- Postnatal interventions to support newborn survival: updates for the Lives Saved Tool.Journal of global health · 2026Review
- Antenatal interventions to support newborn survival: updates for the Lives Saved Tool.Journal of global health · 2026Review
- Challenges in implementing optimal perinatal regionalization: a scoping review.Maternal health, neonatology and perinatology · 2026Review
- Population-oriented health promotion and disease prevention interventions in primary healthcare: a scoping review of reviews.BMC primary care · 2026Article
- Maternal and perinatal risk factors for necrotizing enterocolitis.World journal of pediatric surgery · 2026Review
- Article
- Maternity Care Access and Infant Mortality.JAMA network open · 2025Article
- Drivers of care and outcomes for people facing fetal conditions in the United States: a conceptual framework.Journal of perinatology : official journal of the California Perinatal Association · 2025Review
- A Survey on the Organization and Operation of Level II/III Neonatal Intensive Care Units in Greece: A Comparison Between 2004 and 2022.Children (Basel, Switzerland) · 2025Article
- Neonatal Care in Low- and Middle-Income Countries: A Fresh Look.Neonatology · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAppropriate perinatal care provision and utilization is crucial to improve maternal and newborn survival and potentially meet Sustainable Development Goal 3. Ensuring availability of healthcare infrastructure as well as skilled personnel can potentially help improve maternal and neonatal outcomes globally as well as in resource-limited settings.
methodsA systematic review on effectiveness of perinatal care regionalization was updated, and a new review on facility-based interventions to improve postnatal care coverage and outcomes was conducted. The interventions were identified through literature reviews and included transport, mHealth, telemedicine, maternal education, capacity building, and incentive packages. Search was conducted in relevant databases and meta-analysis conducted on Review Manager 5.4. We conducted subgroup analysis for evidence from low- and middle-income countries (LMICs).
resultsImplementation of regionalization programs significantly decreased maternal mortality in LMICs (OR: 0.43; 95% CI: 0.34-0.55, 2 studies), stillbirth overall (OR: 0.70; 95% CI: 0.54-0.89, 5 studies), perinatal mortality overall (OR: 0.54; 95% CI: 0.5-0.58, 2 studies), and LMICs (OR: 0.54; 95% CI: 0.50-0.58, 1 study). Transport-related interventions significantly decreased maternal mortality overall (OR: 0.55; 95% CI: 0.40-0.74, 1 study), neonatal mortality (RR: 0.76; 95% CI: 0.66-0.88, 1 study), perinatal mortality (RR: 0.86; 95% CI: 0.77-0.95, 1 study), and improved postnatal care coverage (OR: 6.89; 95% CI: 5.15-9.21, 1 study) in LMICs. Adding maternity homes/units significantly decreased stillbirth (OR: 0.75; 95% CI: 0.61-0.93, 1 study) in LMICs. Incentives for postnatal care significantly improved infant mortality (RR: 0.79; 95% CI: 0.65-0.96, 1 study), stillbirth (OR: 0.60; 95% CI: 0.44-0.83, 1 study), and postnatal care coverage (RR: 1.13; 95% CI: 1.03-1.25, 1 study) in LMICs. Telemedicine improved postnatal care coverage significantly in LMICs (RR: 2.54; 95% CI: 1.22-5.28, 3 studies) and decreased maternal mortality (OR: 0.46; 95% CI: 0.21-0.98, 1 study) and infant mortality (OR: 0.65; 95% CI: 0.45-0.95) in LMICs. Maternal education significantly decreased neonatal mortality (RR: 0.75; 95% CI: 0.66-0.84, 2 studies), perinatal mortality (RR: 0.86; 95% CI: 0.77-0.95, 1 study), infant mortality (RR: 0.79; 95% CI: 0.65-0.96, 1 study), and stillbirth (RR: 0.61; 95% CI: 0.45-0.82, 1 study). Capacity-building interventions significantly decreased maternal mortality in LMICs (OR: 0.37; 95% CI: 0.29-0.46, 5 studies), neonatal mortality overall (OR: 0.72; 95% CI: 0.53-0.98, 4 studies) and in LMICs (OR: 0.63; 95% CI: 0.54-0.74, 3 studies, and RR: 0.61; 95% CI: 0.48-0.79, 3 studies), perinatal mortality (OR: 0.53; 95% CI: 0.45-0.62, 2 studies, and RR: 0.86; 95% CI: 0.77-0.95, 1 study), infant mortality (OR: 0.50; 95% CI: 0.43-0.59, 1 study, and RR: 0.79; 95% CI: 0.65-0.96, 1 study), under-5 mortality (RR: 0.79; 95% CI: 0.66-0.94, 1 study), and stillbirth in LMICs (OR: 0.71; 95% CI: 0.62-0.82, 4 studies), and preterm birth overall (OR: 0.39; 95% CI: 0.19-0.81, 1 study).
conclusionPerinatal regionalization and facility-based interventions have a positive impact on maternal and neonatal outcomes and calls for implementation in high burden settings but a better understanding of optimal interventions is needed through comprehensive trials in diverse settings.
introductionAppropriate perinatal care provision and utilization is crucial to improve maternal and newborn survival and potentially meet Sustainable Development Goal 3. Ensuring availability of healthcare infrastructure as well as skilled personnel can potentially help improve maternal and neonatal outcomes globally as well as in resource-limited settings.
methodsA systematic review on effectiveness of perinatal care regionalization was updated, and a new review on facility-based interventions to improve postnatal care coverage and outcomes was conducted. The interventions were identified through literature reviews and included transport, mHealth, telemedicine, maternal education, capacity building, and incentive packages. Search was conducted in relevant databases and meta-analysis conducted on Review Manager 5.4. We conducted subgroup analysis for evidence from low- and middle-income countries (LMICs).
resultsImplementation of regionalization programs significantly decreased maternal mortality in LMICs (OR: 0.43; 95% CI: 0.34-0.55, 2 studies), stillbirth overall (OR: 0.70; 95% CI: 0.54-0.89, 5 studies), perinatal mortality overall (OR: 0.54; 95% CI: 0.5-0.58, 2 studies), and LMICs (OR: 0.54; 95% CI: 0.50-0.58, 1 study). Transport-related interventions significantly decreased maternal mortality overall (OR: 0.55; 95% CI: 0.40-0.74, 1 study), neonatal mortality (RR: 0.76; 95% CI: 0.66-0.88, 1 study), perinatal mortality (RR: 0.86; 95% CI: 0.77-0.95, 1 study), and improved postnatal care coverage (OR: 6.89; 95% CI: 5.15-9.21, 1 study) in LMICs. Adding maternity homes/units significantly decreased stillbirth (OR: 0.75; 95% CI: 0.61-0.93, 1 study) in LMICs. Incentives for postnatal care significantly improved infant mortality (RR: 0.79; 95% CI: 0.65-0.96, 1 study), stillbirth (OR: 0.60; 95% CI: 0.44-0.83, 1 study), and postnatal care coverage (RR: 1.13; 95% CI: 1.03-1.25, 1 study) in LMICs. Telemedicine improved postnatal care coverage significantly in LMICs (RR: 2.54; 95% CI: 1.22-5.28, 3 studies) and decreased maternal mortality (OR: 0.46; 95% CI: 0.21-0.98, 1 study) and infant mortality (OR: 0.65; 95% CI: 0.45-0.95) in LMICs. Maternal education significantly decreased neonatal mortality (RR: 0.75; 95% CI: 0.66-0.84, 2 studies), perinatal mortality (RR: 0.86; 95% CI: 0.77-0.95, 1 study), infant mortality (RR: 0.79; 95% CI: 0.65-0.96, 1 study), and stillbirth (RR: 0.61; 95% CI: 0.45-0.82, 1 study). Capacity-building interventions significantly decreased maternal mortality in LMICs (OR: 0.37; 95% CI: 0.29-0.46, 5 studies), neonatal mortality overall (OR: 0.72; 95% CI: 0.53-0.98, 4 studies) and in LMICs (OR: 0.63; 95% CI: 0.54-0.74, 3 studies, and RR: 0.61; 95% CI: 0.48-0.79, 3 studies), perinatal mortality (OR: 0.53; 95% CI: 0.45-0.62, 2 studies, and RR: 0.86; 95% CI: 0.77-0.95, 1 study), infant mortality (OR: 0.50; 95% CI: 0.43-0.59, 1 study, and RR: 0.79; 95% CI: 0.65-0.96, 1 study), under-5 mortality (RR: 0.79; 95% CI: 0.66-0.94, 1 study), and stillbirth in LMICs (OR: 0.71; 95% CI: 0.62-0.82, 4 studies), and preterm birth overall (OR: 0.39; 95% CI: 0.19-0.81, 1 study).
conclusionPerinatal regionalization and facility-based interventions have a positive impact on maternal and neonatal outcomes and calls for implementation in high burden settings but a better understanding of optimal interventions is needed through comprehensive trials in diverse settings.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.