Abstract
BackgroundNeonatal mortality is one of the major public health problems throughout the world and most notably in developing countries. There exist inconclusive findings on the effect of antenatal care visits on neonatal death worldwide. Thus, the aim of this systematic review and meta-analysis was to reveal the pooled effect of antenatal care visits on neonatal death.MethodsThe present systematic review and meta-analysis was performed using published literature, which was accessed from national and international databases such as, Medline/PubMed, EMBASE, CINAHL, Cochrane Central library, Google Scholar, and HINARI. STATA/SE for windows version 13 software was used to calculate the pooled effect size with 95% confidence intervals (95% CI) of maternal antenatal care visits on neonatal death using the DerSimonian and Laird random effects meta-analysis (random effects model), and results were displayed using forest plot. Statistical heterogeneity was checked using the Cochran Q test (chi-squared statistic) and I2 test statistic and by visual examination of the forest plot.ResultsA total of 18 studies, which fulfilled the inclusion criteria, were included in the present systematic review and meta-analysis. The finding of the present systematic review and meta-analysis revealed that antenatal care visits decrease the risk of neonatal mortality [pooled effect size 0.66 (95% CI, 0.54, 0.80)]. Cochrane Q test (P < 0.001) revealed no significant heterogeneity among included studies, but I2 statistic revealed sizeable heterogeneity up to 80.5% (I2 = 80.5%). In the present meta-analysis traditional funnel plot, Egger’s weighted regression (P = 0.48) as well as Begg’s rank correlation statistic (P = 0.47) revealed no evidence of publication bias.ConclusionsThe present systematic review and meta-analysis revealed that antenatal care visits were significantly associated with lower rates of neonatal death. The risk of neonatal death was significantly reduced by 34% among newborns delivered from mothers who had antenatal care visits. Thus, visiting antenatal care clinics during pregnancy is strongly recommended especially in resource-limited settings like countries of sub-Saharan Africa.
Highlights
Neonatal mortality is one of the major public health problems throughout the world and most notably in developing countries
Accessed studies The reports of the present meta-analysis was presented based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline [18] (Additional file 2: Table S2)
444 articles were excluded by their titles which were found to be non-pertinent because of one of the following reasons: the titles of most of the papers were not directly related to the present topic, the titles of some of the papers consider an individual predictor other than antenatal care (ANC) follow-up as exposure variable for neonatal health, and the titles of the remaining paper were for reviews in other topic areas
Summary
Neonatal mortality is one of the major public health problems throughout the world and most notably in developing countries. There exist inconclusive findings on the effect of antenatal care visits on neonatal death worldwide. The aim of this systematic review and meta-analysis was to reveal the pooled effect of antenatal care visits on neonatal death. Neonatal mortality is one of the major public health problems throughout the world, most notably in developing countries. An estimated number of 2.6 million neonatal deaths occurred in 2016, accounting for 46% of deaths among under-five children [2, 3]. Africa and South Asia have made the least progress in reducing neonatal deaths [1]. Sub-Saharan Africa (SSA) carries the highest neonatal mortality in the world and achieved the lowest progress in the reduction of neonatal mortality [4]
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