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Review
. 2018 Dec 17:39:33.
doi: 10.1186/s40985-018-0110-y. eCollection 2018.

The effect of antenatal care follow-up on neonatal health outcomes: a systematic review and meta-analysis

Amsalu Taye Wondemagegn  1 , Animut Alebel  2 , Cheru Tesema  3 , Worku Abie  1
Affiliations
Review

The effect of antenatal care follow-up on neonatal health outcomes: a systematic review and meta-analysis

Amsalu Taye Wondemagegn et al. Public Health Rev. .

Abstract

Background: 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. Thus, the aim of this systematic review and meta-analysis was to reveal the pooled effect of antenatal care visits on neonatal death.

Methods: The 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 I 2 test statistic and by visual examination of the forest plot.

Results: A 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 I 2 statistic revealed sizeable heterogeneity up to 80.5% (I 2 = 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.

Conclusions: The 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.

Keywords: Antenatal care; Follow up; Maternal health service; Meta-analysis; Neonatal mortality/death; Utilizations; Visits.

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Conflict of interest statement

Not applicableNot applicableThe authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow chart, which reveals the procedures of study selection for the current systematic review and meta-analysis
Fig. 2
Fig. 2
Traditional funnel plot of 18 included studies of the effect of ANC on neonatal death; the horizontal line refers the effect estimate, and the vertical line refers the expected 95% confidence intervals
Fig. 3
Fig. 3
Begg’s funnel plot of 18 included studies of the effect of ANC visits on neonatal death; the horizontal line in the plot refers to the natural logarithm of effect estimate, and the vertical line refers the expected 95% confidence intervals
Fig. 4
Fig. 4
Forest plot of 18 included studies, which reveal the effect of ANC visits on neonatal death. The size of the square is proportional to the precision of the study-specific effect estimates, and the bars indicate the corresponding 95% CIs. The diamond is centered on the summary ES of all included studies, and the width indicates the corresponding 95% CI
See this image and copyright information in PMC

References

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