Saving Newborn Lives/Save the Children-US, Cape Town, South Africa.
Semin Perinatol. 2010 Dec;34(6):371-86. doi: 10.1053/j.semperi.2010.09.011.
Each year 3.6 million infants are estimated to die in the first 4 weeks of life (neonatal period)--but the majority continue to die at home, uncounted. This article reviews progress for newborn health globally, with a focus on the countries in which most deaths occur--what data do we have to guide accelerated efforts? All regions are advancing, but the level of decrease in neonatal mortality differs by region, country, and within countries. Progress also differs by the main causes of neonatal death. Three major causes of neonatal deaths (infections, complications of preterm birth, and intrapartum-related neonatal deaths or "birth asphyxia") account for more than 80% of all neonatal deaths globally. The most rapid reductions have been made in reducing neonatal tetanus, and there has been apparent progress towards reducing neonatal infections. Limited, if any, reduction has been made in reducing global deaths from preterm birth and for intrapartum-related neonatal deaths. High-impact, feasible interventions to address these 3 causes are summarized in this article, along with estimates of potential for lives saved. A major gap is reaching mothers and babies at birth and in the early postnatal period. There are promising community-based service delivery models that have been tested mainly in research studies in Asia that are now being adapted and evaluated at scale and also being tested through a network of African implementation research trials. To meet Millennium Development Goal 4, more can and must be done to address neonatal deaths. A critical step is improving the quantity, quality and use of data to select and implement the most effective interventions and strengthen existing programs, especially at district level.
每年约有 360 万婴儿在生命的头 4 周（新生儿期）死亡，但大多数死亡仍发生在家里，未被统计。本文回顾了全球新生儿健康方面的进展，重点关注大多数死亡发生的国家——我们有哪些数据可以指导加速努力？所有地区都在取得进展，但新生儿死亡率的下降水平因地区、国家和国家内部而异。进展也因新生儿死亡的主要原因而异。新生儿死亡的三个主要原因（感染、早产并发症和分娩期间与新生儿有关的死亡或“出生窒息”）占全球所有新生儿死亡的 80%以上。在减少新生儿破伤风方面取得了最快的进展，在减少新生儿感染方面也取得了明显的进展。在减少早产和分娩期间与新生儿有关的死亡方面，全球几乎没有任何减少。本文总结了针对这三个原因的高影响力、可行的干预措施，并估计了潜在的拯救生命的效果。一个主要的差距是在出生时和出生后早期无法为母亲和婴儿提供服务。亚洲的一些研究性试验已经测试了一些有前途的以社区为基础的服务提供模式，现在正在进行调整和评估，规模扩大，并通过一个非洲实施研究试验网络进行测试。为了实现千年发展目标 4，需要做更多的工作来解决新生儿死亡问题。一个关键步骤是改善数据的数量、质量和使用，以选择和实施最有效的干预措施，并加强现有方案，特别是在区一级。
