School of Nursing, George Mason University, 4400 University Drive, Fairfax, VA 22030, USA.
Midwifery. 2012 Apr;28(2):204-15. doi: 10.1016/j.midw.2011.03.004. Epub 2011 May 10.
to identify the current state of knowledge regarding the effects of births kits on clean birth practices and on newborn and maternal outcomes.
the scoping review was informed through a systematic literature review; a call for information distributed to experts in maternal and child health, relevant research centres and specialist libraries; and a search of the web sites of groups working in the area of maternal and child health. Data were synthesised to produce a summary of the state of knowledge regarding birth kits. Meta-analysis was not attempted because of the varied study designs and the heterogeneous nature of the interventions.
births kit use was identified in 51 low resource countries, but evaluations were scarce, with only nine studies reporting effects of intervention packages including births kits.
the quality of evidence for inferring causality was weak, with only one randomised controlled trial. In two studies, births kit use along with co-interventions resulted in a statistically significant increase in the likelihood of the attendant having clean hands. The impact on other aspects of cleanliness was less clear. Intervention packages which include births kits were associated with reduced newborn mortality (three studies), omphalitis (four studies), and puerperal sepsis (three studies). The one study that considered maternal mortality was not large enough to estimate relative reduction with much precision. None of the studies reported any adverse effects; however, none explicitly described looking for negative consequences.
providing birth kits to facilitate clean practices seems commonsense, but there is no evidence to indicate effects, positive or negative, separate from those achieved by a broader intervention package. More robust methods and knowledge systems are needed to understand the contextual factors and share relevant implementation lessons.
确定关于产包对清洁分娩实践以及新生儿和产妇结局影响的现有知识状况。
通过系统文献回顾为范围界定审查提供信息；向孕产妇和儿童健康方面的专家、相关研究中心和专业图书馆分发信息征集通知；并搜索在孕产妇和儿童健康领域开展工作的团体的网站。对数据进行综合，以概述关于产包的知识状况。由于研究设计和干预措施的异质性，未尝试进行荟萃分析。
在 51 个资源匮乏的国家确定了产包的使用情况，但评估很少，只有九项研究报告了包括产包在内的干预措施包的效果。
推断因果关系的证据质量较弱，仅有一项随机对照试验。在两项研究中，产包的使用加上共同干预措施，使护理人员清洁双手的可能性具有统计学意义的增加。对其他清洁方面的影响不太明确。包括产包的干预措施包与降低新生儿死亡率（三项研究）、脐炎（四项研究）和产褥期败血症（三项研究）相关。唯一一项考虑产妇死亡率的研究规模不够大，无法准确估计相对减少的幅度。没有研究报告任何不良影响；但是，没有研究明确描述寻找负面后果。
提供产包以促进清洁实践似乎是常识，但没有证据表明除了更广泛的干预措施包之外，还会产生积极或消极的影响。需要更强大的方法和知识系统来了解背景因素并分享相关的实施经验。
