|NICHD Launches Project to Treat Infant
Asphyxia In Lower Income Countries
Scientists in a federally sponsored global research
network will undertake a new project that will train
midwives and traditional birth attendants in resource
poor countries on how to treat newborn asphyxia, a major
cause of infant death. The treatment, developed in the
United States, is the standard of care provided to infants
born in this country.
Newborn asphyxia — an infant’s failure to begin or sustain
breathing — is a serious problem in resource poor countries
where births do not occur in a health care facility
and where birth attendants are not trained in newborn
resuscitation. In the United States and more developed
regions of the world, trained health care professionals
can rapidly take steps to treat asphyxia.
The project will be undertaken by the Global Network
for Women’s and Children’s Health Research, which is
sponsored by the National Institute of Child Health
and Human Development of the National Institutes of
Health, in partnership with the Bill and Melinda Gates
The new project seeks to determine if training midwives
and other traditional birth attendants in standard infant
resuscitation practices commonly used in the United
States can reduce the death and disability from newborn
asphyxia in resource poor settings.
The Network project was announced on World Health Day
April 7, 2005.
Newborn asphyxia claims the lives of 1 million infants
each year, according to the World Health Organization.
One estimate holds that newborn asphyxia afflicts from
6 to 10 percent of all births.
“The theme for this year’s World Health Day is ‘Making
every mother and child count,’” said NICHD Director
Duane Alexander, M.D. “In keeping with that sentiment,
the Global Network’s new project will seek to reduce
the death and disability resulting when newborn asphyxia
occurs in the developing world.”
Newborns may stop breathing for a variety of reasons.
For example, the placenta may tear free from the uterine
wall during the birth process. Newborn asphyxia may
also result when the umbilical cord is compressed between
the baby’s body and the uterine wall, or when the umbilical
cord becomes knotted. Other causes of newborn asphyxia
remain unknown, but are thought to involve abnormalities
of the brain or heart.
When newborn asphyxia occurs, the chances that an infant
will survive without brain damage are greatest if the
infant can be resuscitated early — within the first 2
minutes after delivery.
The First Breath initiative will be implemented at
seven Global Network sites located in South Asia, Africa,
and Latin America. Nearly 80 communities will participate
in this study to determine whether a standard newborn
resuscitation program taught to birth attendants in
the United States (the Birth Resuscitation Program of
the American Academy of Pediatrics) can reduce the newborn
death rate as well as other complications from newborn
asphyxia. The program provides instruction in newborn
resuscitation techniques for birth attendants who first
come in contact with newborns.
Midwives and birth attendants who participate in the
Global Network program will be taught such basic techniques
as checking an infant’s throat for obstructions, monitoring
heart rate, and using mechanical ventilation to induce
an infant to breathe. The Global Network study will
involve 40,000 births per year over the two-year study
The Global Network for Women’s and Children’s Health
Research supports partnerships at 10 sites in Asia,
Africa and Latin America. The Network is dedicated to
improving the health of women and infants in developing
regions. The Network seeks to develop local scientific
capacity to solve public health problems and works to
convey its findings to improve health at a local level.
“International health research benefits people in all
countries,” said Danuta Krotoski, Ph.D., NICHD’s Acting
Associate Director for Prevention Research and International
Programs. “Studies conducted abroad contribute to the
health of populations living in those countries as well
as to the health of people around the world.”
Dr. Krotoski noted that the NICHD has funded numerous
studies abroad that contributed important information
for the U.S. health population. For example, she said,
studies conducted in England and Tasmania were instrumental
in the establishment of the Back to Sleep campaign.
The campaign seeks to reduce infants’ risk of dying
from Sudden Infant Death syndrome, the sudden, unexplained
death of an infant less than one year of age. Since
the campaign began in 1994, the rate of Sudden Infant
Death syndrome in the United States declined by more
than 50 percent.
The NICHD is part of the National Institutes of
Health (NIH), the biomedical research arm of the federal
government. NIH is an agency of the U.S. Department
of Health and Human Services. The NICHD sponsors research
on development, before and after birth; maternal,
child, and family health; reproductive biology and
population issues; and medical rehabilitation.