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Cohort study
In China, hospital births are associated with a 62% decreased risk of neonatal mortality
  1. Joseph R Wax
  1. Division of Maternal-Fetal Medicine, Maine Medical Center, Portland, Maine, USA
  1. Correspondence to Joseph R Wax
    Division of Maternal-Fetal Medicine, Maine Medical Center, 887 Congress Street, Suite 200, Portland ME 04102, USA; waxj{at}mmc.org

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World wide, neonatal mortality constitutes a significant percentage of all under-five child mortality. Four million (41%) child deaths annually are neonatal deaths, with three-fourths occurring in the first week, and one-fourth of those children dying on the first day of life. Just five countries accounted for over 50% of neonatal deaths in 1990, with China contributing 12.3% of the total.1 At least 16 evidence-based, cost-effective interventions, some of which require facility-based care, are effective in reducing neonatal mortality from the leading causes of death.2 In 1988, 44.3% of Chinese women delivered in hospital versus 94.7% in 2008, following government-implemented facility-based obstetrical care.3 The impact of facility-based births on China's neonatal death rates has not previously been evaluated. …

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