Nelly Zavaleta

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OBJECTIVE To assess the risks and benefits associated with caesarean delivery compared with vaginal delivery. DESIGN Prospective cohort study within the 2005 WHO global survey on maternal and perinatal health. SETTING 410 health facilities in 24 areas in eight randomly selected Latin American countries; 123 were randomly selected and 120 participated(More)
BACKGROUND Caesarean delivery rates continue to increase worldwide. Our aim was to assess the association between caesarean delivery and pregnancy outcome at the institutional level, adjusting for the pregnant population and institutional characteristics. METHODS For the 2005 WHO global survey on maternal and perinatal health, we assessed a multistage(More)
BACKGROUND We report the main findings of the WHO Multicountry Survey on Maternal and Newborn Health (WHOMCS), which aimed to assess the burden of complications related to pregnancy, the coverage of key maternal health interventions, and use of the maternal severity index (MSI) in a global network of health facilities. METHODS In our cross-sectional(More)
OBJECTIVE To set up a global system for monitoring maternal and perinatal health in 54 countries worldwide. METHODS The WHO Global Survey for Monitoring Maternal and Perinatal Health was implemented through a network of health institutions, selected using a stratified multistage cluster sampling design. Focused information on maternal and perinatal health(More)
Mild-to-moderate zinc deficiency may be relatively common worldwide, but the public health importance of this degree of zinc deficiency is not well defined. The purpose of this review was to provide a conceptual framework for evaluating the public health importance of maternal zinc deficiency as it relates to fetal growth and development, complications of(More)
BACKGROUND Maternal zinc deficiency during pregnancy may be widespread among women in developing countries, but few data are available on whether prenatal zinc supplementation improves maternal and neonatal zinc status. OBJECTIVE We studied whether maternal zinc supplementation improved the zinc status of mothers and neonates participating in a(More)
To estimate the effect of maternal zinc deficiency on pregnancy outcomes, we conducted a zinc supplementation trial in an urban shantytown in Lima, Peru, a population with habitual low zinc intakes. Beginning at 10-24 wk gestation, 1295 mothers were randomly assigned to receive prenatal supplements containing 60 mg iron and 250 (g folate, with or without 15(More)
BACKGROUND It is estimated that 60% of pregnant women worldwide are anemic. OBJECTIVE We aimed to examine the influence of iron status on iron absorption during pregnancy by measuring supplemental iron absorption, red blood cell iron incorporation, and iron status in pregnant women. DESIGN Subjects were 45 pregnant Peruvian women (33+/-1 wk gestation),(More)
OBJECTIVE To determine if vitamin C and E supplementation in high-risk pregnant women with low nutritional status reduces pre-eclampsia. DESIGN Multicentred, randomised, controlled, double-blinded trial. SETTING Antenatal care clinics and Hospitals in four countries. POPULATION Pregnant women between 14 and 22 weeks' gestation. METHOD Randomised(More)
BACKGROUND Caesarean section rates continue to increase worldwide with uncertain medical consequences. Auditing and analysing caesarean section rates and other perinatal outcomes in a reliable and continuous manner is critical for understanding reasons caesarean section changes over time. METHODS We analyzed data on 97,095 women delivering in 120(More)