Impact of education and training on neonatal resuscitation practices in 14 teaching hospitals in India

Deorari, A. K.; Paul, V. K.; Singh, M.; Vidyasagar, D.

doi:10.1080/02724930020028885

Cited by 43 publications

(38 citation statements)

References 4 publications

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“…Although NRP training reduces neonatal mortality in controlled, nonrandomized studies in China, India, and Africa [10, 15, 32, 33], the literature surrounding NRP curriculums' impact is not consistent. Our results contribute to that literature.…”

Section: Discussionmentioning

confidence: 99%

“…Data at the individual patient level could have revealed a statistically significant impact of the LPCH neonatal resuscitation curriculum on neonatal mortality for certain subpopulations of neonates born at St. Gabriel's such as stillbirths. A prospective study, for example, in India found that while neonatal mortality did not decrease following the implementation of neonatal resuscitation programs, asphyxia-related deaths did significantly decline [33]. We were limited in our ability to individually track cases because such data is not collected at St. Gabriel's Hospital; thus, we were unable to compare the two cohorts on variables such as maternal age, prenatal health, and maternal health.…”

Section: Discussionmentioning

confidence: 99%

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A Neonatal Resuscitation Curriculum in Malawi, Africa: Did It Change In-Hospital Mortality?

Hole

Olmsted

Kiromera

et al. 2012

International Journal of Pediatrics

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Objective. The WHO estimates that 99% of the 3.8 million neonatal deaths occur in developing countries. Neonatal resuscitation training was implemented in Namitete, Malawi. The study's objective was to evaluate the training's impact on hospital staff and neonatal mortality rates. Study Design. Pre-/postcurricular surveys of trainee attitude, knowledge, and skills were analyzed. An observational, longitudinal study of secondary data assessed neonatal mortality. Result. All trainees' (n = 18) outcomes improved, (P = 0.02). Neonatal mortality did not change. There were 3449 births preintervention, 3515 postintervention. Neonatal mortality was 20.9 deaths per 1000 live births preintervention and 21.9/1000 postintervention, (P = 0.86). Conclusion. Short-term pre-/postintervention evaluations frequently reveal positive results, as ours did. Short-term pre- and postintervention evaluations should be interpreted cautiously. Whenever possible, clinical outcomes such as in-hospital mortality should be additionally assessed. More rigorous evaluation strategies should be applied to training programs requiring longitudinal relationships with international community partners.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Neonatal Resuscitation Curriculum in Malawi, Africa: Did It Change In-Hospital Mortality?

Hole

Olmsted

Kiromera

et al. 2012

International Journal of Pediatrics

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“…10, 11 However, neonatal resuscitation training has had limited penetration in many LMIC despite findings that when implemented mortality decreases by 20%–50%. 7, 12, 13 …”

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confidence: 99%

Developmental trajectories of children with birth asphyxia through 36months of age in low/low–middle income countries

Wallander

Bann

Chomba

et al. 2014

Early Human Development

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Background Resuscitation following birth asphyxia reduces mortality, but may be argued to increase risk for neurodevelopmental disability in survivors. Aims To test the hypothesis that development of infants who received resuscitation following birth asphyxia is not significantly different through 36 months of age from infants who had healthy births. Study Design Prospective observational cohort design comparing infants exposed to birth asphyxia with resuscitation or healthy birth. Subjects A random sample of infants with birth asphyxia who received bag-and-mask resuscitation was selected from birth records in selected communities in 3 countries. Exclusion criteria: birth weight < 1500g, severely abnormal neurological examination at 7 days, mother < 15 years, unable to participate, or not expected to remain in the target area. A random sample of healthy-birth infants (no resuscitation, normal neurological exam) was also selected. Eligible = 438, consented = 407, and ≥ 1 valid developmental assessment during first 36 months = 376. Outcome Measure(s) Bayley Scales of Infant Development-II Mental (MDI) and Psychomotor (PDI) Development Index. Results Trajectories of MDI (p = .069) and PDI (p = .143) over 3 yearly assessments did not differ between children with birth asphyxia and healthy-birth children. Rather there was a trend for birth asphyxia children to improve more than healthy-birth children. Conclusions The large majority of infants who are treated with resuscitation and survived birth asphyxia can be expected to evidence normal development at least until age 3. The risk for neurodevelopmental disability should not justify the restriction of effective therapies for birth asphyxia.

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“…About six to 10% of all newly-born infants need some assistance to establish normal breathing at birth. 4–6 Once spontaneous breathing is established, most of these infants survive without requiring further support during the post natal period. 4 …”

mentioning

confidence: 99%

Neurodevelopmental Outcomes in Infants Requiring Resuscitation in Developing Countries

Carlo

Goudar

Pasha³

et al. 2012

The Journal of Pediatrics

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Objective To determine whether resuscitation of infants who failed to develop effective breathing at birth increases survivors with neurodevelopmental impairment. Study design Infants unresponsive to stimulation who received bag and mask ventilation at birth in a resuscitation trial and infants who did not require any resuscitation were randomized to early neurodevelopmental intervention or control. Infants were evaluated by trained neurodevelopmental evaluators masked to both their resuscitation history and intervention group. The 12-month neurodevelopmental outcome data for both resuscitated and non-resuscitated infants randomized to the control groups are reported. Results The study provided no evidence of a difference between the resuscitated (N = 86) and the non-resuscitated infants (N = 115) in the percentage of infants at 12 months with a mental developmental index < 85 on the Bayley Scales of Infant Development-II (primary outcome) (18% versus 12%; p = 0.22) and in other neurodevelopmental outcomes. Conclusions The overwhelming majority of infants who received resuscitation with bag and mask ventilation at birth have 12-month neurodevelopmental outcomes in the normal range. Longer follow-up is needed because of increased risk for neurodevelopmental impairments.

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Impact of education and training on neonatal resuscitation practices in 14 teaching hospitals in India

Cited by 43 publications

References 4 publications

A Neonatal Resuscitation Curriculum in Malawi, Africa: Did It Change In-Hospital Mortality?

A Neonatal Resuscitation Curriculum in Malawi, Africa: Did It Change In-Hospital Mortality?

Developmental trajectories of children with birth asphyxia through 36months of age in low/low–middle income countries

Neurodevelopmental Outcomes in Infants Requiring Resuscitation in Developing Countries

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