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Table 2 Observational studies of neonatal resuscitation training programs in facility settings with mortality outcomes

From: Neonatal resuscitation and immediate newborn assessment and stimulation for the prevention of neonatal deaths: a systematic review, meta-analysis and Delphi estimation of mortality effect

Author Setting/Country Study Design Intervention definition Outcomes: definition Distinguish Preterm from Intrapartum Deaths N (Births) A = Baseline
B = Endline
Effect Size
Zhu XY et al 1997[3] Urban Hospital China Before-and-after study AAP NRP training at of all delivery room staff at hospital 1) Early Neonatal Mortality (first 7 days): ALL cause Not stated A) 1,722;
B) 4,751
1) RR 0.34
Deorari AK et al 2001[2] 14 University Hospitals, India Before-and-after study AAP NRP training of 2 faculty/hospital, subsequent training of DR room nurses and doctors; competency based certification 1) Asphyxia neonatal mortality [Features of fetal hypoxia and 5 min Apgar <6 following complications of pregnancy or delivery];
2) Hypoxic Ischemic Encephalopathy;
3) Preterm mortality [BW < 1000 g with HMD, IVH or AOP]
Excluded BW < 1000 g, death from HMD/IVH or AOP A) 7,070; B)25,713 1) RR 0.70
2) RR 1.68
3) RR 0.95
Vakrilova L et al 2005[44] All hospitals with delivery rooms in Bulgaria Before-and-after study French-Bulgarian Program on Newborn Resuscitation, training in all obstetric wards in country 1) Asphyxia Neonatal Mortality [ICD 9 'perinatal and intrapartum asphyxia'],
2) Early neonatal mortality (first 7 days)
3) Preterm complication [ICD-9 'immaturity related' and 'respiratory distress syndrome']
Excluded death due to preterm complications by ICD-9 A) 67,948;
B) 67,647
1) RR 0.83
2) RR 0.86
3) RR 1.33 (1.03-1.73)
Carlo, et all 2010 [38]/Chomba E et al 2008[39] 18 Urban Low-risk delivery centers, Zambia Before-and-after study,then RCT WHO ENC Package, including basic resuscitation with bag-mask,taught by demonstration, clinical practice sessions, and performance evaluations; followed by longer in depth training in NRP including bag-mask ventilation and chest compressions 1) Asphyxia Early Neonatal Mortality (7 d), [not breathing at birth];
2) Early Neonatal Mortality [first 7 days];
3) Preterm Mortality [preterm or BW <1500]
Preterm or LBW (< 1500 g) as separate cause of death, though no hierarchy specified for single cause of death A) 8,148;
B) 20,534
1) RR 0.56 (NS)
2) RR 0.60 (0.48-0.76)
3) RR 0.74 (NS)