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Table 3 Additional observational studies of neonatal resuscitation training programs in facilities, excluded from meta-analysis

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 Preterm vs. Intrapartum N (Births) A = Baseline
B = Endline
Effect Size
Zhu et al* 1993[45] Health center, Yinshan, China Before-and-after study ABCDE protocol of modern resuscitation with labour ward personel 1) Asphyxia Case Fatality Not Stated A) Number of resuscitations
1) RR 0.94
Tholpadi SR et al* 2000[40] 32 peripheral health centers; Kerala, India Before-and-after study AAP NRP Training of village health center physicians, nurses, birth attendants; performance checklist; refresher in 3 months 1) Asphyxia
2) Asphyxia Mortality (definitions not stated)
Not Stated A) 874;
B) 960
1) RR 0.68
Jeffery HE et al* 2004[33] 3 Tertiary care, 13 District Hospitals;
Before-and-after study 10 month perinatal training program doctors and nurses (Neonatal resuscitation, thermal care, jaundice, respiratory distress syndrome, infection control) 1) PMR
2) Fetal mortality
3) NMR
< 1000 g excluded A) 68,755
B) 44,263
1) RR 0.72 (0.66-0.78)
2) RR 0.79 (0.71-0.89)
3) RR 0.64 (0.56-0.72)
O'Hare BA et al* 2006[49] Teaching Hospital; Kampala, Uganda Before-and-after study Team of nurses trained in basic resuscitation to attend all deliveries in 1 month period, performance based evaluation; 1) Mortality of NICU admissions Preterms excluded A) 1296;
B) 1,046
20.8% in control vs. 17.3% in pilot
Duran R et al* 1998[42] Tertiary Care Hospital; Trakya, Turkey Before-and-after study NRP courses in Trakya region, Turkey 2003 & 2004 1) "Asphyxia" NICU admissions
2) Duration of asphyxia hospitalization
Not Stated Not Stated 1) 35 vs 13 NICU admissions for asphyxia
2) 15 to 6 days
Draycott et al* 2006[37] Maternity Unit; South Meade, UK Before-and-after study EOC training course: CTG obstetric emergency drills, and neonatal resuscitation 1) HIE (MacLennan): Not Stated A) 8,430
B) 11,030
1) RR 0.50
Wang H et al* 2008[41] 17 general, 23 maternal child health hospitals; China Before-and-after study Nationwide AAP NRP training, started in 2004 in 20 provinces 1) Asphyxia Mortality [Delivery room death infant 1 min Apgar <7] Preterms not excluded A) 51,306;
B) 68, 247
1) RR 0.67 (0.34-1.30)
Mufti P et al* 2006[35] Teaching Hospital, Karachi, Pakistan Before-and-after study Training in management of low birthweight, respiratory distress, feeding, neonatal sepsis, and neonatal resuscitation. 1) PMR
2) NMR
Not Stated A) 2871
B) 4106
1) RR 0.85 (0.69-1.05)
2) RR 0.72 (0.51-1.02)
Boo et al* 2009[43] National training in all states Malaysia Historical/ecological study AAP NRP, national training and certification Perinatal Society; written/practical test for certification; retraining 1) PMR;
2) NMR (all cause)
Not Stated National annual births over 8 years Annual NMR reported over 8 years
Sen et al* 2009[34] District Hospital, Purulia India Before-and-after study Training in neonatal resuscitation, equipping labor room-OR with resuscitation equipment. 1) Labor room death (hospital) Not Stated A) 5077
B) 6704
1) RR 0.56 (0.42-0.75)
Opiyo N et al* 2008[46] Public Hospital, Nairobi, Kenya RCT and before-after Training of delivery room nurses-midwives in adapted UK resuscitation council. Written-clinical competency assessment. 1) NMR (all cause) Not Stated A) 4367
B) 4084
NMR 25(pre) vs 26.2 (post-intervention)
Berglund et al* 2010[36] Three maternity wards, Ukraine Before-and-after study Training maternity staff WHO "Effective Perinatal Care" including emergency obstetric and neonatal care. All maternities equipped for resuscitation 1) Early NMR Not Stated A) 1696
B) 2439
No significant effect on ENMR