Neonatal near miss: a systematic review

BMC Pregnancy and Childbirth

Jose G. Cecatti⁴  Suzanne J. Serruya¹  Pablo Duran¹  Antonio A. Silva²  Jose S. Camelo³  Cynthia Pileggi-Castro³  Juliana P. Santos⁴ 

[1] Latin American Center of Perinatology (CLAP), Pan-American Health Organization (PAHO), Montevideo, Uruguay;Department of Public Health, Federal University of Maranhão, Sao Luis, Brazil;Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, Brazil;Department of Gynecology and Obstetrics, School of Medicine, University of Campinas (UNICAMP), Campinas, Brazil

关键词: Systematic review;    Neonatal near miss;    Neonatal mortality;    Neonatal morbidity;   

Others  :  1234500
DOI  :  10.1186/s12884-015-0758-y

 received in 2015-01-28, accepted in 2015-11-23,  发布年份 2015

【 摘 要 】

Background

The concept of neonatal near miss has been proposed as a tool for assessment of quality of care in neonates who suffered any life-threatening condition. However, there are no internationally agreed concepts or criteria for defining or identifying neonatal near miss. The purpose of this study was to perform a systematic review of studies and markers that are able to identify neonatal near miss cases and predict neonatal mortality.

Methods

Electronic searches were performed in the Medline, Embase and Scielo databases, with no time or language restriction, until December 2014. The term “neonatal near miss” was used alone or in combination with terms related to neonatal morbidity/mortality and neonatal severity scores. Study selection criteria involved three steps: title, abstract and full text of the articles. Two researchers performed study selection and data extraction independently. Heterogeneity of study results did not permit the performance of meta-analysis.

Results

Following the inclusion and exclusion criteria adopted, only four articles were selected. Preterm and perinatal asphyxia were used as near miss markers in all studies. Health indicators on neonatal morbidity and mortality were extracted or estimated. The neonatal near miss rate was 2.6 to 8 times higher than the neonatal mortality rate.

Conclusions

Pragmatic and management criteria are used to help develop the neonatal near miss concept. The most severe cases are identified and mortality is predicted with these criteria. Furthermore, the near miss concept can be used as a tool for evaluating neonatal care. It is the first step in building management strategies to reduce mortality and long-term sequelae.

【 授权许可】

   
2015 Santos et al.

【 图 表 】

Fig. 1.

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