Table 3

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



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

Lee et al. BMC Public Health 2011 11(Suppl 3):S12   doi:10.1186/1471-2458-11-S3-S12

Open Data