Table 4

GRADE assessment of studies of the effect of Neonatal Resuscitation training in facilities on neonatal mortality from Intrapartum-related events (ie. “birth asphyxia”)

No of studies

Design

Limitations

Consistency

Generalizability to Population of Interest

Generalizability of intervention of interest

Post-InterventionEvents

Control- Baseline Events

Relative Risk (95% CI)


Mortality(Intrapartum-related Neonatal Deaths): Moderate outcome specific mortality

3 [2,38,44]

Before-and-after

Low quality

No evidence of heterogeneity (P=0.5)

Facility settings (ranging primary to tertiary care level), LIC-MIC

Advanced NRP in 2 studies, WHO Basic ENC in another

360*

185

0.70 (0.59, 0.84)a


Mortality(Early Neonatal Deaths): Moderate outcome specific mortality

3 [3,38,44]

Before-and-after

Low quality

Strong evidence of heterogenity (P=0.002)

Facility settings (ranging primary to tertiary care level), LIC-MIC

Advanced NRP in 2 studies, WHO Basic ENC in another

454*

458

0.62 (0.41, 0.94)b


Morbidity(Hypoxic Ischemic Encephalopathy): Low outcome specific morbidity

1 [2]

Before-and-after

Low quality

NA

Only 1 study, tertiary care hospital

Advanced NRP

128*

21

1.68 (1.06, 2.66)c


a) MH pooled RR; b) D & L pooled RR random effect meta-analysis; c) Directly calculated from study results

* Note numbers of events in post-intervention period are based on longer duration of observation period than baseline

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

Open Data