The impact of Neonatal Resuscitation Program courses on mortality and morbidity of newborn infants with perinatal asphyxia. 2008

Ridvan Duran, and Nükhet Aladağ, and Ulfet Vatansever, and Necdet Süt, and Betül Acunaş
Department of Pediatrics, Trakya University School of Medicine, Edirne, Turkey. ridvan_duran@yahoo.com

OBJECTIVE Neonatal care provided within the first few minutes of life plays a major role in the reduction of neonatal morbidity and mortality. Neonatal Resuscitation Program (NRP) courses had been held since 1996. The aim of this study was to evaluate the impact of the NRP on morbidity and mortality of newborn infants with perinatal asphyxia. METHODS This retrospective study comprised newborn infants who were born in hospitals at Trakya region of Turkey during the last 3 years and were diagnosed as perinatal asphyxia and were referred to our Neonatal Unit. Those patients who were referred before NRP course (pretraining period) were designated as Group 1, those who were referred after the first NRP course (transition period) as Group 2, and those who were referred after the second NRP course (post-training period) as Group 3. Chart review was performed with regard to gestational age, birth weight, Apgar scores, resuscitation type, stage of hypoxic ischemic encephalopathy (HIE), existence of meconium aspiration syndrome (MAS), progress of the disease, duration of hospitalization. RESULTS The study comprised 66 patients; 35 in Group 1, 18 in Group 2 and 13 in Group 3. The number of cases who had not been resuscitated was 10 in the pretraining period, 3 in the transition period and 1 in the post-training period which decreased significantly. The first minute Apgar scores in three groups were as follows; 2.08+/-1.2, 2.2+/-1.1 and 3.7+/-1.4, and this increase was statistically significant. The fifth minute Apgar scores also increased from 5.43+/-1.5 in the pretraining period to 6.5+/-1.9 in the post-training period, but this increase was not statistically significant. The number of patients with Stage 1 and 2 HIE decreased more in Group 3 (n=11 in Stage 1 HIE, n=17 in Stage 2 HIE) compared to those in Group 1 (n=7 in Stage 1 HIE, n=5 in Stage 2 HIE) but the difference was not statistically significant. The duration of hospitalization decreased in post-training period (15.1+/-10.3 days in pretraining period, 12.0+/-8.9 days in transition period, 6.1+/-1.2 days in post-training period). CONCLUSIONS After NRP courses, the number of patients with perinatal asphyxia and with no resuscitation and also the duration of hospitalization decreased significantly, whereas the first minute Apgar scores increased significantly.

UI MeSH Term Description Entries
D007226 Infant Mortality Postnatal deaths from BIRTH to 365 days after birth in a given population. Postneonatal mortality represents deaths between 28 days and 365 days after birth (as defined by National Center for Health Statistics). Neonatal mortality represents deaths from birth to 27 days after birth. Neonatal Mortality,Mortality, Infant,Postneonatal Mortality,Infant Mortalities,Mortalities, Infant,Mortalities, Neonatal,Mortalities, Postneonatal,Mortality, Neonatal,Mortality, Postneonatal,Neonatal Mortalities,Postneonatal Mortalities
D007230 Infant, Low Birth Weight An infant having a birth weight of 2500 gm. (5.5 lb.) or less but INFANT, VERY LOW BIRTH WEIGHT is available for infants having a birth weight of 1500 grams (3.3 lb.) or less. Low Birth Weight,Low-Birth-Weight Infant,Birth Weight, Low,Birth Weights, Low,Infant, Low-Birth-Weight,Infants, Low-Birth-Weight,Low Birth Weight Infant,Low Birth Weights,Low-Birth-Weight Infants
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D008297 Male Males
D008471 Meconium Aspiration Syndrome A condition caused by inhalation of MECONIUM into the LUNG of FETUS or NEWBORN, usually due to vigorous respiratory movements during difficult PARTURITION or respiratory system abnormalities. Meconium aspirate may block small airways leading to difficulties in PULMONARY GAS EXCHANGE and ASPIRATION PNEUMONIA. Aspiration, Meconium,Meconium Aspiration,Meconium Inhalation,Aspiration Syndrome, Meconium,Syndrome, Meconium Aspiration
D008505 Medical Staff, Hospital Professional medical personnel approved to provide care to patients in a hospital. Attending Physicians, Hospital,Hospital Medical Staff,Physicians, Junior,Registrars, Hospital,Attending Physician, Hospital,Hospital Attending Physician,Hospital Attending Physicians,Hospital Medical Staffs,Medical Staffs, Hospital,Hospital Registrar,Hospital Registrars,Junior Physician,Junior Physicians,Physician, Junior,Registrar, Hospital,Staff, Hospital Medical,Staffs, Hospital Medical
D010043 Outcome and Process Assessment, Health Care Evaluation procedures that focus on both the outcome or status (OUTCOMES ASSESSMENT) of the patient at the end of an episode of care - presence of symptoms, level of activity, and mortality; and the process (ASSESSMENT, PROCESS) - what is done for the patient diagnostically and therapeutically. Outcome and Process Assessment (Health Care),Donabedian Model,Donabedian Triad,Outcome and Process Assessment,Structure Process Outcome Triad,Model, Donabedian,Triad, Donabedian
D004493 Education Acquisition of knowledge as a result of instruction in a formal course of study. Literacy Programs,Training Programs,Activities, Educational,Educational Activities,Workshops,Activity, Educational,Educational Activity,Literacy Program,Program, Literacy,Program, Training,Programs, Literacy,Programs, Training,Training Program,Workshop
D005260 Female Females
D006760 Hospitalization The confinement of a patient in a hospital. Hospitalizations

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