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Effectiveness of neonatal "near miss" audits in reducing perinatal morbidity and mortality: a systematic review
Poliana Medeiros1, Cheryl Bailey1, Christine Andrews1
1Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia.
Insights
Neonatal near-miss audits may help reduce newborn deaths and complications. This systematic review assesses their effectiveness in healthcare settings globally to improve infant survival rates.
Area of Science:
- Perinatal health
- Neonatal care
- Public health
Background:
- Globally, 2.5 million newborns die annually, with preventable deaths occurring at an alarming rate.
- The decline in neonatal mortality lags behind maternal and child mortality rates.
- Neonatal near-miss cases are hypothesized to be part of the stillbirth-neonatal death spectrum, offering opportunities for intervention.
Purpose of the Study:
- To systematically review the effectiveness of neonatal near-miss audits in reducing perinatal mortality and morbidity.
- To assess the global implementation of these audits in healthcare facilities.
Main Methods:
- A systematic review of various study designs, including RCTs, cohort studies, and case series.
- Searches of major databases (MEDLINE, Embase, Scopus, etc.) without date or language restrictions.
- Methodological quality assessment using JBI critical appraisal tools and GRADE for confidence in findings; meta-analysis or narrative synthesis as appropriate.
Main Results:
- This section is to be populated upon completion of the review.
Conclusions:
- This section is to be populated upon completion of the review.
Objective:
This review will assess the effectiveness of neonatal near-miss audits in reducing perinatal mortality and morbidity, as implemented in health care facilities.
Introduction:
Every year, 2.5 million newborns die and 2.6 million more are stillborn worldwide. While many perinatal deaths are preventable, their reduction has been markedly slower than the decline of maternal or child mortality rates. It is hypothesized that neonatal near miss is part of the spectrum of stillbirth-neonatal death and that auditing these cases might reduce perinatal mortality and morbidity.
Inclusion Criteria:
This review will consider neonatal near-miss audits implemented in health care facilities worldwide. Randomized controlled trials, cluster-randomized trials, quasi-randomized controlled trials, controlled before-and-after studies, interrupted time series, case-control, cohort studies, cross-sectional studies, and case series will be included. Conference abstracts, letters, studies duplicating validation data from previous studies, gray literature, and unpublished studies will be excluded.
Methods:
Using the JBI guidelines for conducting systematic reviews of effectiveness, the review will search the following electronic bibliographic databases: MEDLINE, Embase, Scopus, CINAHL, LILACS, and SciELO. No publication date or language limits will be imposed. Two independent reviewers will screen titles, abstracts, and full-text studies, assessing methodological quality with the JBI critical appraisal tools. GRADE will be used to assess the confidence in the findings. Covidence will be used for data extraction and management. A meta-analysis will be performed if the selected studies are sufficiently homogeneous. If not, the results will be discussed as a narrative synthesis.
Systematic Review Registration Number:
PROSPERO (CRD42021224090).
