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Published on: August 15, 2018
Effect of the Helping Babies Breathe Program on Newborn Outcomes: Systematic Review and Meta-Analysis
Sergio Agudelo-Pérez1, Annie Cifuentes-Serrano1, Paula Ávila-Celis1
1School of Medicine, Universidad de La Sabana, Campus Puente del Común, Km. 7, Autopista Norte de Bogotá, Chía 250001, Colombia.
Insights
The Helping Babies Breathe (HBB) program significantly reduces neonatal mortality in low- and middle-income countries by improving resuscitation skills. This intervention lowers overall, intrapartum stillbirth, and first-day mortality rates.
Area of Science:
- Neonatal Health
- Global Public Health
- Medical Education
Background:
- Perinatal asphyxia is a primary cause of neonatal mortality in low- and middle-income countries.
- Neonatal resuscitation training is crucial for reducing mortality.
- The Helping Babies Breathe (HBB) program targets resource-limited settings.
Approach:
- A systematic review and meta-analysis of observational studies and clinical trials were conducted.
- Eleven studies reporting on HBB implementation in low- and middle-income countries were included.
- Random-effect models and stratified analyses addressed heterogeneity in outcomes.
Key Points:
- The HBB program trains healthcare professionals in basic neonatal resuscitation.
- Pooled results demonstrated a significant reduction in overall mortality (OR 0.67).
- Significant decreases were observed in intrapartum stillbirth (OR 0.62) and first-day mortality (OR 0.70).
Conclusions:
- Implementation of the HBB program leads to a substantial decrease in early neonatal mortality.
- Heterogeneity in study results was partly attributed to variations in gestational age.
- The HBB program is an effective strategy for improving newborn outcomes in resource-limited regions.
Abstract:
Background and objectives: In low- and middle-income countries, the leading cause of neonatal mortality is perinatal asphyxia. Training in neonatal resuscitation has been shown to decrease this cause of mortality. The program "Helping Babies Breathe" (HBB) is a program to teach basic neonatal resuscitation focused on countries and areas with limited economic resources. The aim of the study was to determine the effect of the implementation of the HBB program on newborn outcomes: mortality and morbidity. Material and Methods: A systematic review was carried out on observational studies and clinical trials that reported the effect of the implementation in low- and middle-income countries of the HBB program on neonatal mortality and morbidity. We carried out a meta-analysis of the extracted data. Random-effect models were used to evaluate heterogeneity, using the Cochrane Q and I2 tests, and stratified analyses were performed by age and type of outcome to determine the sources of heterogeneity. Results: Eleven studies were identified. The implementation of the program includes educational strategies focused on the training of doctors, nurses, midwives, and students of health professions. The poled results showed a decrease in overall mortality (OR 0.67; 95% CI 0.57, 0.80), intrapartum stillbirth mortality (OR 0.62; 95% CI 0.51, 0.75), and first-day mortality (OR 0.70; 95% IC 0.64, 0.77). High heterogeneity was found, which was partly explained by differences in the gestational age of the participants. Conclusions: The implementation of the program HBB in low- and medium-income countries has a significant impact on reducing early neonatal mortality.
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