Neonatal Resuscitation Technique in Reducing Neonatal Asphyxia Rate and Mortality Rate in China: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

 LIHong-bin ¹ , FENGHai-juan ² , CHENJi-hua ¹ , FANHe-lian ¹ , DINGYan ¹ , ZHUJi-hua ¹ , ZHANGXiao-yan ¹

1. Maternal and Child Health Care Family Planning Service Center of Rugao, Rugao 226500, China;
2. The People's Hospital of Rugao, Rugao 226500, China;

Corresponding?author：

Keywords：

Resuscitation; Neonatal asphyxia; Systematic Review; Meta-analysis; Mortality rate

DOI：

10.7507/1672-2531.20160218

Video：

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Objective To systematically review the efficacy of promoting neonatal resuscitation technique in treatment of neonatal asphyxia in China. Methods Electronical databases including WanFang Data, CNKI, VIP, Jiangsu Engineering and Technology Literature Information Center, PubMed and The Cochrane Library (Issue 5, 2016) were searched to collect studies of neonatal resuscitation technique in treatment of neonatal asphyxia up to June 1st, 2016. Two reviewers independently screened literature, extracted data and assessed the risk bias of included studies, and then meta-analysis was performed by using RevMan 5.2 software. Results A total of eighteen observational studies were included, involving 28 144 cases of neonatal asphyxia and 32 636 cases of control, 2 148 death cases of neonatal asphyxia and 1 679 cases of controls. The results of meta-analysis showed that neonatal resuscitation technique could reduce newborn suffocation rate compared with the control group in hospital surveys (RR=0.59, 95%CI 0.55 to 0.63, P<0.000 01) and in regional project surveys (RR=0.72, 95%CI 0.69 to 0.75, P<0.000 01). Neonatal resuscitation could also reduce neonatal asphyxia mortality rate in hospital surveys (RR=0.26, 95%CI 0.16 to 0.42, P<0.000 01) and in regional surveys (RR=0.65, 95%CI 0.55 to 0.77, P<0.000 01). Conclusion The existing evidence shows that neonatal resuscitation technology could effectively reduce the incidence of neonatal asphyxia and mortality rate in China. Due to the limitations of the quantity and quality of present studies, we need to carry out prospective multicenter cohort studies to verify the current results.

Citation： LIHong-bin, FENGHai-juan, CHENJi-hua, FANHe-lian, DINGYan, ZHUJi-hua, ZHANGXiao-yan. Neonatal Resuscitation Technique in Reducing Neonatal Asphyxia Rate and Mortality Rate in China: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2016, 16(12): 1454-1464. doi: 10.7507/1672-2531.20160218 Copy

1.	American Academy of Pediatrics. Neonatal resuscitation ProgramTM.[2016-06-29] Available at:http://www2.aap.org/nrp/about.html.
2.	Ersdal HL, Singhal N. Resuscitation in resource-limited settings. Semin Fetal Neonatal Med, 2013, 18(6):373-378.
3.	Lee AC, Cousens S, Wall SN, et al. Neonatal resuscitation and immediate newborn assessment and stimulation for the prevention of neonatal deaths:a systematic review, meta-analysis and Delphi estimation of mortality effect. BMC Public Health, 2011, 11(Suppl 3):S12.
4.	2015AHA心肺復蘇及心血管急救指南更新. Available at:http://circ.cmt.com.cn/detail/970133.html.[2016-07-20].
5.	Curran V, Fleet L, White S, et al. A randomized controlled study of manikin simulator fidelity on neonatal resuscitation program learning outcomes. Adv Health Sci Educ Theory Pract, 2015, 20(1):205-218.
6.	Ersdal HL, Vossius C, Bayo E, et al. A one-day "Helping Babies Breathe" course improves simulated performance but not clinical management of neonates. Resuscitation, 2013, 84(10):1422-1427.
7.	Lee M, Brown L, Bender J, et al. A medical simulation-based educational intervention for emergency medicine residents in neonatal resuscitation. Acad Emerg Med, 2012, 19:577-585.
8.	Rubio-Gurung S, Putet G, Touzet S, et al. In situ simulation training for neonatal resuscitation:an RCT. Pediatrics, 2014, 134(3):790-977.
9.	Dempsey E, Pammi M, Ryan AC, et al. Standardised formal resuscitation training programmes for reducing mortality and morbidity in newborn infants. Cochrane Database Syst Rev, 2015, (9):CD009106.
10.	徐韜, 王惠珊, 宮麗敏, 等. 中國新生兒窒息復蘇培訓項目中期效果評價. 中華圍產醫學雜志, 2009, 12(6):409-412.
11.	王凌云, 宋志英, 曹玉蓮. 實施新生兒復蘇項目對降低我院新生兒窒息發生率和死亡率的意義. 中華圍產醫學雜志, 2013, 16(12):745-746.
12.	李鴻斌, 顧建明, 馮海娟, 等. 復蘇技術降低我國新生兒窒息發生率和死亡率的Meta分析. 中國婦幼健康研究, 2015, 26(5):1031-1034.
13.	李鴻斌, 王潔, 吉蘇梅, 等. 新生兒復蘇項目發展歷程、現狀與政策趨向. 中國實用護理雜志, 2016, 32(16):1273-1276.
14.	顧建明, 李鴻斌, 陸平, 等. 如皋市民營一級醫院新生兒復蘇現狀分析. 中國婦幼健康研究, 2015, 26(3):539-542.
15.	葉鴻瑁. 再接再厲, 繼續深入開展我國的新生兒復蘇工作. 中華圍產醫學雜志, 2016, 19(1):12-13.
16.	劉鳴. 系統評價、Meta分析設計與實施方法. 北京:人民衛生出版社, 2011:72-73.
17.	張潔晶, 顧承萍. 婦幼保健院新生兒復蘇管理模式的作用. 中醫藥管理雜志, 2016, 24(4):150-152.
18.	申巧俐, 曹玉蓮, 郭朝得, 等. 新生兒復蘇質量控制體系實施效果研究. 中國婦幼衛生雜志, 2015, 6(2):16-19.
19.	譚瑋, 丁香平, 周錦龍, 等. 新生兒窒息復蘇流程臨床應用效果評價. 中國新生兒科雜志, 2013, 28(4):256-258.
20.	覃超強. 新生兒窒息復蘇指南應用效果之評價. 中國實用醫藥, 2012, 7(14):17-18.
21.	尹麗霞, 胡艷麗. 新生兒窒息規范化復蘇培訓效果分析. 中國婦幼保健, 2008, 23(5):594-595.
22.	候林霞, 何艷君, 張麗清. 新生兒窒息新法復蘇術的臨床效果觀察. 中外醫療, 2013, (16):59-61.
23.	譚春迎, 王海鷗. 新生兒窒息復蘇效果評價. 中國婦幼保健, 2010, 25(15):2085-2086.
24.	鄧順周, 林建國, 朱惠清, 等. 不同時期新生兒新法復蘇效果對比分析. 中國婦幼保健, 2011, 26(19):2935-2937.
25.	李明珠, 王曉軍, 李龍, 等. 新疆新生兒復蘇培訓項目的實施及效果評價. 中華圍產醫學雜志, 2013, 16(12):741-744.
26.	王穎, 張萬恩, 徐韜, 等. 浙江新生兒復蘇項目管理模式探討及效果評估. 中國婦幼衛生雜志, 2015, 6(4):64-66.
27.	徐韜, 宮麗敏, 王惠珊, 等. 我國4縣開展新生兒復蘇長效機制試點干預效果評價. 中國兒童保健雜志, 2012, 20(6):504-506.
28.	毛新梅, 高紅衛, 李曉強, 等. 基層新生兒復蘇技術培訓模式的探索及效果評價. 中國婦幼衛生雜志, 2016, 7(2):17-20, 29.
29.	高淑強. 新生兒窒息新法復蘇技術推廣5年總結. 中國婦幼保健, 2009, 24(2):198-199.
30.	許厚琴, 朱麗萍, 杜莉, 等. 上海市推廣新生兒窒息復蘇技術對降低圍產兒死亡率的效果. 中國婦幼保健, 2012, 27(12):12-14.
31.	陳暉, 李燕, 王靜. 農村基層醫院開展新生兒窒息復蘇培訓項目的效果評價. 中外婦兒健康, 2011, 19(5):74-74.
32.	吳迅, 郭小芳, 方文, 等. 基層醫療機構新生兒窒息復蘇培訓模式的探討及效果評價.中國兒童保健雜志, 2010, 18(5):422-425.
33.	國家衛生和計劃生育委員會統計信息中心. 2016年3月底全國醫療衛生機構數.[2016-07-22] Available at:http://www.moh.gov.cn/mohwsbwstjxxzx/s7967/201607/5dde54faa3dd4efc8cd213e3fd53cebc.shtml.
34.	張悅, 徐韜, 馬藝, 等. 我國163所醫療機構新生兒復蘇工作現狀調查. 中華圍產醫學雜志, 2013, 16(12):736-740.
35.	羅杰, 冷衛東. 系統評價/Meta分析理論與實踐. 北京:軍事醫學科學出版社, 2013:160-164.
36.	國家衛生和計劃生育委員會. 中國衛生和計劃生育統計年鑒2014. 北京:中國協和醫科大學出版社, 2015:217.
37.	Carlo WA, Goudar SS, Jehan I, et al. Newborn-care training and perinatal mortality in developing countries. N Engl J Med, 2010, 362(7):614-623.
38.	Carlo WA, Goudar SS, Jehan I, et al. for the First Breath Study Group. High mortality rates for very low birth weight infants in developing countries despite training. Pediatrics, 2010, 126(5):1072-1080.
39.	Gill CJ, Phiri-Mazala G, Guerina NG, et al. Effect of training traditional birth attendants on neonatal mortality (Lufwanyama Neonatal Survival Project):randomised controlled study. BMJ, 2011, 342:d346.

1. American Academy of Pediatrics. Neonatal resuscitation ProgramTM.[2016-06-29] Available at:http://www2.aap.org/nrp/about.html.
2. Ersdal HL, Singhal N. Resuscitation in resource-limited settings. Semin Fetal Neonatal Med, 2013, 18(6):373-378.
3. Lee AC, Cousens S, Wall SN, et al. Neonatal resuscitation and immediate newborn assessment and stimulation for the prevention of neonatal deaths:a systematic review, meta-analysis and Delphi estimation of mortality effect. BMC Public Health, 2011, 11(Suppl 3):S12.
4. 2015AHA心肺復蘇及心血管急救指南更新. Available at:http://circ.cmt.com.cn/detail/970133.html.[2016-07-20].
5. Curran V, Fleet L, White S, et al. A randomized controlled study of manikin simulator fidelity on neonatal resuscitation program learning outcomes. Adv Health Sci Educ Theory Pract, 2015, 20(1):205-218.
6. Ersdal HL, Vossius C, Bayo E, et al. A one-day "Helping Babies Breathe" course improves simulated performance but not clinical management of neonates. Resuscitation, 2013, 84(10):1422-1427.
7. Lee M, Brown L, Bender J, et al. A medical simulation-based educational intervention for emergency medicine residents in neonatal resuscitation. Acad Emerg Med, 2012, 19:577-585.
8. Rubio-Gurung S, Putet G, Touzet S, et al. In situ simulation training for neonatal resuscitation:an RCT. Pediatrics, 2014, 134(3):790-977.
9. Dempsey E, Pammi M, Ryan AC, et al. Standardised formal resuscitation training programmes for reducing mortality and morbidity in newborn infants. Cochrane Database Syst Rev, 2015, (9):CD009106.
10. 徐韜, 王惠珊, 宮麗敏, 等. 中國新生兒窒息復蘇培訓項目中期效果評價. 中華圍產醫學雜志, 2009, 12(6):409-412.
11. 王凌云, 宋志英, 曹玉蓮. 實施新生兒復蘇項目對降低我院新生兒窒息發生率和死亡率的意義. 中華圍產醫學雜志, 2013, 16(12):745-746.
12. 李鴻斌, 顧建明, 馮海娟, 等. 復蘇技術降低我國新生兒窒息發生率和死亡率的Meta分析. 中國婦幼健康研究, 2015, 26(5):1031-1034.
13. 李鴻斌, 王潔, 吉蘇梅, 等. 新生兒復蘇項目發展歷程、現狀與政策趨向. 中國實用護理雜志, 2016, 32(16):1273-1276.
14. 顧建明, 李鴻斌, 陸平, 等. 如皋市民營一級醫院新生兒復蘇現狀分析. 中國婦幼健康研究, 2015, 26(3):539-542.
15. 葉鴻瑁. 再接再厲, 繼續深入開展我國的新生兒復蘇工作. 中華圍產醫學雜志, 2016, 19(1):12-13.
16. 劉鳴. 系統評價、Meta分析設計與實施方法. 北京:人民衛生出版社, 2011:72-73.
17. 張潔晶, 顧承萍. 婦幼保健院新生兒復蘇管理模式的作用. 中醫藥管理雜志, 2016, 24(4):150-152.
18. 申巧俐, 曹玉蓮, 郭朝得, 等. 新生兒復蘇質量控制體系實施效果研究. 中國婦幼衛生雜志, 2015, 6(2):16-19.
19. 譚瑋, 丁香平, 周錦龍, 等. 新生兒窒息復蘇流程臨床應用效果評價. 中國新生兒科雜志, 2013, 28(4):256-258.
20. 覃超強. 新生兒窒息復蘇指南應用效果之評價. 中國實用醫藥, 2012, 7(14):17-18.
21. 尹麗霞, 胡艷麗. 新生兒窒息規范化復蘇培訓效果分析. 中國婦幼保健, 2008, 23(5):594-595.
22. 候林霞, 何艷君, 張麗清. 新生兒窒息新法復蘇術的臨床效果觀察. 中外醫療, 2013, (16):59-61.
23. 譚春迎, 王海鷗. 新生兒窒息復蘇效果評價. 中國婦幼保健, 2010, 25(15):2085-2086.
24. 鄧順周, 林建國, 朱惠清, 等. 不同時期新生兒新法復蘇效果對比分析. 中國婦幼保健, 2011, 26(19):2935-2937.
25. 李明珠, 王曉軍, 李龍, 等. 新疆新生兒復蘇培訓項目的實施及效果評價. 中華圍產醫學雜志, 2013, 16(12):741-744.
26. 王穎, 張萬恩, 徐韜, 等. 浙江新生兒復蘇項目管理模式探討及效果評估. 中國婦幼衛生雜志, 2015, 6(4):64-66.
27. 徐韜, 宮麗敏, 王惠珊, 等. 我國4縣開展新生兒復蘇長效機制試點干預效果評價. 中國兒童保健雜志, 2012, 20(6):504-506.
28. 毛新梅, 高紅衛, 李曉強, 等. 基層新生兒復蘇技術培訓模式的探索及效果評價. 中國婦幼衛生雜志, 2016, 7(2):17-20, 29.
29. 高淑強. 新生兒窒息新法復蘇技術推廣5年總結. 中國婦幼保健, 2009, 24(2):198-199.
30. 許厚琴, 朱麗萍, 杜莉, 等. 上海市推廣新生兒窒息復蘇技術對降低圍產兒死亡率的效果. 中國婦幼保健, 2012, 27(12):12-14.
31. 陳暉, 李燕, 王靜. 農村基層醫院開展新生兒窒息復蘇培訓項目的效果評價. 中外婦兒健康, 2011, 19(5):74-74.
32. 吳迅, 郭小芳, 方文, 等. 基層醫療機構新生兒窒息復蘇培訓模式的探討及效果評價.中國兒童保健雜志, 2010, 18(5):422-425.
33. 國家衛生和計劃生育委員會統計信息中心. 2016年3月底全國醫療衛生機構數.[2016-07-22] Available at:http://www.moh.gov.cn/mohwsbwstjxxzx/s7967/201607/5dde54faa3dd4efc8cd213e3fd53cebc.shtml.
34. 張悅, 徐韜, 馬藝, 等. 我國163所醫療機構新生兒復蘇工作現狀調查. 中華圍產醫學雜志, 2013, 16(12):736-740.
35. 羅杰, 冷衛東. 系統評價/Meta分析理論與實踐. 北京:軍事醫學科學出版社, 2013:160-164.
36. 國家衛生和計劃生育委員會. 中國衛生和計劃生育統計年鑒2014. 北京:中國協和醫科大學出版社, 2015:217.
37. Carlo WA, Goudar SS, Jehan I, et al. Newborn-care training and perinatal mortality in developing countries. N Engl J Med, 2010, 362(7):614-623.
38. Carlo WA, Goudar SS, Jehan I, et al. for the First Breath Study Group. High mortality rates for very low birth weight infants in developing countries despite training. Pediatrics, 2010, 126(5):1072-1080.
39. Gill CJ, Phiri-Mazala G, Guerina NG, et al. Effect of training traditional birth attendants on neonatal mortality (Lufwanyama Neonatal Survival Project):randomised controlled study. BMJ, 2011, 342:d346.

Chinese Journal of Evidence-Based Medicine

Neonatal Resuscitation Technique in Reducing Neonatal Asphyxia Rate and Mortality Rate in China: A Systematic Review

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