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dc.contributor.authorJanet, S
dc.contributor.authorCarrara, VI
dc.contributor.authorSimpson, JA
dc.contributor.authorThin, NWW
dc.contributor.authorSay, WW
dc.contributor.authorPaw, NTM
dc.contributor.authorChotivanich, K
dc.contributor.authorTurner, C
dc.contributor.authorCrawley, J
dc.contributor.authorMcGready, R
dc.date.accessioned2020-12-18T03:52:18Z
dc.date.available2020-12-18T03:52:18Z
dc.date.issued2018-01-05
dc.identifierpii: PONE-D-17-29686
dc.identifier.citationJanet, S., Carrara, V. I., Simpson, J. A., Thin, N. W. W., Say, W. W., Paw, N. T. M., Chotivanich, K., Turner, C., Crawley, J. & McGready, R. (2018). Early neonatal mortality and neurological outcomes of neonatal resuscitation in a resource-limited setting on the Thailand-Myanmar border: A descriptive study. PLOS ONE, 13 (1), https://doi.org/10.1371/journal.pone.0190419.
dc.identifier.issn1932-6203
dc.identifier.urihttp://hdl.handle.net/11343/255955
dc.description.abstractBACKGROUND: Of the 4 million neonatal deaths worldwide yearly, 98% occur in low and middle-income countries. Effective resuscitation reduces mortality and morbidity but long-term outcomes in resource-limited settings are poorly described. This study reports on newborn neurological outcomes following resuscitation at birth in a resource-limited setting where intensive newborn care including intubation is unavailable. METHODS: Retrospective analysis of births records from 2008 to 2015 at Shoklo Malaria Research Unit (SMRU) on the Thailand-Myanmar border. FINDINGS: From 21,225 newbonrs delivered, 15,073 (71%) met the inclusion criteria (liveborn, singleton, ≥28 weeks' gestation, delivered in SMRU). Neonatal resuscitation was performed in 460 (3%; 422 basic, 38 advanced) cases. Overall early neonatal mortality was 6.6 deaths per 1000 live births (95% CI 5.40-8.06). Newborns receiving basic and advanced resuscitation presented an adjusted rate for death of 1.30 (95%CI 0.66-2.55; p = 0.442), and 6.32 (95%CI 3.01-13.26; p<0.001) respectively, compared to newborns given routine care. Main factors related to increased need for resuscitation were breech delivery, meconium, and fetal distress (p<0.001). Neurodevelopmental follow-up to one year was performed in 1,608 (10.5%) of the 15,073 newborns; median neurodevelopmental scores of non-resuscitated newborns and those receiving basic resuscitation were similar (64 (n = 1565) versus 63 (n = 41); p = 0.732), while advanced resuscitation scores were significantly lower (56 (n = 5); p = 0.017). INTERPRETATIONS: Newborns requiring basic resuscitation at birth have normal neuro-developmental outcomes at one year of age compared to low-risk newborns. Identification of risk factors (e.g., breech delivery) associated with increased need for neonatal resuscitation may facilitate allocation of staff to high-risk deliveries. This work endorses the use of basic resuscitation in low-resource settings, and supports on-going staff training to maintain bag-and-mask ventilation skills.
dc.languageEnglish
dc.publisherPUBLIC LIBRARY SCIENCE
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.titleEarly neonatal mortality and neurological outcomes of neonatal resuscitation in a resource-limited setting on the Thailand-Myanmar border: A descriptive study
dc.typeJournal Article
dc.identifier.doi10.1371/journal.pone.0190419
melbourne.affiliation.departmentMelbourne School of Population and Global Health
melbourne.source.titlePLoS One
melbourne.source.volume13
melbourne.source.issue1
dc.rights.licenseCC BY
melbourne.elementsid1290570
melbourne.contributor.authorSimpson, Julie
dc.identifier.eissn1932-6203
melbourne.accessrightsOpen Access


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