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2015 ; 15
(ä): 320
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Neonatal near miss: a systematic review
#MMPMID26625905
Santos JP
; Pileggi-Castro C
; Camelo JS Jr
; Silva AA
; Duran P
; Serruya SJ
; Cecatti JG
BMC Pregnancy Childbirth
2015[Dec]; 15
(ä): 320
PMID26625905
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BACKGROUND: The concept of neonatal near miss has been proposed as a tool for
assessment of quality of care in neonates who suffered any life-threatening
condition. However, there are no internationally agreed concepts or criteria for
defining or identifying neonatal near miss. The purpose of this study was to
perform a systematic review of studies and markers that are able to identify
neonatal near miss cases and predict neonatal mortality. METHODS: Electronic
searches were performed in the Medline, Embase and Scielo databases, with no time
or language restriction, until December 2014. The term "neonatal near miss" was
used alone or in combination with terms related to neonatal morbidity/mortality
and neonatal severity scores. Study selection criteria involved three steps:
title, abstract and full text of the articles. Two researchers performed study
selection and data extraction independently. Heterogeneity of study results did
not permit the performance of meta-analysis. RESULTS: Following the inclusion and
exclusion criteria adopted, only four articles were selected. Preterm and
perinatal asphyxia were used as near miss markers in all studies. Health
indicators on neonatal morbidity and mortality were extracted or estimated. The
neonatal near miss rate was 2.6 to 8 times higher than the neonatal mortality
rate. CONCLUSIONS: Pragmatic and management criteria are used to help develop the
neonatal near miss concept. The most severe cases are identified and mortality is
predicted with these criteria. Furthermore, the near miss concept can be used as
a tool for evaluating neonatal care. It is the first step in building management
strategies to reduce mortality and long-term sequelae.
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