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复苏培训能否降低资源匮乏社区的新生儿死亡率?文献系统综述

Does Resuscitation Training Reduce Neonatal Deaths in Low-Resource Communities? A Systematic Review of the Literature.

作者信息

Sousa Sarah, Mielke John G

机构信息

University of Waterloo, Waterloo, ON, Canada.

University of Waterloo, Waterloo, ON, Canada

出版信息

Asia Pac J Public Health. 2015 Oct;27(7):690-704. doi: 10.1177/1010539515603447.

Abstract

Every year, nearly 1 million babies succumb to birth asphyxia (BA) within the Asia-Pacific region. The present study sought to determine whether educational interventions containing some element of resuscitation training would decrease the relative risk (RR) of neonatal mortality attributable to BA in low-resource communities. We systematically reviewed 3 electronic databases and identified 14 relevant reports. For community deliveries, providing traditional birth attendants (TBAs) with neonatal resuscitation training modestly reduced the RR in 3 of 4 studies. For institutional deliveries, training a range of clinical staff clearly reduced the RR within 2 of 8 studies. When resuscitation-specific training was directed to community and institutional health care workers, a slight benefit was observed in 1 of 2 studies. Specific training in neonatal resuscitation appears most effective when provided to TBAs (specifically, those presented with ongoing opportunities to review and update their skills), but this particular intervention alone may not appreciably reduce mortality.

摘要

在亚太地区,每年有近100万婴儿死于出生窒息(BA)。本研究旨在确定包含某些复苏培训内容的教育干预措施是否会降低资源匮乏社区中因BA导致的新生儿死亡相对风险(RR)。我们系统检索了3个电子数据库,确定了14篇相关报告。对于社区分娩,在4项研究中有3项显示,为传统助产士(TBA)提供新生儿复苏培训可适度降低RR。对于机构分娩,在8项研究中有2项表明,培训一系列临床工作人员可明显降低RR。当针对社区和机构医护人员进行特定的复苏培训时,在2项研究中有1项显示有轻微益处。当向传统助产士(特别是那些有持续机会复习和更新技能的人员)提供新生儿复苏的特定培训时,似乎最为有效,但仅这一特定干预措施可能不会显著降低死亡率。

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