Department of Emergency Medicine, University of Iowa, Roy J. and Lucille A. Carver College of Medicine, 200 Hawkins Drive, IA, 52242, Iowa City, USA.
Department of Emergency Medicine, University of Washington, Harborview Medical Center, Box 359702, 325 Ninth Avenue, WA, 98104, Seattle, USA.
BMC Pediatr. 2022 Jan 3;22(1):7. doi: 10.1186/s12887-021-02987-4.
Helping Babies Breathe (HBB) is an American Academy of Pediatrics neonatal resuscitation program designed to reduce neonatal mortality in low resource settings. The 2017 neonatal mortality rate in Haiti was 28 per 1000 live births and an estimated 85 % of Haitian women deliver at home. Given this, the Community Health Initiative implemented an adapted HBB (aHBB) in Haiti to evaluate neonatal mortality.
Community Health Workers taught an aHBB program to laypeople, which didn't include bag-valve-mask ventilation. Follow-up after delivery assessed for maternal and neonatal mortality and health.
Analysis included 536 births of which 84.3 % (n=452) were attended by someone trained in aHBB. The odds of neonatal mortality was not significantly different among the two groups (aOR=0.48 [0.16-1.44]). Composite outcome of neonatal health as reported by the mother (subjective morbidity and mortality) was significantly lower in aHBB attended births (aOR=0.31 [0.14-0.70]).
This analysis of the aHBB program indicates that community training to laypersons in low resource settings may reduce neonatal ill-health but not neonatal mortality. This study is likely underpowered to find a difference in neonatal mortality. Further work is needed to evaluate which components of the aHBB program are instrumental in improving neonatal health.
帮助婴儿呼吸（HBB）是美国儿科学会新生儿复苏计划，旨在降低资源匮乏环境中的新生儿死亡率。2017 年海地的新生儿死亡率为每 1000 例活产 28 例，估计 85%的海地妇女在家中分娩。鉴于此，社区卫生倡议组织在海地实施了适应性 HBB（aHBB），以评估新生儿死亡率。
社区卫生工作者向非专业人员教授 aHBB 计划，该计划不包括气囊面罩通气。分娩后随访评估母婴死亡率和健康状况。
分析纳入了 536 例分娩，其中 84.3%（n=452）由接受过 aHBB 培训的人员接生。两组新生儿死亡率的比值比无显著差异（aOR=0.48 [0.16-1.44]）。由母亲报告的新生儿健康综合结局（主观发病率和死亡率）在 aHBB 分娩中显著较低（aOR=0.31 [0.14-0.70]）。
对 aHBB 计划的分析表明，在资源匮乏环境中向非专业人员进行社区培训可能会降低新生儿健康不良的发生率，但不会降低新生儿死亡率。本研究可能因效力不足而无法发现新生儿死亡率的差异。需要进一步研究来评估 aHBB 计划的哪些组成部分对改善新生儿健康状况具有重要作用。
