Mackay Amy, Ishoso Daniel, Mafuta Eric, Eilevstjønn Joar, Gomez Patricia, Carlo Waldemar, Bauserman Melissa, Bose Carl, Patterson Jackie K
Department of Pediatrics, University of Alabama at Birmingham School of Medicine, Birmingham, AL.
Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
PLoS One. 2025 May 23;20(5):e0324332. doi: 10.1371/journal.pone.0324332. eCollection 2025.
Improving neonatal resuscitation practices reduces neonatal mortality. In low- and middle-income countries (LMICs), granular details about provider actions during resuscitation are largely unknown; therefore, identifying targets for improvement is difficult. The International Liaison Committee on Resuscitation (ILCOR) recognizes the importance of uniform reporting of clinical neonatal resuscitation studies and published a guideline recommending specific variables to include. We established an open cohort study for newborn resuscitation in the Democratic Republic of the Congo (DRC) as a platform for developing and evaluating novel strategies to improve newborn resuscitation. We included all in-born neonates at two health facilities in Kinshasa, DRC. We gathered data on all enrollees via delivery registry and medical record abstraction. Using the Liveborn Observation app, we directly observed care at birth for a convenience sample. We collected heart rate data when providers used NeoBeat, a battery-operated heart rate meter. From September 2022 to August 2023, we abstracted delivery registry and medical record data for 6,414 newborns and gathered observational data on the infant's breathing status and provider actions for 3,166 (49%). Our dataset includes 85% of ILCOR's recommended core variables applicable to this setting, and 50% of ILCOR's applicable supplemental variables. Our registry also contains variables beyond those recommended by ILCOR that are contextually important for evaluating resuscitation care in LMICs such as duration of suctioning, pauses in positive pressure ventilation and fresh stillbirth. Our experience establishing a resuscitation registry with novel tools in the DRC serves as a model for resuscitation research in low-resource settings. Our cohort study provides important insight to inform subsequent versions of ILCOR's guideline on uniform reporting of neonatal resuscitations studies globally.
改进新生儿复苏操作可降低新生儿死亡率。在低收入和中等收入国家(LMICs),关于复苏过程中医疗人员操作的详细信息大多未知;因此,确定改进目标很困难。国际复苏联合委员会(ILCOR)认识到统一报告临床新生儿复苏研究的重要性,并发布了一项指南,推荐了应纳入的特定变量。我们在刚果民主共和国(DRC)开展了一项新生儿复苏开放队列研究,作为开发和评估改善新生儿复苏新策略的平台。我们纳入了刚果民主共和国金沙萨两家医疗机构的所有出生新生儿。我们通过分娩登记和病历摘要收集了所有入组者的数据。使用“活产观察”应用程序,我们对一个方便样本直接观察了出生时的护理情况。当医疗人员使用电池供电的心率计NeoBeat时,我们收集了心率数据。从2022年9月到2023年8月,我们提取了6414名新生儿的分娩登记和病历数据,并收集了3166名(49%)婴儿呼吸状况和医疗人员操作的观察数据。我们的数据集包括适用于该环境的ILCOR推荐核心变量的85%,以及ILCOR适用补充变量的50%。我们的登记册还包含了ILCOR推荐之外的变量,这些变量对于评估低收入和中等收入国家的复苏护理具有重要背景意义,如吸引时间、正压通气暂停和新鲜死产。我们在刚果民主共和国使用新工具建立复苏登记册的经验,为低资源环境下的复苏研究提供了一个范例。我们的队列研究提供了重要见解,为ILCOR全球新生儿复苏研究统一报告指南的后续版本提供参考。