The impact of Neonatal Resuscitation Program courses on mortality and morbidity of newborn infants with perinatal asphyxia.
OBJECTIVE
Neonatal care provided within the first few minutes of life plays a major role in the reduction of neonatal morbidity and mortality. Neonatal Resuscitation Program (NRP) courses had been held since 1996. The aim of this study was to evaluate the impact of the NRP on morbidity and mortality of newborn infants with perinatal asphyxia.


METHODS
This retrospective study comprised newborn infants who were born in hospitals at Trakya region of Turkey during the last 3 years and were diagnosed as perinatal asphyxia and were referred to our Neonatal Unit. Those patients who were referred before NRP course (pretraining period) were designated as Group 1, those who were referred after the first NRP course (transition period) as Group 2, and those who were referred after the second NRP course (post-training period) as Group 3. Chart review was performed with regard to gestational age, birth weight, Apgar scores, resuscitation type, stage of hypoxic ischemic encephalopathy (HIE), existence of meconium aspiration syndrome (MAS), progress of the disease, duration of hospitalization.


RESULTS
The study comprised 66 patients; 35 in Group 1, 18 in Group 2 and 13 in Group 3. The number of cases who had not been resuscitated was 10 in the pretraining period, 3 in the transition period and 1 in the post-training period which decreased significantly. The first minute Apgar scores in three groups were as follows; 2.08+/-1.2, 2.2+/-1.1 and 3.7+/-1.4, and this increase was statistically significant. The fifth minute Apgar scores also increased from 5.43+/-1.5 in the pretraining period to 6.5+/-1.9 in the post-training period, but this increase was not statistically significant. The number of patients with Stage 1 and 2 HIE decreased more in Group 3 (n=11 in Stage 1 HIE, n=17 in Stage 2 HIE) compared to those in Group 1 (n=7 in Stage 1 HIE, n=5 in Stage 2 HIE) but the difference was not statistically significant. The duration of hospitalization decreased in post-training period (15.1+/-10.3 days in pretraining period, 12.0+/-8.9 days in transition period, 6.1+/-1.2 days in post-training period).


CONCLUSIONS
After NRP courses, the number of patients with perinatal asphyxia and with no resuscitation and also the duration of hospitalization decreased significantly, whereas the first minute Apgar scores increased significantly.
Duran
Ridvan
R
Department of Pediatrics, Trakya University School of Medicine, Edirne, Turkey. ridvan_duran@yahoo.com
Aladağ
Nükhet
N
Vatansever
Ulfet
U
Süt
Necdet
N
Acunaş
Betül
B
D001034:Apgar Score; D001238:Asphyxia Neonatorum / Q000401:mortality* / Q000517:prevention & control / Q000628:therapy*; D016887:Cardiopulmonary Resuscitation / Q000193:education* / Q000706:statistics & numerical data* / Q000639:trends; D015331:Cohort Studies; D018450:Disease Progression; D004493:Education / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000401:mortality / Q000517:prevention & control / Q000628:therapy; D007226:Infant Mortality / Q000639:trends; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D008471:Meconium Aspiration Syndrome / Q000453:epidemiology; D008505:Medical Staff, Hospital / Q000193:education / Q000706:statistics & numerical data; D010043:Outcome and Process Assessment, Health Care; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology