From: Neonatal near-misses in Ghana: a prospective, observational, multi-center study
All babies at enrollment (N = 394) N(%) | Indicators at 28-day follow-up | ||||
---|---|---|---|---|---|
Not classified as a near-miss (N = 52) N(%) | Confirmed near-misses at 28 days (N = 274) N(%) | Babies who died within 28 days of birth (N = 68) N(%) | Chi2 P Value | ||
NNMAT Category 1: Evidence of severe complication (yes to any of the following: Apgar score < 7 at 5 min (n = 193), gestational age < 33 weeks (n = 150), birthweight < 1800 g (n = 196), suspected subgaleal bleed (n = 39), major congenital abnormality (n = 37), axillary temperature < 35 °C or > 39 °C (n = 131), severe jaundice that required blood exchange (n = 15), surgery in first week (n = 4)) | 260 (66.0) | 0 (0) | 204 (74.5) | 56 (82.4) | < 0.001 |
NNMAT Category 2: Intervention-Based Criteria (yes to any of the following: Resuscitation (bag & mask) immediately after birth (n = 201), resuscitation in the NICU (n = 208), chest compressions/cardiac massage (n = 15), IV fluid bolus (n = 178), intubation (n = 11), double phototherapy (n = 64), double volume exchange blood transfusion (n = 19), oxygen therapy (n = 323), caffeine citrate/aminophylline (n = 169), thermal protection (n = 188)) | 293 (74.4) | 0 (0) | 233 (85.0) | 60 (88.2) | < 0.001 |
NNMAT Category 3: Organ-Dysfunction-Based Criteria (yes to specific indicators for cardiovascular (n = 31), respiratory (n = 148), renal (n = 56), gastroenterologic (n = 17), neurologic (n = 292)) | 186 (47.2) | 0 (0) | 134 (48.9) | 52 (76.5) | < 0.001 |
NNMAT Category 4: Investigation-based criteria (yes to any: haematocrit > 30% (n = 8), hemoglobin < 10gd/dl (n = 10), serum bilirubin >10x gestational age (n = 9), positive blood culture (n = 7)) | 23 (5.8) | 0 (0) | 16 (5.8) | 7 (10.3) | 0.058 |
Met no criteria | 53 (13.5) | 52 (100) | 0 (0) | 1 (1.5) | < 0.001 |
Met one category of criteria | 76 (19.3) | 0 (0) | 69 (25.2) | 7 (10.3) | |
Met two categories of criteria | 120 (30.5) | 0 (0) | 106 (38.7) | 14 (20.6) | |
Met three categories of criteria | 134 (34.0) | 0 (0) | 90 (32.9) | 44 (64.7) | |
Met four categories of criteria | 11 (2.8) | 0 (0) | 9 (3.3) | 2 (2.9) |