Table 2 Neonatal near miss definitions

DeKnif et al. [33]

NNM criteria described by Avenant:

Respiratory failure/dysfunction: need for intubation and ventilation including nasal CPAP

Cardiac failure/dysfunction: need for adrenalin, other inotropic support or volume expansion

CNS failure/dysfunction: any convulsions or need for therapeutic anticonvulsants

Hypovolaemia: need for blood transfusion or volume expansion

Haematological failure/dysfunction: need for phototherapy or exchange blood transfusion, need for neupogen to increase white cells

Endocrine failure/dysfunction: need to treat hypoglycaemia (additional glucose)

Renal failure/ dysfunction: haematuria and/or oliguria / anuria

Immunologic failure/ dysfunction (congenital infection): CRP greater than or equal to 10 or raising CRP

Muscle-skeletal morbidity: any fracture

GIT/Hepatic failure/dysfunction

Bonnaerens et al. [18]

Established metabolic acidosis at birth:

Arterial pH < 7.05 or venous pH < 7.17, in association with base excess ≤ -10 mmol/L

In cases of sampling or analysis-error, neonates with persistently low Apgar score of ≤ 6 after 5 min were considered clinically at risk for metabolic acidosis

Rana et al. [34]

Adapted from WHO Multi-country Survey (Pileggi-Castro):

Clinical sign-based criteria:

Loss of consciousness > five minutes, persistent bradycardia (heart rate < 80 beats/minute), persistent tachycardia (heart rate > 200 beats/minute), poor capillary refill (> three seconds), acute central cyanosis in room air, gasping respiration, anuria lasting > six hours, visible haematuria, failure to form clots (bedside clotting time > seven minutes, clots that break easily, the absence of clotting from iv sites or suture lines after 7–10 min), use of therapeutic intra venous antibiotics, visible jaundice in first 24 h, uncontrollable fit/status epilepticus

Danger signs-based criteria:

not breathing even after stimulation and suction, fast breathing/pneumonia, severe chest indrawing, lethargy/unconsciousness, poor sucking/unable to suck mother’s milk in term baby, hypothermia (temperature < 36.5°C), fever (> 100.4°F/ > 38°C)

reddish umbilicus extending to the surrounding skin/single boil/

10 pustules on the skin, convulsion, nasal flaring, bulging anterior fontanelle, grunting, jaundice within 24 h of birth (visible on palms and soles), diarrhoea with severe dehydration, persistent vomiting; conditions at birth-based criteria very low birthweight (< 1500 g), preterm (< 30 weeks)