Newborn Heart Rate as a Catalyst for Improved Survival

Organization: 
The American Academy of Pediatrics
Organization Location: 
Elk Grove Village, Illinois, USA

NeoBeat, a new, low-cost, innovative newborn heart rate monitor, combined with the Helping Babies Breathe (HBB) educational training program, addresses the widespread global health problem of neonatal mortality and morbidity due to misclassification of stillbirths and birth asphyxia. An estimated 1.19 million intrapartum stillbirths occur yearly, of which 98% take place in low and middle-income countries. Many of these newborns have a heart rate (HR) when they are born, but do not breathe. Data suggests that misclassification of stillbirths is a major problem and increasing evidence suggests that many of these infants could survive with resuscitation. Closing this gap in the quality of care may provide lifesaving resuscitation to 500,000 newborns per year. However, current methods for assessing HR are inaccurate and/or impossible to do for a single provider without delaying or stopping the lifesaving ventilation of the asphyxiated newborn, thus are not included in the initial assessment of HR in non-breathing newborns. To address these gaps in the quality of care in low-resource settings, this project proposes: 1) the introduction of NeoBeat, to measure HR in all non-breathing newborns; and 2) the incorporation of HR into the resuscitation algorithm outlined in HBB to align with the new ILCOR recommendations. In this clinical trial comparing the impact of HBB training with and without the use of NeoBeat, this proposal expects that the HBB + NeoBeat approach will demonstrate an added reduction in newborn mortality and stillbirth rate because: 1) assessing HR will ensure live-born non-breathing babies are not misclassified as stillborn and receive effective resuscitation; 2) during assisted ventilation, HR provides vital information about the effectiveness of the ventilation and the need for additional corrective measures.

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