The evolution of the criteria for identifying the new concept of `Neonatal Near Miss`: a systematic review.

BACKGROUND: The concept of Near Miss, has been used in the field of obstetrics as a tool for assessing and improving the quality of care. However, there is no standardized definition or international criteria for identifying neonatal near misses. The current review aims to investigate the development of the neonatal near miss concept based on the results of studies conducted so far on neonatal near misses and their identification criteria. RESULTS: Sixty-two articles were retrieved by the electronic search, and after examination of different abstracts and reading of full texts, 17 articles were considered eligible meeting our inclusion criteria. All selected articles varied in terms of concept definition and criteria used. Neonatal Near Miss was defined as any newborn with pragmatic and/or management criteria who survived the first 27 days of life. All studies reviewed showed a Neonatal Near Miss rate that was 2.6 to 10 times higher than the neonatal mortality rate. CONCLUSIONS: Neonatal Near Miss is a new concept that is currently being debated. There is a need for universal consensus on the definition and its identification criteria. Further efforts are needed to standardize the definition of this concept, including the development of criteria that can be assessed in a neonatal care setting. This is to improve the quality of neonatal care in every setting, regardless of the local level.

The Prevalence of Neonatal Near Misses in Rabat, Morocco.

BACKGROUND: The concept of near-miss neonatal (NMN) is a potentially useful approach in assessing the quality of newborn care. However, data collected on the status of NMN cases in Morocco is scarce. OBJECTIVE: The objective of this study is to determine the prevalence of NMN cases among live births at the University Hospital of Rabat, Morocco. MATERIALS AND METHODS: An observational cross-sectional study was conducted on 2676 newborns born at the University Hospital of Rabat, Morocco, and admitted to the National Reference Center of Neonatology and Nutrition (NRCN) from January 1 to December 31, 2021. The main inclusion criteria were the pragmatic and/or management markers of the definition of NMN. Data were extracted using a structured, pre-tested checklist, entered into EpiData, and exported to Statistical Software for the Social Sciences (SPSS) version 23 (IBM Corp., Armonk, NY), and descriptive statistics were performed. RESULTS: Among the 2676 selected live births, 2367 were NMN cases (88.5%; 95% CI: 88.3-90.7). More than half of new mothers (57.5%) were referrals, 59.9% of women were multiparous, and 78.5% had under four prenatal care consultations. Obstetric problems affected 373 of the women during pregnancy. A pragmatic criterion was met in 43.6% of NMN situations. Among the management criteria, the use of intravenous antibiotics was the most common factor at 56.0%. CONCLUSIONS: This study revealed a high prevalence of NMN. Therefore, concerted efforts are needed to improve maternal health care services, including early identification of complications and appropriate management.