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

Abstract

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.

Keywords: Neonatal Near Miss; emergency neonatal care - identification criteria; neonatal morbidity; neonatal mortality.