Neonatal near-miss audits to reduce perinatal mortality and morbidity

Neonatal near-miss (NNM) audits, when combined with perinatal mortality reviews, have the potential to inform strategies to better prevent adverse perinatal outcomes. However, there is currently no standard definition of NNM, there is lack of standardised definitions of NNM and limited evidence of implementation of NNM audits. The aim of this study was to describe definitions of NNM and assess current approaches and attitudes toward perinatal mortality and morbidity audit.

This study achieved global participation engaged over 120 perinatal healthcare professionals to better understand how neonatal near-miss (NNM) events are defined and used in practice.

Key findings:

• Respondents outlined the main characteristics to define NNM within the study and majority of participants (97.5%) considered NNM important for identifying cases for perinatal morbidity audits.
• The study found only 10.0% of their institutions used a NNM definition.
• Overall, 98.4% of participants considered perinatal mortality and morbidity audits important to prevent adverse outcomes.

Neonatal near-miss audit is viewed as a valuable tool to reduce adverse neonatal outcomes. There was reasonable consensus that NNM encompassed evidence of birth asphyxia and/or advanced neonatal resuscitation. Data from this international survey identifies a starting point for a consensus definition of NNM, which can be used for perinatal audits to identify opportunities for improvement.

Research team: Poliana de Barros Medeiros, Helen Liley, Christine Andrews, Adrienne Gordon, Alexander Heazell, Alison Kent, Susannah Leisher, Vicki Flenady.

Publication

de Barros Medeiros P, Liley H, Andrews C, Gordon A, Heazell AEP, Kent AL, et al. Current approach and attitudes toward neonatal near-miss and perinatal audits: An exploratory international survey. Aust N Z J Obstet Gynaecol. 2023;63(3):352-9.