Academic Journal
A systematic review of mortality and severe morbidities following newborn chest compressions at birth.
| Title: | A systematic review of mortality and severe morbidities following newborn chest compressions at birth. |
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| Authors: | Bayih WA; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Eastwood K; School of Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia., Liley HG; Mater Research, Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Brisbane, Australia., Trang J; The Children's Hospital at Westmead, New South Wales, Australia., Ardern J; School of Nursing, University of Auckland, Auckland, New Zealand; Kidz First Neonatal Care, Counties Manukau Health, Auckland, New Zealand., Choong K; School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia., Bray JE; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Prehospital, Resuscitation and Emergency Care Research Unit, Curtin University, Western Australia, Australia. Electronic address: Janet.bray@monash.edu.au. |
| Source: | Resuscitation [Resuscitation] 2026 Aug; Vol. 225, pp. 111115. Date of Electronic Publication: 2026 Apr 30. |
| Publication Type: | Journal Article; Systematic Review; Review |
| Language: | English |
| Journal Info: | Publisher: Elsevier/north-Holland Biomedical Press Country of Publication: Ireland NLM ID: 0332173 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-1570 (Electronic) Linking ISSN: 03009572 NLM ISO Abbreviation: Resuscitation Subsets: MEDLINE |
| Imprint Name(s): | Publication: Limerick : Elsevier/north-Holland Biomedical Press Original Publication: London, Middlesex Pub. Co. |
| MeSH Terms: | Cardiopulmonary Resuscitation*/mortality , Cardiopulmonary Resuscitation*/methods , Cardiopulmonary Resuscitation*/adverse effects , Heart Massage*/mortality , Heart Massage*/adverse effects , Heart Massage*/methods, Humans ; Infant, Newborn ; Hospital Mortality |
| Abstract: | Aim: To synthesise evidence for severe short-term outcomes following delivery room (DR) chest compressions (CC) and variation by birth setting, gestation, and level of care. Methods: Five databases and grey literature were systematically searched to 8 September 2025, for studies reporting mortality or severe morbidity after DR-CC (CRD42024487027). Study selection followed a population-exposure-outcome framework, and risk of bias was assessed using the JBI checklist. The primary outcome was mortality. Results: Twenty-six studies (9,747 CC recipients, 1989-2019) from 16 high-income countries were included. DR-CC definitions varied (unspecified duration, ≥30-60 s, or plus epinephrine), with heart rate trigger rarely reported. Mortality ranged from 21% among moderate and late preterm infants to 27-74% among very preterm or very low birth weight infants, while severe neurological injury (NI) ranged between 16% and 42%. Studies with definitions that also required epinephrine reported higher mortality (39-74%) and severe NI (19-42%). Most studies did not distinguish DR deaths from subsequent in-hospital mortality. Evidence from low- and middle-income countries and for late preterm, term, and outborn infants, by care level, and by CC timeliness was sparse. Conclusions: The substantial variation in CC outcome estimates cannot be reliably ascribed to temporal or geographic factors, given the heterogeneity in inclusion criteria. Persistent gaps in differentiating DR deaths and stratifying outcomes by gestation, birth setting, care level, and CC timeliness underscore the need for prospective studies aligned with the Neonatal Utstein to improve precision and comparison of evidence in neonatal resuscitation. (Copyright © 2026 The Author(s). Published by Elsevier B.V. All rights reserved.) |
| Competing Interests: | Declaration of competing interest Janet Bray is a member of the Resuscitation editorial board. |
| Contributed Indexing: | Keywords: Chest compressions; Epinephrine; Infant; Morbidity; Mortality; Outcomes; Resuscitation |
| Entry Date(s): | Date Created: 20260502 Date Completed: 20260624 Latest Revision: 20260625 |
| Update Code: | 20260626 |
| DOI: | 10.1016/j.resuscitation.2026.111115 |
| PMID: | 42069040 |
| Database: | MEDLINE |
| ISSN: | 1873-1570 |
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| DOI: | 10.1016/j.resuscitation.2026.111115 |