Facility-based stillbirth review processes used in different countries across the world: a systematic review.
Facility-based stillbirth review processes used in different countries across the world: a systematic review.
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DOI：
10.1016/j.eclinm.2023.101976
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发表时间：
2023-05
影响因子：
15.1
通讯作者：
Nair, Manisha
中科院分区：
文献类型：
--
作者：
Boo, Yebeen Ysabelle;Gwacham-Anisiobi, Uchenna;Thakrar, Dixa B.;Roberts, Nia;Kurinczuk, Jennifer J.;Lakhanpaul, Monica;Nair, Manisha
以设施为基础的死产审查提供了机会来估计死产的发生率，评估死产的原因和风险因素，并确定与妊娠和分娩护理质量有关的任何需要改进的问题。我们的目标是系统地审查世界各地不同国家使用的基于设施的死产审查程序的所有类型和方法，检查世界各地设施环境中的死产审查是如何进行的，并确定实施审查的结果。此外，通过进行分组分析，找出影响执行已确定的以设施为基础的死产审查程序的促进者和障碍。通过检索MEDLINE(OvidSP)[1946-Present]、EMBASE(OvidSP)[1974-Present]、WHO Global Index Medicus(GlobalindexMedicus.net)、Global Health(OvidSP)[1973-2022 Week 8]和CINAHL(EBSCOhost)[1982-Present]对已发表的文献进行系统评价。对于未发表的或灰色文献，搜索WHO数据库、Google Scholar和ProQuest Dumptions&Teses Global，以及手工搜索所收录研究的参考列表。包括“∗临床审计”、“∗围产期死亡率”、“妊娠并发症”和“死产”的网状术语与布尔运算符一起使用。使用基于设施的回顾过程或任何方法来评估死产前护理的研究被包括在内，并解释了使用的方法。评论和社论被排除在外。三位作者(YYB、UGA和DBT)独立筛选和提取数据，并使用修改后的JBI病例系列检查表评估偏倚的风险。一个逻辑模型被用来为叙事综合提供信息。审查方案在Propero注册，CRD42022304239。来自17个高收入国家(高收入国家)和22个低收入和中等收入国家(低收入和中等收入国家)的68项研究在总共7258项已确定的记录中符合纳入标准。这些是在不同级别进行的死产审查：地区、州、国家和国际。确定了三种类型：审计、审查和保密询问，但大多数程序并不包括所有需要的组成部分，这导致对类型的描述与实际使用的方法不匹配。来自医院记录的常规数据是识别死胎的最常见数据来源，在68项研究中，有48项病例评估基于死胎定义。医院病历是关于所接受的护理和死产的原因/风险因素的最常见信息来源。14项研究报告了短期和中期结果，但任何研究都没有报告审查过程对减少死产的影响，这一点更难确定。从14项研究中确定的在实施成功的死产审查过程中的促进者和障碍主要集中在三个主题：资源、专门知识和承诺。这项系统审查的结果表明，需要有明确的指导方针，说明如何根据死产审查的结果和方法衡量实施改革的影响，以便能够在未来有效传播学习要点，并通过培训平台加以推广。此外，有必要制定和通过死胎的普遍定义，以便于对各区域之间的死胎率进行有意义的比较。这一综述的主要局限性在于，尽管使用逻辑模型进行叙事合成被认为是最适合本研究的，但在现实世界中实施死胎综述的顺序并不是线性的，而且假设往往不被满足。因此，本研究提出的逻辑模型在设计死产复核过程时应灵活地加以解释。从死产审查过程中得出的经验教训为行动计划提供了依据，并使各机构能够考虑应在哪里进行改革，以提高这些机构的护理质量，从而取得积极的短期和中期成果。、、和(MRC)。
Facility-based stillbirth review provides opportunities to estimate incidence, evaluate causes and risk factors for stillbirths, and identify any issues related to the quality of pregnancy and childbirth care which require improvement. Our aim was to systematically review all types and methods of facility-based stillbirth review processes used in different countries across the world, to examine how stillbirth reviews in facility settings are being conducted worldwide and to identify the outcomes of implementing the reviews. Moreover, to identify facilitators and barriers influencing the implementation of the identified facility-based stillbirth reviews processes by conducting subgroup analyses. A systematic review of published literature was conducted by searching MEDLINE (OvidSP) [1946-present], EMBASE (OvidSP) [1974-present], WHO Global Index Medicus (globalindexmedicus.net), Global Health (OvidSP) [1973–2022 Week 8] and CINAHL (EBSCOHost) [1982-present] from their inception until 11 January, 2023. For unpublished or grey literature, the WHO databases, Google Scholar and ProQuest Dissertations & Theses Global were searched, as well as hand searching the reference lists of included studies. MESH terms encompassing “∗Clinical Audit”, “∗Perinatal Mortality”, “Pregnancy Complications”, and “Stillbirth” were used with Boolean operators. Studies that used a facility-based review process or any approach to evaluate care prior to stillbirth, and explained the methods used were included. Reviews and editorials were excluded. Three authors (YYB, UGA, and DBT) independently screened and extracted data, and assessed the risk of bias using an adapted JBI's Checklist for Case Series. A logic model was used to inform the narrative synthesis. The review protocol was registered with PROSPERO, CRD42022304239. A total of 68 studies from 17 high-income (HICs) and 22 low-and-middle-income countries (LMICs) met the inclusion criteria from a total of 7258 identified records. These were stillbirth reviews conducted at different levels: district, state, national, and international. Three types were identified: audit, review, and confidential enquiry, but not all desired components were included in most processes, which led to a mismatch between the description of the type and the actual method used. Routine data from hospital records was the most common data source for identifying stillbirths, and case assessment was based on stillbirth definition in 48 out of 68 studies. Hospital notes were the most common source of information about care received and causes/risk factors for stillbirth. Short-term and medium-term outcomes were reported in 14 studies, but impact of the review process on reducing stillbirth, which is more difficult to establish, was not reported in any study. Facilitators and barriers in implementing a successful stillbirth review process identified from 14 studies focused on three main themes: resources, expertise, and commitment. This systematic review's findings identified that there is a need for clear guidelines on how to measure the impact of implementation of changes based on outputs of stillbirth reviews and methods to enable effective dissemination of learning points in the future and promoting them through training platforms. In addition, there is a need to develop and adopt a universal definition of stillbirth to facilitate meaningful comparison of stillbirth rates between regions. The key limitation of this review is that while using a logic model for narrative synthesis was deemed most appropriate for this study, sequence of implementing a stillbirth review in the real world is not linear, and assumptions are often not met. Therefore, the logic model proposed in this study should be interpreted with flexibility when designing a stillbirth review process. The generated learnings from the stillbirth review processes inform the action plans and allow facilities to consider where the changes should happen to improve the quality of care in the facilities, enabling positive short-term and medium-term outcomes. , , , and (MRC).
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DOI：
10.1016/s1470-0328(02)01077-7
发表时间：
2002-06-01
影响因子：
5.8
作者：
Essén, B;Bödker, B;Östergren, PO
通讯作者：
Östergren, PO
影响因子：
4.2
作者：
Curtis, Kate;Fry, Margaret;Considine, Julie
通讯作者：
Considine, Julie
影响因子：
4.3
作者：
Berge, Lillian Nordbo;Rasmussen, Svein;Dahl, Lauritz Bredrup
通讯作者：
Dahl, Lauritz Bredrup
影响因子：
2.8
作者：
Bandali, Sarah;Thomas, Camille;Fulton, Nicole
通讯作者：
Fulton, Nicole
DOI：
10.1111/j.1651-2227.1986.tb10151.x
发表时间：
1986-01-01
期刊：
ACTA PAEDIATRICA SCANDINAVICA
影响因子：
--
作者：
EKSMYR, R;LARSSEN, KE;KNOFF, H
通讯作者：
KNOFF, H