Summary of findings for Post-NRT versus Pre-NRT groups
| Outcomes | Anticipated absolute effects (95% CI) Risk with pre-NRP | Anticipated absolute effects (95% CI) Risk with post-NRP | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) |
| All stillbirths | 8 per 1000 | 7 per 1000 (7 to 8) | RR 0.88 (0.83 to 0.94) | 1 425 540 (12 observational studies) | ⨁◯◯◯ Very low*†‡ |
| Fresh stillbirths | 15 per 1000 | 11 per 1000 (9 to 13) | RR 0.74 (0.61 to 0.90) | 296 819 (8 observational studies) | ⨁◯◯◯ Very low*†§ |
| 1-day neonatal mortality | 8 per 1000 | 5 per 1000 (4 to 7) | RR 0.58 (0.42 to 0.82) | 280 080 (6 observational studies) | ⨁◯◯◯ Very low *¶ |
| 7-day neonatal mortality | 13 per 1000 | 11 per 1000 (9 to 12) | RR 0.82 (0.73 to 0.93) | 360 383 (7 observational studies) | ⨁◯◯◯ Very low *† ** |
| 28-day neonatal mortality | 8 per 1000 | 7 per 1000 (5 to 9) | RR 0.86 (0.65 to 1.13) | 1 116 463 (7 observational studies) | ⨁◯◯◯ Very low * †† |
| Perinatal mortality | 14 per 1000 | 12 per 1000 (10 to 13) | RR 0.82 (0.74 to 0.91) | 1 243 802 (6 observational studies) | ⨁◯◯◯ Very low * §§ ¶¶ |
*Pre–post studies. Quality of evidence downgraded by one for risk of bias (table 1 and 2).
† Studies differ in the settings, type of NRP, duration and type trainees. Quality of evidence downgraded by one for indirectness (table 1 and 2).
‡ Publication bias detected in the funnel plot. Quality of evidence downgraded by one for publication bias (figure 12).
§ Although I2 is 84%, the effect estimates of all included studies do not differ in the direction of effect. Quality of effect downgraded by one for inconsistency (figure 7).
¶ Although I2 is 89%, the effect estimates of all the included studies (except Bellard et al.) do not differ in the direction of effect. Quality of effect downgraded by one for inconsistency (figure 8).
** Although I2 is 71%, the effect estimates of all the included studies (except Bellard et al.) do not differ in the direction of effect. Quality of effect downgraded by one for inconsistency (figure 9).
†† I2 is 95% and the effect estimates cross the life of no effect. Quality of evidence downgraded by two for inconsistency and imprecision (figure 10).
‡‡The effect estimate crosses the line of no effect. Quality of evidence downgraded by one for imprecision (figure 10).
§§ Although I2 is 90%, the effect estimates of all the included studies do not differ in the direction of effect. Quality of effect downgraded by one for inconsistency (figure 11).
¶¶ Studies differ in setting, type of NRP and trainees. Quality of evidence downgraded by one for indirectness (table 1 and 2).
NRP, Neonatal Resuscitation Program; NRT, neonatal resuscitation trainings; RR, risk ratio; SB, stillbirths.