{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T14:04:58Z","timestamp":1791813898827,"version":"4.3.4"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T00:00:00Z","timestamp":1650844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Training in neonatal resuscitation has been shown to reduce deaths related to intrapartum asphyxia. Helping Babies Breathe (HBB) is a simulation-based program focusing on training healthcare providers (HCPs) in immediate neonatal care including stimulation, initiating bag mask ventilation (BMV) in the absence of breathing by 1 min of life, and delayed (30\u201360 s after birth) umbilical cord clamping (DCC). Data on implementation of HBB posttraining are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine time from birth to spontaneous breathing, cord clamping, and initiation of BMV in a setting where the majority of HCPs are HBB trained.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Two research nurses observed deliveries conducted in two referral hospitals. Timing included the onset of breathing, cord clamping, and initiation of BMV. Deliveries were grouped according to the mode of delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 496 neonates were observed; 410 (82.7%) neonates cried or had spontaneous breathing (median time 17 s) soon after birth, 25\/86 (29%) of neonates not breathing responded to stimulation, 61 (12.3%) neonates required BMV, and 2 (0.4%) neonates required chest compression and\/or adrenalin. Neonates delivered by cesarean section (CS) took longer to initiate first breath than those delivered vaginally (median time 19 vs. 14 s;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.009). Complete data were available in 58\/61 (95%) neonates receiving BMV, which was initiated in 54\/58 (93%) cases within 60 s of life (the \u201cGolden Minute\u201d). Median time to cord clamping was 74 s, with 414 (83.5%) and 313 (63.0%) having cord clamped at \u2265 30 and \u2265 60 s, respectively. Factors associated with BMV were CS delivery [odds ratio (OR) 29.9; 95% CI 3.37\u2013229], low birth weight (LBW) (birthweight &amp;lt; 2,500 g) (OR 2.47; 95% CI 1.93\u20135.91), and 1 min Apgar score &amp;lt; 7 (OR 149; 95% CI 49.3\u20135,021). DCC (\u2265 60 s) was less likely following CS delivery (OR 0.14; 95% CI 0.02\u20130.99) and being LBW (OR 0.43; 95% CI 0.24\u20130.77).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Approximately 83% of neonates initiated spontaneous breathing soon after birth and 29% of neonates not breathing responded to physical stimulation. BMV was initiated within the Golden Minute in most neonates, but under two-thirds had DCC (\u226560 s). HBB implementation followed guidelines, suggesting that knowledge and skills taught from HBB are retained and applied by HCP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2022.864431","type":"journal-article","created":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T09:12:35Z","timestamp":1650877955000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Assessing Implementation of Helping Babies Breathe Program Through Observing Immediate Care of Neonates at Time of Delivery"],"prefix":"10.3389","volume":"10","author":[{"given":"Martha","family":"Mayer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nomvuyo","family":"Xhinti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vuyiswa","family":"Dyavuza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luzuko","family":"Bobotyana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Perlman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sithembiso","family":"Velaphi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,4,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"S47","DOI":"10.1016\/j.ijgo.2009.07.013","article-title":"Neonatal resuscitation in low-resource settings: what, who, and how to overcome challenges to scale up?.","volume":"107","author":"Wall","year":"2009","journal-title":"Int J Gynaecol Obstet."},{"key":"B2","doi-asserted-by":"publisher","first-page":"S12","DOI":"10.1186\/1471-2458-11-S3-S12","article-title":"Neonatal resuscitation and immediate newborn assessment and stimulation for the prevention of neonatal deaths: a systematic review, meta-analysis and Delphi estimation of mortality effect.","volume":"11","author":"Lee","year":"2011","journal-title":"BMC Public Health."},{"key":"B3","doi-asserted-by":"publisher","first-page":"869","DOI":"10.1016\/j.resuscitation.2011.12.011","article-title":"Early initiation of basic resuscitation interventions including face mask ventilation may reduce birth asphyxia related mortality in low-income countries: a prospective descriptive observational study.","volume":"83","author":"Ersdal","year":"2012","journal-title":"Resuscitation."},{"key":"B4","doi-asserted-by":"publisher","first-page":"S516","DOI":"10.1161\/CIRCULATIONAHA.110.971127","article-title":"Part 11: neonatal resuscitation: 2010 International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations.","volume":"122","author":"Perlman","year":"2010","journal-title":"Circulation."},{"key":"B5","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1001\/archpedi.1995.02170130022005","article-title":"Cardiopulmonary resuscitation in the delivery room. 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