DiscussionThe data in this report f

Discussion
The data in this report for the first time describe the natural
transitional respiratory adaption of newborns delivered in a rural
setting in a low-income country, and the population of newborns
needing basic stabilization/resuscitation in the delivery room. Thus
84% initiated spontaneous respirations within the “Golden Minute
SM , with an additional 15% responding to stimulation/suctioning
alone or with FMV by initiating breathing. This proportion of newborns
in need of basic resuscitative interventions is much higher
than estimated global numbers,1 but comparable to recent findings
obtained from a district setting in Zambia.15
An important observation is that death was significantly more
likely to occur in infants who were administered FMV with almost
ten per cent mortality noted in this group. Moreover, there was a
significant relationship between a delay in the initiation of FMV and
admission to the neonatal area and/or death. Specifically the risk for
death and morbidity increases 16% for every 30 s delay in initiation
of FMV up to six minutes, and more than two thirds of the deaths
occurred when ventilation was administered beyond four minutes.
The association between delayed FMV and adverse neonatal outcome
was found after multiple logistic modelling and adjusted for
BW, GA, pregnancy, and labour complications. Nevertheless, other
potential confounding factors, i.e. severe fetal acidemia, might have
influenced this association. The reasons for the delay in initiating
FMV in some infants is unclear, but may reflect a gradual learning
curve of some of the single providers to first manage a depressed
baby rather than the mother.

ผลลัพธ์ (ไทย) 1:

DiscussionThe data in this report for the first time describe the naturaltransitional respiratory adaption of newborns delivered in a ruralsetting in a low-income country, and the population of newbornsneeding basic stabilization/resuscitation in the delivery room. Thus84% initiated spontaneous respirations within the “Golden MinuteSM , with an additional 15% responding to stimulation/suctioningalone or with FMV by initiating breathing. This proportion of newbornsin need of basic resuscitative interventions is much higherthan estimated global numbers,1 but comparable to recent findingsobtained from a district setting in Zambia.15An important observation is that death was significantly morelikely to occur in infants who were administered FMV with almostten per cent mortality noted in this group. Moreover, there was asignificant relationship between a delay in the initiation of FMV andadmission to the neonatal area and/or death. Specifically the risk fordeath and morbidity increases 16% for every 30 s delay in initiationof FMV up to six minutes, and more than two thirds of the deathsoccurred when ventilation was administered beyond four minutes.The association between delayed FMV and adverse neonatal outcomewas found after multiple logistic modelling and adjusted forBW, GA, pregnancy, and labour complications. Nevertheless, otherpotential confounding factors, i.e. severe fetal acidemia, might haveอิทธิพลต่อความสัมพันธ์นี้ สาเหตุของความล่าช้าในการเริ่มต้นFMV ในทารกบางไม่ชัดเจน แต่อาจสะท้อนการเรียนรู้ที่ค่อย ๆเส้นโค้งของบางผู้ให้บริการเดียวก่อน จัดการความหดหู่เด็กมากกว่าแม่