Impact of Simulation-Based Training on Maternal and Neonatal Outcomes in Delivery Rooms: A Systematic Review.

Abstract

This systematic review examines the impact of simulation-based training (SBT) in delivery rooms on maternal and neonatal outcomes in high-resource settings. Given the persistently high rates of maternal and neonatal mortality worldwide, SBT has emerged as a promising method to enhance clinical performance, decision-making, and teamwork in obstetric emergencies. Eight studies published between 2014 and 2023 were included, covering over 177,000 deliveries. The composite analysis showed a significant reduction in adverse outcomes, including postpartum hemorrhage requiring transfusion and neonatal Apgar scores <7 at five minutes, dropping from 6.9% pre-SBT to 3.8% post-SBT. The improvements were more pronounced in neonatal outcomes than maternal ones. Despite these encouraging findings, the review highlights several limitations: lack of standardization in training protocols, heterogeneity in study designs and outcome measures, and limited data on long-term effects. Additionally, generalizing results to low-resource settings remains a challenge. The authors call for future research using individual patient data, standardized training approaches, cost-effectiveness evaluations, and innovative methods to adapt SBT for broader global use, ultimately aiming to strengthen perinatal safety worldwide.