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Delivery Room Resuscitation and Short-Term Outcomes in Moderately Preterm Infants
- Source :
- The Journal of Pediatrics. 195:33-38.e2
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Objectives To describe the frequency and extent of delivery room resuscitation and evaluate the association of delivery room resuscitation with neonatal outcomes in moderately preterm (MPT) infants. Study design This was an observational cohort study of MPT infants delivered at 290/7 to 336/7 weeks' gestational age (GA) enrolled in the Neonatal Research Network MPT registry. Infants were categorized into 5 groups based on the highest level of delivery room intervention: routine care, oxygen and/or continuous positive airway pressure, bag and mask ventilation, endotracheal intubation, and cardiopulmonary resuscitation including chest compressions and/or epinephrine use. The association of antepartum and intrapartum risk factors and discharge outcomes with the intensity of resuscitation was evaluated. Results Of 7014 included infants, 1684 (24.0%) received routine care and no additional resuscitation, 2279 (32.5%) received oxygen or continuous positive airway pressure, 1831 (26.1%) received bag and mask ventilation, 1034 (14.7%) underwent endotracheal intubation, and 186 (2.7%) received cardiopulmonary resuscitation. Among the antepartum and intrapartum factors, increasing GA, any exposure to antenatal steroids and prolonged rupture of membranes decreased the likelihood of receipt of all levels of resuscitation. Infants who were small for GA (SGA) had increased risk of delivery room resuscitation. Among the neonatal outcomes, respiratory support at 28 days, days to full oral feeds and length of stay were significantly associated with the intensity of delivery room resuscitation. Higher intensity of resuscitation was associated with increased risk of mortality. Conclusions The majority of MPT infants receive some level of delivery room resuscitation. Increased intensity of delivery room interventions was associated with prolonged respiratory and nutritional support, increased mortality, and a longer length of stay.
- Subjects :
- Male
Resuscitation
medicine.medical_treatment
Article
03 medical and health sciences
0302 clinical medicine
Risk Factors
030225 pediatrics
Outcome Assessment, Health Care
Intubation, Intratracheal
Humans
Rupture of membranes
Medicine
Prospective Studies
Registries
030212 general & internal medicine
Cardiopulmonary resuscitation
Continuous positive airway pressure
Respiratory system
Continuous Positive Airway Pressure
business.industry
Delivery Rooms
Delivery room
Infant, Newborn
Oxygen Inhalation Therapy
Gestational age
Cardiopulmonary Resuscitation
Anesthesia
Infant, Small for Gestational Age
Pediatrics, Perinatology and Child Health
Female
business
Infant, Premature
Cohort study
Subjects
Details
- ISSN :
- 00223476
- Volume :
- 195
- Database :
- OpenAIRE
- Journal :
- The Journal of Pediatrics
- Accession number :
- edsair.doi.dedup.....3f007969866163b61953edb4cef0fc28