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Delivery room resuscitation and adverse outcomes among very low birth weight preterm infants

Journal of Perinatology volume 37, pages 1010–1016 (2017)Cite this article

Subjects

Abstract

Objective:

To evaluate risk factors and impact of delivery room cardiopulmonary resuscitation (DR-CPR) on very low birth weight (VLBW) preterm infants.

Study Design:

A national, population-based, observational study evaluating risk factors and short-term neonatal outcomes associated with DR-CPR among VLBW, extremely preterm infants (EPIs, 24 to 27 weeks’ gestation) and very preterm infants (VPI, 28 to 31 weeks’ gestation) born in 1995 to 2010.

Results:

Among 17 564 VLBW infants, 636 (3.6%) required DR-CPR. In the group of 6478 EPI, 412 (6.4%) received DR-CPR compared with 224 of 11 086 infants (2.0%) in the VPI group. EPI who underwent DR-CPR had higher odds ratios (ORs (95% confidence interval)) for mortality compared to EPI not requiring DR-CPR (OR 3.32 (2.58, 4.29)), grades 3 to 4 intraventricular hemorrhage (IVH) (OR 1.59 (1.20, 2.10)) and periventricular leukomalacia (OR 1.81 (1.17, 2.82)). DR-CPR among VPI was associated with higher ORs for mortality (OR 4.99 (3.59, 6.94)), early sepsis (OR 2.07 (1.05, 4.09)), grades 3 to 4 IVH (OR 3.74 (2.55, 5.50)) and grades 3 to 4 retinopathy of prematurity (ROP) (OR 2.53 (1.18, 5.41)) compared to VPI not requiring DR-CPR. Only 11% of infants in the EPI DR-CPR group had favorable outcomes compared with 44% in the VPI DR-CPR group. Significantly higher ORs for mortality, IVH and ROP were found in the VPI compared to the EPI group.

Conclusion:

Preterm VLBW infants requiring DR-CPR were at increased risk of adverse outcomes compared to those not requiring CPR. This effect was more pronounced in the VPI group.

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Acknowledgements

The Israel National VLBW infant database is partially funded by the Israel Center for Disease Control and the Israel Ministry of Health.

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Authors and Affiliations

  1. Department of Neonatology, Meir Medical Center, Kfar Saba, Israel

    S Arnon, T Dolfin, R H Regev & I Litmanovitz

  2. The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    S Arnon, T Dolfin, B Reichman, R H Regev, L Lerner-Geva & I Litmanovitz

  3. The Women and Children’s Health Research Unit, Gertner Institute, Chaim Sheba Medical Center, Tel Hashomer, Israel

    B Reichman, L Lerner-Geva & V Boyko

Authors
  1. S Arnon
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  2. T Dolfin
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  5. L Lerner-Geva
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in collaboration with the Israel Neonatal Network

Corresponding author

Correspondence to S Arnon.

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The authors declare no conflict of interest.

Appendices

Coordinating center

The Israel Neonatal Network, participating centers in the Israel National Very Low Birth Weight Infant database

The Women and Children’s Health Research Unit, Gertner Institute, Tel Hashomer.

Neonatology departments

Assaf Harofeh Medical Center, Rishon Le Zion; Barzilay Medical Center, Ashkelon; Bikur Holim Hospital, Jerusalem; Bnei Zion Medical Center, Haifa; Carmel Medical Center, Haifa; English (Scottish) Hospital, Nazareth; French Hospital, Nazareth; Hadassah University Hospital Ein Kerem, Jerusalem; Hadassah University Hospital Har Hazofim, Jerusalem; Haemek Medical Center, Afula; Hillel Yafe Medical Center, Hadera; Italian Hospital, Nazareth; Kaplan Hospital, Rehovot; Laniado Hospital, Netanya; Maayanei Hayeshua Hospital, Bnei Brak; Meir Medical Center, Kfar Saba; Misgav Ladach Hospital, Jerusalem; Naharia Hospital, Naharia; Poria Hospital, Tiberias; Rambam Medical Center, Haifa; Rivka Ziv Hospital, Safed; Schneider Children’s Medical Center of Israel, Petach Tikva; Rabin Medical Center (Beilinson Campus), Petach Tikva; Shaare Zedek Hospital, Jerusalem; Sheba Medical Center, Tel Hashomer; Soroka Medical Center, Beer Sheba; Sourasky Medical Center, Tel Aviv; Wolfson Medical Center, Holon; Yoseftal Hospital, Eilat.

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Arnon, S., Dolfin, T., Reichman, B. et al. Delivery room resuscitation and adverse outcomes among very low birth weight preterm infants. J Perinatol 37, 1010–1016 (2017). https://doi.org/10.1038/jp.2017.99

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