Abstract
Objective:
To compare the characteristics of infants born at 22 weeks gestational age (GA) who were resuscitated at birth with those of infants who were not resuscitated.
Study Design:
We reviewed records of all the infants with a GA of 22 0/7 through 22 6/7 weeks who were born alive at William Beaumont Hospital from 1990 through 2009. Deliveries were attended by a neonatologist if they were in the hospital at the time of delivery or requested by the obstetrician and otherwise were attended by a pediatric resident or neonatal nurse practitioner.
Result:
There were 85 infants born alive at 22 weeks GA during the study period. Thirty-six were intubated in the delivery room and defined as having been resuscitated. Two of them survived. On multivariate analysis, a higher birth weight (odds ratio 2.39 per 100 g increase, 95% confidence interval 1.21 to 4.73) and the presence of a neonatologist at delivery (odds ratio 6.72, 95% confidence interval 1.72 to 26.2) were each associated with an increased likelihood of resuscitation.
Conclusion:
Infants born at 22 weeks GA were more likely to be resuscitated if they were larger or if the delivery was attended by a neonatologist. We encourage neonatal groups to follow the recommendations of the American Academy of Pediatrics Committee on the Fetus and Newborn regarding initiation of resuscitation in these infants: inform parents that a good outcome is very unlikely and respect the parents’ choice of whether resuscitation should be initiated.
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Holtrop, P., Swails, T., Riggs, T. et al. Resuscitation of infants born at 22 weeks gestation: a 20-year retrospective. J Perinatol 33, 222–225 (2013). https://doi.org/10.1038/jp.2012.88
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DOI: https://doi.org/10.1038/jp.2012.88
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