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Decision-making in the delivery room: a survey of neonatologists

Journal of Perinatology volume 27, pages 754–760 (2007)Cite this article

Abstract

Objective:

To examine influences on neonatologists' decision-making regarding resuscitation of extremely premature infants.

Study Design:

A mailed survey of Illinois neonatologists evaluated influences on resuscitation. Personal and parentally opposed (that is, acting against parental wishes) gray zones of resuscitation were defined, with the lower limit (LL) the gestational age at or below which resuscitation would be consistently withheld and the upper limit (UL) above which resuscitation was mandatory.

Result:

Among the 85 respondents, LL and UL of the personal and parentally opposed gray zones were median 22 and 25 weeks, respectively. Neonatologists with an UL personal gray zone <25 completed weeks were significantly more fearful of litigation, more likely to have received didactic/continuing medical education teaching, and less likely to always consider parents' opinions in resuscitation decisions. Neonatologists with an UL parentally opposed gray zone <25 completed weeks were more fearful of litigation.

Conclusion:

Neonatologists perceive a ‘gray zone’ of resuscitative practices and should understand that external influences may affect their delivery room resuscitation practices.

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Acknowledgements

Funding for the project was received from the Children's Memorial Hospital Senior Resident Research Fund, Children's Memorial Institute for Education and Research (now, Children's Memorial Research Center), Chicago, IL. We want to thank Kathy Farrow MD, PhD, Joel Frader MD, MA, and Teresa Savage PhD, RN, for their helpful suggestions in the preparation of the manuscript for publication.

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Authors and Affiliations

  1. Pediatrics, Children's Memorial Hospital, Chicago, IL, USA

    A R Weiss, H J Binns, J W Collins Jr & R-A deRegnier

  2. Pediatrics Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    A R Weiss, H J Binns, J W Collins Jr & R-A deRegnier

  3. Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    H J Binns

  4. Mary Ann and J Milburn Smith Child Health Research Program, Children's Memorial Research Center, Chicago, IL, USA

    H J Binns

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  1. A R Weiss
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Correspondence to A R Weiss.

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Weiss, A., Binns, H., Collins, J. et al. Decision-making in the delivery room: a survey of neonatologists. J Perinatol 27, 754–760 (2007). https://doi.org/10.1038/sj.jp.7211821

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