Delivery Room Resuscitation and Short-Term Outcomes in Moderately Preterm Infants

Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network

Research output: Contribution to journalArticle

4 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)33-38.e2
JournalJournal of Pediatrics
Volume195
DOIs
StatePublished - Apr 1 2018
Externally publishedYes

Fingerprint

Delivery Rooms
Premature Infants
Resuscitation
Gestational Age
Continuous Positive Airway Pressure
Intratracheal Intubation
Cardiopulmonary Resuscitation
Masks
Length of Stay
Oxygen
Nutritional Support
Mortality
Epinephrine
Observational Studies
Registries
Rupture
Cohort Studies
Thorax
Steroids

Keywords

  • CPR
  • delivery room
  • endotracheal intubation
  • moderate Preterm
  • oxygen
  • resuscitation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network (2018). Delivery Room Resuscitation and Short-Term Outcomes in Moderately Preterm Infants. Journal of Pediatrics, 195, 33-38.e2. https://doi.org/10.1016/j.jpeds.2017.11.039

Delivery Room Resuscitation and Short-Term Outcomes in Moderately Preterm Infants. / Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network.

In: Journal of Pediatrics, Vol. 195, 01.04.2018, p. 33-38.e2.

Research output: Contribution to journalArticle

Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network 2018, 'Delivery Room Resuscitation and Short-Term Outcomes in Moderately Preterm Infants', Journal of Pediatrics, vol. 195, pp. 33-38.e2. https://doi.org/10.1016/j.jpeds.2017.11.039
Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Delivery Room Resuscitation and Short-Term Outcomes in Moderately Preterm Infants. Journal of Pediatrics. 2018 Apr 1;195:33-38.e2. https://doi.org/10.1016/j.jpeds.2017.11.039
Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. / Delivery Room Resuscitation and Short-Term Outcomes in Moderately Preterm Infants. In: Journal of Pediatrics. 2018 ; Vol. 195. pp. 33-38.e2.
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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.",
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AU - Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network

AU - Bajaj, Monika

AU - Natarajan, Girija

AU - Shankaran, Seetha

AU - Wyckoff, Myra

AU - Laptook, Abbot R.

AU - Bell, Edward F.

AU - Stoll, Barbara J.

AU - Carlo, Waldemar A.

AU - Vohr, Betty R.

AU - Saha, Shampa

AU - Van Meurs, Krisa P.

AU - Sanchez, Pablo J.

AU - D'Angio, Carl T.

AU - Higgins, Rosemary D.

AU - Das, Abhik

AU - Newman, Nancy

AU - Walsh, Michele C.

AU - Polin, Richard A.

AU - Keszler, Martin

AU - Hensman, Angelita M.

AU - Vieira, Elisa

AU - Hibbs, Anna Marie

AU - Siner, Bonnie S.

AU - Truog, William E.

AU - Pallotto, Eugenia K.

AU - Kilbride, Howard W.

AU - Gauldin, Cheri

AU - Holmes, Anne

AU - Johnson, Kathy

AU - Poindexter, Brenda B.

AU - Schibler, Kurt

AU - Kallapur, Suhas G.

AU - Grisby, Cathy

AU - Alexander, Barbara

AU - Fischer, Estelle E.

AU - Jackson, Lenora

AU - Kirker, Kristin

AU - Jennings, Jennifer

AU - Wuertz, Sandra

AU - Muthig, Greg

AU - Cotten, C. Michael

AU - Goldberg, Ronald N.

AU - Finkle, Joanne

AU - Fisher, Kimberley A.

AU - Laughon, Matthew M.

AU - Bose, Carl L.

AU - Bernhardt, Janice

AU - Clark, Cindy

AU - Carlton, David P.

AU - Lakshminrusimha, Satyanarayana

PY - 2018/4/1

Y1 - 2018/4/1

N2 - 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.

AB - 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.

KW - CPR

KW - delivery room

KW - endotracheal intubation

KW - moderate Preterm

KW - oxygen

KW - resuscitation

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