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 language | English (US) |
|---|---|
| Pages (from-to) | 33-38.e2 |
| Journal | Journal of Pediatrics |
| Volume | 195 |
| DOIs | |
| State | Published - Apr 1 2018 |
| Externally published | Yes |
Fingerprint
Keywords
- CPR
- delivery room
- endotracheal intubation
- moderate Preterm
- oxygen
- resuscitation
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
Cite this
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 journal › Article
}
TY - JOUR
T1 - Delivery Room Resuscitation and Short-Term Outcomes in Moderately Preterm Infants
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
UR - http://www.scopus.com/inward/record.url?scp=85039838265&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85039838265&partnerID=8YFLogxK
U2 - 10.1016/j.jpeds.2017.11.039
DO - 10.1016/j.jpeds.2017.11.039
M3 - Article
C2 - 29306493
AN - SCOPUS:85039838265
VL - 195
SP - 33-38.e2
JO - Journal of Pediatrics
JF - Journal of Pediatrics
SN - 0022-3476
ER -