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Resuscitation of infants born at 22 weeks gestation: a 20-year retrospective
Journal of Perinatology, 07/06/2012
Holtrop P et al. – Infants born at 22 weeks gestational age (GA) were more likely to be resuscitated if they were larger or if the delivery was attended by a neonatologist. The authors 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.
Methods- The authors reviewed records of all the infants with a GA of 220/7 through 226/7 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.
- 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.