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J Perinatol. 2013 Mar;33(3):222-5. doi: 10.1038/jp.2012.88. Epub 2012 Jul 5.

Resuscitation of infants born at 22 weeks gestation: a 20-year retrospective.

Author information

  • 1Department of Pediatrics, Beaumont Children's Hospital, Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA. paul.holtrop@beaumont.edu

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.

PMID:
22766742
[PubMed - indexed for MEDLINE]
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