Impact of the perception of viability on resource allocation in the neonatal intensive care unit

J Perinatol. 1998 Sep-Oct;18(5):347-51.

Abstract

Objective: To understand how neonatologists' perceptions of viability impact their willingness to recommend or provide medical interventions for infants born at 23 to 24 weeks' gestation.

Study design: A 25-question survey mailed to 3056 neonatologists in the United States in 1992 yielded 1131 responses. Seven hundred seventy-five (775 of 1131, 69%) reported they believed that the lower limit of viability was 23 to 24 weeks' gestation. These respondents were asked if they were willing to recommend or provide a series of medical interventions for infants born at 23 and 24 weeks' gestation.

Results: Most respondents would provide ventilation (82% and 95%) and surfactant (62% and 78%) for infants born at 23 and 24 weeks' gestation, respectively. The respondent's prediction of <100% mortality, infant factors, and parental wishes were significant predictors of willingness to resuscitate infants born at 23 weeks' gestation.

Conclusion: There is considerable variation among neonatologists in their willingness to recommend or provide medical interventions for infants born at 23 to 24 weeks' gestation.

MeSH terms

  • Attitude of Health Personnel*
  • Gestational Age
  • Health Care Rationing / statistics & numerical data*
  • Health Care Surveys / statistics & numerical data
  • Humans
  • Infant Mortality
  • Infant, Newborn
  • Infant, Premature*
  • Infant, Very Low Birth Weight*
  • Intensive Care Units, Neonatal / statistics & numerical data*
  • Intensive Care, Neonatal / statistics & numerical data*
  • Perception
  • Practice Patterns, Physicians' / statistics & numerical data
  • United States