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Iran J Pediatr. 2013 Dec;23(6):675-80.

Neonatal resuscitation in the delivery room from a tertiary level hospital: risk factors and outcome.

Author information

1
Pediatric Infections Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; Mahdieh Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2
Hamedan University of Medical Sciences, Hamedan, Iran.
3
Mahdieh Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Abstract

OBJECTIVE:

Timely identification and prompt resuscitation of newborns in the delivery room may cause a decline in neonatal morbidity and mortality. We try to identify risk factors in mother and fetus that result in birth of newborns needing resuscitation at birth.

METHODS:

Case notes of all deliveries and neonates born from April 2010 to March 2011 in Mahdieh Medical Center (Tehran, Iran), a Level III Neonatal Intensive Care Unit, were reviewed; relevant maternal, fetal and perinatal data was extracted and analyzed.

FINDINGS:

During the study period, 4692 neonates were delivered; 4522 (97.7%) did not require respiratory assistance. One-hundred seven (2.3%) newborns needed resuscitation with bag and mask ventilation in the delivery unit, of whom 77 (1.6%) babies responded to bag and mask ventilation while 30 (0.65%) neonates needed endotracheal intubation and 15 (0.3%) were given chest compressions. Epinephrine/volume expander was administered to 10 (0.2%) newborns. In 17 patients resuscitation was continued for >10 mins. There was a positive correlation between the need for resuscitation and following risk factors: low birth weight, preterm labor, chorioamnionitis, pre-eclampsia, prolonged rupture of membranes, abruptio placentae, prolonged labor, meconium staining of amniotic fluid, multiple pregnancy and fetal distress. On multiple regression; low birth weight, meconium stained liquor and chorioamnionitis revealed as independent risk factors that made endotracheal intubation necessary.

CONCLUSION:

Accurate identification of risk factors and anticipation at the birth of a high-risk neonate would result in adequate preparation and prompt resuscitation of neonates who need some level of intervention and thus, reducing neonatal morbidity and mortality.

KEYWORDS:

Delivery Room; Neonate; Newborn; Respiratory Assistance; Resuscitation; Risk Factors

PMID:
24910747
PMCID:
PMC4025126

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