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Delivery room resuscitation intensity and associated neonatal outcomes of 24+0-31+6 weeks'preterm infants in China:a retrospective cross-sectional study

摘要Background The aim of this study was to review current delivery room(DR)resuscitation intensity in Chinese tertiary neonatal intensive care units and to investigate the association between DR resuscitation intensity and short-term outcomes in preterm infants born at 24+0-31+6 weeks'gestation age(GA).Methods This was a retrospective cross-sectional study.The source population was infants born at 24+0-31+6 weeks'GA who were enrolled in the Chinese Neonatal Network 2019 cohort.Eligible infants were categorized into five groups:(1)regular care;(2)oxygen supplementation and/or continuous positive airway pressure(O2/CPAP);(3)mask ventilation;(4)endotracheal intubation;and(5)cardiopulmonary resuscitation(CPR).The association between DR resuscitation and short-term outcomes was evaluated by inverse propensity score-weighted logistic regression.Results Of 7939 infants included in this cohort,2419(30.5%)received regular care,1994(25.1%)received O2/CPAP,1436(18.1%)received mask ventilation,1769(22.3%)received endotracheal intubation,and 321(4.0%)received CPR in the DR.Advanced maternal age and maternal hypertension correlated with a higher need for resuscitation,and antenatal steroid use tended to be associated with a lower need for resuscitation(P<0.001).Severe brain impairment increased significantly with increasing amounts of resuscitation in DR after adjusting for perinatal factors.Resuscitation strategies vary widely between centers,with over 50%of preterm infants in eight centers requiring higher intensity resuscitation.Conclusions Increased intensity of DR interventions was associated with increased mortality and morbidities in very preterm infants in China.There is wide variation in resuscitative approaches across delivery centers,and ongoing quality improve-ment to standardize resuscitation practices is needed.

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作者 Si-Lu Wang [1] Chun Chen [2] Xin-Yue Gu [3] Zhao-Qing Yin [4] Le Su [4] Si-Yuan Jiang [5] Yun Cao [5] Li-Zhong Du [6] Jian-Hua Sun [7] Jiang-Qin Liu [1] Chuan-Zhong Yang [2] on behalf of Chinese Neonatal Network Investigators 学术成果认领
作者单位 Department of Neonatology,Shanghai Key Laboratory of Maternal Fetal Medicine,Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology,Shanghai First Maternity and Infant Hospital,School of Medicine,Tongji University,No.2699,Gaoke Western Road,Pudong District,Shanghai 201204,China [1] Department of Neonatology,Affiliated Shenzhen Maternity and Child Healthcare Hospital,Southern Medical University,No.2004,Hongli Road,Futian District,Shenzhen 518028,China [2] NHC Key Laboratory of Neonatal Diseases,Fudan University,Children's Hospital of Fudan University,Shanghai,China [3] Department of Neonatology,People's Hospital of Dehong,Kunming Medical University,Dehong,China [4] NHC Key Laboratory of Neonatal Diseases,Fudan University,Children's Hospital of Fudan University,Shanghai,China;Department of Neonatology,Children's Hospital of Fudan University,Shanghai,China [5] Department of Neonatology,Children's Hospital,Zhejiang University School of Medicine,Hangzhou,China [6] Department of Neonatology,Shanghai Children's Medical Center,School of Medicine,Shanghai Jiao Tong University,Shanghai,China [7]
栏目名称 Original articles
DOI 10.1007/s12519-023-00738-2
发布时间 2024-03-14
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