Document Detail


Delivery room strategies and outcomes in preterm infants with gestational age 24-28 weeks.
MedLine Citation:
PMID:  16966126     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the effect of different delivery room strategies on survival, short term morbidity, and outcomes in extremely premature infants. METHODS: This retrospective cohort study included all preterm infants with a gestational age between 24 and 28 weeks who were born in 1992-1997 (period A; n = 161) and in 1998-2003 (period B; n = 163). In period A, elective intubation was performed. In period B, if spontaneous breathing was present, nasal continuous positive airway pressure (nCPAP) was applied. RESULTS: Survival rate and the number of never-intubated infants significantly increased in period B. No differences were found concerning short-term morbidity. Among major outcomes, the need for retinopathy of prematurity (ROP) surgery and the length of stay were significantly lower in period B. Subgroup analysis showed no significant differences from period A to period B in infants with gestational age 24-26 weeks. In the 27-28 weeks subgroup, the never-intubated infants rate increased from 2.8% to 21.3% and survival rate increased from 63% to 79%. A reduced need for ROP surgery and a shorter hospital stay were also observed. CONCLUSIONS: Changes in delivery room strategy tending to reduce mechanical ventilation in extremely premature infants are likely to benefit essentially infants of 27-28 weeks of gestation. Extension of such benefits to premature infants at the limit of viability requires further research.
Authors:
Enrico Zecca; Daniele de Luca; Simonetta Costa; Marco Marras; Pierluigi de Turris; Costantino Romagnoli
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  19     ISSN:  1476-7058     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-09-12     Completed Date:  2007-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  569-74     Citation Subset:  IM    
Affiliation:
Division of Neonatology, Neonatal Intensive Care Unit, Catholic University of the Sacred Heart, Rome, Italy. enrizecca@rm.unicatt.it
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MeSH Terms
Descriptor/Qualifier:
Cohort Studies
Continuous Positive Airway Pressure
Delivery Rooms*
Female
Gestational Age
Humans
Infant, Newborn
Infant, Premature*
Intubation
Male
Morbidity
Neonatology / methods*
Obstetrics / methods*
Pregnancy
Premature Birth* / mortality
Retinopathy of Prematurity / epidemiology
Retrospective Studies
Survival Rate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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