Thresholds for Resuscitation of Extremely Preterm Infants in the UK, Sweden, and Netherlands

Pediatrics
Dominic WilkinsonStefan Johansson

Abstract

It is widely acceptable to involve parents in decision-making about the resuscitation of extremely preterm infants (EPIs) in the gray zone. However, there are different views about where the boundaries of the gray zone should lie. Our aim in this study was to compare the resuscitation thresholds for EPIs between neonatologists in the United Kingdom, Sweden, and the Netherlands. We distributed an online survey to consultant neonatologists and neonatal registrars and fellows that included clinical scenarios in which parents requested resuscitation or nonresuscitation. Respondents were asked about the lowest gestational age and/or the worst prognosis at which they would provide resuscitation and the highest gestational age and/or the best prognosis at which they would withhold resuscitation. In additional scenarios, influence of the condition at birth or consideration of available health care resources was assessed. The survey was completed by 162 neonatologists (30% response rate). There was a significant difference between countries; the gray zone for most UK respondents was 23 + 0/7 to 23 + 6/7 or 24 weeks' gestation, compared with 22 + 0/7 to 22 + 6/7 or 23 weeks' gestation in Sweden and 24 + 0/7 to 25 + 6/7 or 26 weeks' gesta...Continue Reading

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Citations

Jan 20, 2019·Journal of Perinatology : Official Journal of the California Perinatal Association·Jeanne A Krick, Dalia M Feltman
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May 1, 2021·Archives of Disease in Childhood. Fetal and Neonatal Edition·Lydia Mietta Di StefanoDominic Wilkinson
Aug 6, 2021·American Journal of Perinatology·Danielle LoReMarin Arnolds
Sep 18, 2021·Journal of Perinatal Medicine·Zohal FaizPetra C A M Bakker

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