J Korean Med Sci.  2015 Oct;30(Suppl 1):S45-S51. 10.3346/jkms.2015.30.S1.S45.

Initial Resuscitation at Delivery and Short Term Neonatal Outcomes in Very-Low-Birth-Weight Infants

• Cho SJ
• Shin J
• Namgung R

• KMID: 2351135
• DOI: http://doi.org/10.3346/jkms.2015.30.S1.S45

Abstract

Survival of very-low-birth-weight infants (VLBWI) depends on professional perinatal management that begins at delivery. Korean Neonatal Network data on neonatal resuscitation management and initial care of VLBWI of less than 33 weeks gestation born from January 2013 to June 2014 were reviewed to investigate the current practice of neonatal resuscitation in Korea. Antenatal data, perinatal data, and short-term morbidities were analyzed. Out of 2,132 neonates, 91.7% needed resuscitation at birth, chest compression was performed on only 104 infants (5.4%) and epinephrine was administered to 80 infants (4.1%). Infants who received cardiac compression and/or epinephrine administration at birth (DR-CPR) were significantly more acidotic (P < 0.001) and hypothermic (P < 0.001) than those who only needed positive pressure ventilation (PPV). On logistic regression, DR-CPR resulted in greater early mortality of less than 7 days (OR, 5.64; 95% CI 3.25-9.77) increased intraventricular hemorrhage > or = grade 3 (OR, 2.71; 95% CI 1.57-4.68), periventricular leukomalacia (OR, 2.94; 95% CI 1.72-5.01), and necrotizing enterocolitis (OR, 2.12; 95% CI 1.15-3.91) compared with those infants who needed only PPV. Meticulous and aggressive management of infants who needed DR-CPR at birth and quality improvement of the delivery room management will result in reduced morbidities and early death for the vulnerable VLBWI.

Keyword

Infant, Very-Low-Birth-Weight; Cardiopulmonary Resuscitation; Infant, Premature; Apgar Score

MeSH Terms

Apgar Score
*Cardiopulmonary Resuscitation
Databases, Factual
Delivery Rooms
Enterocolitis, Necrotizing/complications
Epinephrine/administration & dosage
Gestational Age
Hemorrhage/complications
Humans
Infant
Infant Death
Infant, Newborn
*Infant, Very Low Birth Weight
Leukomalacia, Periventricular/complications
Logistic Models
Odds Ratio
Positive-Pressure Respiration
Retrospective Studies
Epinephrine

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