S Jiang1,2, Y Lyu1,3, X Y Ye1, L Monterrosa4, P S Shah1,5, S K Lee1,5. 1. Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada. 2. Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China. 3. Department of Child Health Development, Capital Institute of Pediatrics, Beijing, China. 4. Department of Paediatrics, Saint John Regional Hospital, Saint John, New Brunswick, Canada. 5. Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.
Abstract
OBJECTIVE: Examine the relationship between delivery room resuscitation intensity and mortality, morbidities and resource use in late preterm infants. STUDY DESIGN: Retrospective cohort study of inborn infants born at 33 to 36 weeks' gestation and admitted to Canadian neonatal intensive care units during 2010 to 2013. The 13 619 infants were grouped according to delivery room resuscitation intensity: no or minimal resuscitation (64.5%); continuous positive airway pressure (10.2%); bag-mask ventilation (21.7%); endotracheal intubation (3.1%); and cardiopulmonary resuscitation (CPR) (0.6%). RESULTS: Overall mortality, early mortality, respiratory distress, pneumothorax, late-onset sepsis and resource use increased with higher intensity resuscitation. Compared with no or minimal resuscitation, intubation and CPR were associated with increased odds of mortality (adjusted odds ratio (95% confidence interval): 50 (20 to 125) and 180 (63 to 518), respectively). CONCLUSIONS: Intubation or higher intensity delivery room resuscitation is associated with increased mortality, morbidities and resource use in late preterm infants. Extra intensive care is required for such infants, especially during the first week of life.
OBJECTIVE: Examine the relationship between delivery room resuscitation intensity and mortality, morbidities and resource use in late preterm infants. STUDY DESIGN: Retrospective cohort study of inborn infants born at 33 to 36 weeks' gestation and admitted to Canadian neonatal intensive care units during 2010 to 2013. The 13 619 infants were grouped according to delivery room resuscitation intensity: no or minimal resuscitation (64.5%); continuous positive airway pressure (10.2%); bag-mask ventilation (21.7%); endotracheal intubation (3.1%); and cardiopulmonary resuscitation (CPR) (0.6%). RESULTS: Overall mortality, early mortality, respiratory distress, pneumothorax, late-onset sepsis and resource use increased with higher intensity resuscitation. Compared with no or minimal resuscitation, intubation and CPR were associated with increased odds of mortality (adjusted odds ratio (95% confidence interval): 50 (20 to 125) and 180 (63 to 518), respectively). CONCLUSIONS: Intubation or higher intensity delivery room resuscitation is associated with increased mortality, morbidities and resource use in late preterm infants. Extra intensive care is required for such infants, especially during the first week of life.
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