Ali Almudeer1, Douglas McMillan1, Colleen O'Connell2, Walid El-Naggar3. 1. Division of Neonatal Perinatal Medicine, Department of Pediatrics, Dalhousie University, Halifax, Canada. 2. Division of Neonatal Perinatal Medicine, Department of Pediatrics, Dalhousie University, Halifax, Canada; Perinatal Epidemiology Research Unit, Departments of Obstetrics and Gynecology and Pediatrics, Dalhousie University, Halifax, Canada. 3. Division of Neonatal Perinatal Medicine, Department of Pediatrics, Dalhousie University, Halifax, Canada. Electronic address: walid.el-naggar@iwk.nshealth.ca.
Abstract
OBJECTIVE: To evaluate the significance and predictive value of each of the Neonatal Resuscitation Program (NRP)-listed ante- and intrapartum risk factors for the need of neonatal intubation at birth. STUDY DESIGN: In this population-based study, perinatal data of all infants born at ≥ 35 weeks gestation in the province of Nova Scotia between 1994 and 2014, were identified and reviewed from the Nova Scotia Atlee Database. The frequency of occurrence of risk factors, incidence of neonatal intubation at birth, and its relationship with the different NRP-listed risk factors, were examined. Variables that were significant (P < .05) in univariate analyses were entered into the regression model. RESULTS: During the 20-year study period, 176,365 infants ≥ 35 weeks gestation were born. In presence of any of the listed risk factors, 0.3% of infants received intubation at birth compared with 0.08% in absence of any risk factor (P < .001). On logistic regression analysis, only 16 of the NRP-listed risk factors had a significant relationship with intubation at birth (P < .001). Delivery in a tertiary care center did not have an impact. CONCLUSIONS: The presence of an intubation-skilled person at birth may not be indicated in all the NRP-listed ante- and intrapartum risk factors. Stratification of the relative significance of different risk factors may be of importance for the less-resourced health care units providing maternal and newborn care.
OBJECTIVE: To evaluate the significance and predictive value of each of the Neonatal Resuscitation Program (NRP)-listed ante- and intrapartum risk factors for the need of neonatal intubation at birth. STUDY DESIGN: In this population-based study, perinatal data of all infants born at ≥ 35 weeks gestation in the province of Nova Scotia between 1994 and 2014, were identified and reviewed from the Nova Scotia Atlee Database. The frequency of occurrence of risk factors, incidence of neonatal intubation at birth, and its relationship with the different NRP-listed risk factors, were examined. Variables that were significant (P < .05) in univariate analyses were entered into the regression model. RESULTS: During the 20-year study period, 176,365 infants ≥ 35 weeks gestation were born. In presence of any of the listed risk factors, 0.3% of infants received intubation at birth compared with 0.08% in absence of any risk factor (P < .001). On logistic regression analysis, only 16 of the NRP-listed risk factors had a significant relationship with intubation at birth (P < .001). Delivery in a tertiary care center did not have an impact. CONCLUSIONS: The presence of an intubation-skilled person at birth may not be indicated in all the NRP-listed ante- and intrapartum risk factors. Stratification of the relative significance of different risk factors may be of importance for the less-resourced health care units providing maternal and newborn care.
Authors: Edgardo Szyld; Michael P Anderson; Birju A Shah; Charles C Roehr; Georg M Schmölzer; Jorge G Fabres; Gary M Weiner Journal: BMJ Paediatr Open Date: 2022-03