Daniele Trevisanuto1, Camilla Gizzi2,3, Luigi Gagliardi4, Stefano Ghirardello5, Sandra Di Fabio6, Artur Beke3,7, Giuseppe Buonocore3,8, Antonia Charitou3,9, Manuela Cucerea3,10, Marina V Degtyareva3,11, Boris Filipović-Grčić3,12, Nelly Georgieva Jekova3,13, Esin Koç14,7, Joana Saldanha3,15, Manuel Sanchez Luna3,16, Dalia Stoniene3,17, Heili Varendi3,18, Giulia Vertecchi3, Fabio Mosca5, Corrado Moretti3,19. 1. Department of Woman's and Child's Health, University of Padova, Padova, Italy. 2. Department of Pediatrics, Ospedale Sandro Pertini, Rome, Italy. 3. Union of European Neonatal and Perinatal Societies (UENPS), Pisa, Italy. 4. Division of Neonatology and Pediatrics, Ospedale Versilia, Viareggio, Azienda USL Toscana Nord Ovest, Pisa, Italy. 5. Department of Pediatrics, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milan, Milan, Italy. 6. Department of Pediatrics, Ospedale San Salvatore, L'Aquila, Italy. 7. 1st Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary. 8. Department of Pediatrics, Azienda Ospedaliera Universitaria Senese, Siena, Italy. 9. Department of Pediatrics, Rea Maternity Hospital, Athens, Greece. 10. Neonatology Department, University of Medicine Pharmacy Sciences and Technology "George Emil Palade", Târgu Mures, Romania. 11. Department of Pediatrics, Pirogov Russian National Research Medical University, Moscow, Russian Federation. 12. Department of Pediatrics, University of Zagreb, School of Medicine, Zagreb, Croatia. 13. Department of Pediatrics, University Hospital "Majchin dom", Sofia, Bulgaria. 14. Division of Neonatology, Department of Pediatrics, School of Medicine, Gazi University, Ankara, Turkey. 15. Department of Pediatrics, Hospital de Santa Maria, Lisbon, Portugal. 16. Neonatology Division, Department of Pediatrics, Hospital General Universitario "Gregorio Marañón", Madrid, Spain. 17. Department of Pediatrics, Lithuanian University of Health Sciences, Kaunas, Lithuania. 18. Department of Pediatrics, Tartu University Hospital, Tartu, Estonia. 19. Department of Pediatrics, Policlinico Umberto I, Sapienza University, Rome, Italy.
Abstract
BACKGROUND: We aimed to evaluate the policies and practices about neonatal resuscitation in a large sample of European hospitals. METHODS: This was a cross-sectional electronic survey. A 91-item questionnaire focusing on the current delivery room practices in neonatal resuscitation domains was individually sent to the directors of 730 European neonatal facilities or (in 5 countries) made available as a Web-based link. A comparison was made between hospitals with ≤2,000 and those with >2,000 births/year and between hospitals in 5 European areas (Eastern Europe, Italy, Mediterranean countries, Turkey, and Western Europe). RESULTS: The response rate was 57% and included participants from 33 European countries. In 2018, approximately 1.27 million births occurred at the participating hospitals, with a median of 1,900 births/center (interquartile range: 1,400-3,000). Routine antenatal counseling (p < 0.05), the presence of a resuscitation team at all deliveries (p < 0.01), umbilical cord management (p < 0.01), practices for thermal management (p < 0.05), and heart rate monitoring (p < 0.01) were significantly different between hospitals with ≤2,000 births/year and those with >2,000 births/year. Ethical and educational aspects were similar between hospitals with low and high birth volumes. Significant variance in practice, ethical decision-making, and training programs were found between hospitals in 5 different European areas. CONCLUSIONS: Several recommendations about available equipment and clinical practices recommended by the international guidelines are already implemented by centers in Europe, but a large variance still persists. Clinicians and stakeholders should consider this information when allocating resources and planning European perinatal programs.
BACKGROUND: We aimed to evaluate the policies and practices about neonatal resuscitation in a large sample of European hospitals. METHODS: This was a cross-sectional electronic survey. A 91-item questionnaire focusing on the current delivery room practices in neonatal resuscitation domains was individually sent to the directors of 730 European neonatal facilities or (in 5 countries) made available as a Web-based link. A comparison was made between hospitals with ≤2,000 and those with >2,000 births/year and between hospitals in 5 European areas (Eastern Europe, Italy, Mediterranean countries, Turkey, and Western Europe). RESULTS: The response rate was 57% and included participants from 33 European countries. In 2018, approximately 1.27 million births occurred at the participating hospitals, with a median of 1,900 births/center (interquartile range: 1,400-3,000). Routine antenatal counseling (p < 0.05), the presence of a resuscitation team at all deliveries (p < 0.01), umbilical cord management (p < 0.01), practices for thermal management (p < 0.05), and heart rate monitoring (p < 0.01) were significantly different between hospitals with ≤2,000 births/year and those with >2,000 births/year. Ethical and educational aspects were similar between hospitals with low and high birth volumes. Significant variance in practice, ethical decision-making, and training programs were found between hospitals in 5 different European areas. CONCLUSIONS: Several recommendations about available equipment and clinical practices recommended by the international guidelines are already implemented by centers in Europe, but a large variance still persists. Clinicians and stakeholders should consider this information when allocating resources and planning European perinatal programs.