Incidence of newborn resuscitative interventions at birth and short-term outcomes: A regional population-based study
Peer reviewed, Journal article
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Original versionBjorland PA, Øymar K, Ersdal HL, Rettedal S. Incidence of newborn resuscitative interventions at birth and short-term outcomes: A regional population-based study. BMJ Paediatrics Open. 2019;3:e000592 https://doi.org/10.1136/bmjpo-2019-000592
Objectives: To determine the incidence and characteristics of resuscitative interventions at different gestational ages and short-term outcomes after resuscitation. Design, setting and patients: A prospective observational study in an unselected population at Stavanger University Hospital, Norway, from October 2016 until September 2017. Interventions: Using a data collection form and video recordings, we registered and analysed resuscitative interventions. Main outcome measures: Incidence of continuous positive airway pressure (CPAP), positive pressure ventilation (PPV), intubation, chest compressions and intravenous fluid or epinephrine boluses. Short-term outcomes of resuscitated newborns. Results: All 4693 newborns in the study period were included in the study. Two hundred and ninety-one (6.2%) newborns received interventions in the first minutes of life beyond drying and stimulation. PPV was provided in 170 (3.6%) while CPAP (without PPV) was provided in 121 (2.6%) newborns. Duration of PPV was median (IQR) 106 s (54–221). Intubations were performed in 19 (0.4%) newborns, with a mean (SD) intubation time of 47 (21) s. Ten (0.2%) newborns received chest compressions and epinephrine was administrated in three (0.1%) newborns. Sixty-three per cent of the treated newborns from 34 weeks’ gestational age were returned to parental care without further follow-up. Conclusions: The need for resuscitative interventions after birth was frequent in this unselected population in a high-resource setting, but full cardiopulmonary resuscitation was rare. Short-term outcomes were good, suggesting that most newborns treated with resuscitative interventions were not severely affected.