Delivery room resuscitation and short-term outcomes of extremely preterm and extremely low birth weight infants: a multicenter survey in North China.

Shuai-jun LI; Qi Feng; Xiu-ying Tian; Ying Zhou; Yong JI; Yue-mei LI; Shu-fen Zhai; Wei Guo; Fang Zhang; Rong-xiu Zheng; Hai-ying HE; Xia Liu; Jun-yi Wang; Hua Mei; Hong-yun Wang; Hua Xie; Chao-mei Zeng; Li MA; Ping-ping Zhang; Jin-yu LI; Xiao-ying Wang; Li-hua LI; Hong Cui; Shu-lan Yang; Lu Chen; Xiao-hong GU; Yan-ju HU; Sheng-shun Que; Li-xia Sun; Ming Yang; Wen-li Zhao; Qiu-yan MA; Hai-juan Wang; Jiu-ye Guo

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Delivery room resuscitation and short-term outcomes of extremely preterm and extremely low birth weight infants: a multicenter survey in North China.

Author: Shuai-Jun LI ¹ ; Qi FENG ¹ ; Xiu-Ying TIAN ² ; Ying ZHOU ³ ; Yong JI ⁴ ; Yue-Mei LI ⁵ ; Shu-Fen ZHAI ⁶ ; Wei GUO ⁷ ; Fang ZHANG ⁸ ; Rong-Xiu ZHENG ⁹ ; Hai-Ying HE ¹⁰ ; Xia LIU ¹¹ ; Jun-Yi WANG ¹² ; Hua MEI ¹³ ; Hong-Yun WANG ¹⁴ ; Hua XIE ¹⁵ ; Chao-Mei ZENG ¹⁶ ; Li MA ¹⁷ ; Ping-Ping ZHANG ¹⁸ ; Jin-Yu LI ¹⁹ ; Xiao-Ying WANG ²⁰ ; Li-Hua LI ²¹ ; Hong CUI ²² ; Shu-Lan YANG ²³ ; Lu CHEN ²⁴ ; Xiao-Hong GU ²⁵ ; Yan-Ju HU ²⁶ ; Sheng-Shun QUE ²⁷ ; Li-Xia SUN ²⁸ ; Ming YANG ²⁹ ; Wen-Li ZHAO ³⁰ ; Qiu-Yan MA ³¹ ; Hai-Juan WANG ³² ; Jiu-Ye GUO ³³
Author Information

1. Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.
2. Department of Neonatology, Tianjin Central Hospital of Gynecology Obstetrics, Tianjin 300100, China.
3. Department of Pediatrics, Peking University Third Hospital, Beijing 100191, China.
4. Neonatal Intensive Care Unit, Children's Hospital of Shanxi, Taiyuan, Shanxi 030031, China.
5. Department of Neonatology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, China.
6. Department of Neonatology, Handan Central Hospital, Handan, Hebei 056004, China.
7. Department of Neonatology, Xingtai People's Hospital, Xingtai, Hebei 054031, China.
8. Department of Neonatology, Tangshan Maternal and Child Health Hospital, Tangshan, Hebei 071023, China.
9. Department of Pediatrics, Tianjin Medical University General Hospital, Tianjin 300052, China.
10. Department of Pediatrics, Baogang Third Hospital of HongCi Group, Baotou, Inner Mongolia Autonomous Region 014010, China.
11. Department of Neonatology, Affiliated Hospital of Chengde Medical University, Chengde, Hebei 067000, China.
12. Department of Pediatrics, The First Hospital of Tsinghua University, Beijing 100016, China.
13. Department of Neonatology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia Autonomous Region 010050, China.
14. Department of Neonatology, Inner Mongolia Maternal and Child Health Hospital, Hohhot, Inner Mongolia Autonomous Region 010020, China.
15. Department of Neonatology, Affiliated Hospital of Chifeng University, Chifeng, Inner Mongolia Autonomous Region 024005, China.
16. Department of Pediatrics, Peking University People's Hospital, Beijing 100044, China.
17. Department of Neonatology, Hebei Children's Hospital, Shijiazhuang, Hebei 050000, China.
18. Department of Neonatology, Tianjin First Central Hospital, Tianjin 300384, China.
19. Department of Pediatrics, Peking Union Medical College Hospital, Beijing 100730, China.
20. Department of Neonatology, Children's Hospital Capital Institute of Pediatrics, Beijing 100020, China.
21. Department of Pediatrics, Beijing Luhe Hospital. Capital Medical University, Beijing 101149, China.
22. Department of Pediatrics, Beijing Friendship Hospital. Capital Medical University, Beijing 100050, China.
23. Department of Neonatology, Chifeng Municipal Hospital, Chifeng, Inner Mongolia Autonomous Region 024099, China.
24. Neonatal Center, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China.
25. Department of Neonatology, Zhangjiakou Maternal and Child Health Hospital, Zhangjiakou, Hebei 075001, China.
26. Department of Neonatology, Xing An Meng Hospital of Inner Mongolia, Xing An Meng, Inner Mongolia Autonomous Region 137499, China.
27. Department of Neonatology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China.
28. Department of Neonatology, Taiyuan Maternal and Child Health Hospital, Taiyuan, Shanxi 030021, China.
29. Neonatal Intensive Care Unit, Beijing United Family Hospital, Beijing 100016, China.
30. Department of Gynecology and Pediatrics, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China.
31. Department of Neonatology, Fenyang Hospital of Shanxi, Fenyang, Shanxi 030009, China.
32. Department of Neonatology, Baoding Maternal and Child Health Hospital, Baoding, Hebei 071023, China.
33. Department of Pediatrics, Chaoyang Maternal and Child Health Hospital of Beijing, Beijing 100024, China.
Publication Type:Multicenter Study
MeSH: Birth Weight; Bronchopulmonary Dysplasia; China/epidemiology*; Delivery Rooms; Female; Gestational Age; Humans; Infant; Infant, Extremely Low Birth Weight; Infant, Extremely Premature; Infant, Newborn; Male; Pregnancy
From: Chinese Medical Journal 2021;134(13):1561-1568
CountryChina
Language:English
Abstract: BACKGROUND:Delivery room resuscitation assists preterm infants, especially extremely preterm infants (EPI) and extremely low birth weight infants (ELBWI), in breathing support, while it potentially exerts a negative impact on the lungs and outcomes of preterm infants. This study aimed to assess delivery room resuscitation and discharge outcomes of EPI and ELBWI in China.
METHODS:The clinical data of EPI (gestational age [GA] <28 weeks) and ELBWI (birth weight [BW] <1000 g), admitted within 72 h of birth in 33 neonatal intensive care units from five provinces and cities in North China between 2017 and 2018, were analyzed. The primary outcomes were delivery room resuscitation and risk factors for delivery room intubation (DRI). The secondary outcomes were survival rates, incidence of bronchopulmonary dysplasia (BPD), and risk factors for BPD.
RESULTS:A cohort of 952 preterm infants were enrolled. The incidence of DRI, chest compressions, and administration of epinephrine was 55.9% (532/952), 12.5% (119/952), and 7.0% (67/952), respectively. Multivariate analysis revealed that the risk factors for DRI were GA <28 weeks (odds ratio [OR], 3.147; 95% confidence interval [CI], 2.082-4.755), BW <1000 g (OR, 2.240; 95% CI, 1.606-3.125), and antepartum infection (OR, 1.429; 95% CI, 1.044-1.956). The survival rate was 65.9% (627/952) and was dependent on GA. The rate of BPD was 29.3% (181/627). Multivariate analysis showed that the risk factors for BPD were male (OR, 1.603; 95% CI, 1.061-2.424), DRI (OR, 2.094; 95% CI, 1.328-3.303), respiratory distress syndrome exposed to ≥2 doses of pulmonary surfactants (PS; OR, 2.700; 95% CI, 1.679-4.343), and mechanical ventilation ≥7 days (OR, 4.358; 95% CI, 2.777-6.837). However, a larger BW (OR, 0.998; 95% CI, 0.996-0.999), antenatal steroid (OR, 0.577; 95% CI, 0.379-0.880), and PS use in the delivery room (OR, 0.273; 95% CI, 0.160-0.467) were preventive factors for BPD (all P < 0.05).
CONCLUSION:Improving delivery room resuscitation and management of respiratory complications are imperative during early management of the health of EPI and ELBWI.