Population-based study shows that resuscitating apparently stillborn extremely preterm babies is associated with poor outcomes

作者：Haines Morgan; Wright Ian M; Bajuk Barbara; Abdel Latif Mohamed E; Hilder Lisa; Challis Daniel; Guaran Robert; Oei Ju Lee^*

来源：Acta Paediatrica, 2016, 105(11): 1305-1311.

DOI：10.1111/apa.13503

• Extremely preterm
• Mortality
• Outcomes
• Resuscitation
• Stillbirth

Aim: This population-based study determined the delivery room management and outcomes of extremely preterm infants born with Apgar scores of 0.
Methods: We linked birth, neonatal intensive care unit (NICU) and death records for babies who were born between 22 + 0 and 27 + 6 weeks of gestation with a one-minute Apgar score of 0, in New South Wales, Australia, between 1998 and 2011.
Results: We classified 2173/2262 (96%) of infants with a one-minute Apgar score of 0 as stillborn. Resuscitation was provided for 48/89 (54%) live births and 40/2173 (2%) stillbirths. Cardiac massage was given to 44 infants, including three 22-week stillborn babies. Of the 13 live births admitted to an NICU, 11 survived to hospital discharge. Most (98%) of the 2212 deaths occurred on the first day of life. One baby who was classified as stillborn lived for 51 days. Resuscitation increased the mean (95% confidence interval) duration of survival from 1 (0-2) to 45 (0-104) hours (p < 0.001). No infant with a five-minute Apgar score of 0 survived.
Conclusion: Clinicians resuscitated extremely preterm infants without a detectable heartbeat, even at 22 weeks of gestation. No infant survived without resuscitation or if their heartbeat was not regained by five minutes.

• 出版日期2016-11