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Delivery Room Resuscitation Decisions for Extremely Low Birthweight Infants in California

Journal of Perinatology volume 21, pages 27–33 (2001)Cite this article

Abstract

OBJECTIVE: To characterize physician–parent counseling and delivery room resuscitation of extremely low birthweight (ELBW) infants.

STUDY DESIGN: Cross-sectional survey of 473 California neonatologists detailing counseling patterns, resuscitation thresholds, and acceptance of parental decision making.

RESULTS: The response rate was 61%. After 23 weeks' gestation, >80% of neonatologists counseled parents expecting ELBW infants. All (>99%) counseled parents about mortality; >25% reported not discussing limiting resuscitation or death despite resuscitation. Decisions to limit resuscitation were affected by congenital anomalies, parents' wishes, or perceptions of pain, suffering, and quality of life. Nearly 70% of neonatologists supported parental decision making at 22 to 23 weeks, whereas 66% to 74% responded that parents should not be allowed to make nonresuscitation decisions after 26 weeks. Median resuscitation thresholds were 23 weeks (range 20–28) and 500 g (range 350–1000).

CONCLUSIONS: Neonatologists' failure to discuss nonresuscitation options, variations in resuscitation thresholds, and unwillingness to accept nonresuscitation decisions for more mature ELBW infants may restrict parental decision making.

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Author notes

  1. Hank Freeman

    Present address: Department of Radiology, Mt. Sinai Medical Center, New York, NY

  2. Erica Weiss

    Present address: Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, CA

Authors and Affiliations

  1. University of California, San Francisco, San Francisco General Hospital, San Francisco, CA

    J Colin Partridge & Alma M Martinez

  2. School of Medicine, Temple University, Philadelphia, PA

    Hank Freeman

  3. School of Medicine, SUNY Stony Brook School of Medicine, Stony Brook, NY

    Erica Weiss

  4. Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, CA

    J Colin Partridge & Alma M Martinez

Authors
  1. J Colin Partridge
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  2. Hank Freeman
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  3. Erica Weiss
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  4. Alma M Martinez
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Additional information

Preliminary results presented at the annual meeting of the California Association of Neonatologists, Carmel, California, February 1997, and at the Society for Pediatric Research, May 1997.

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Colin Partridge, J., Freeman, H., Weiss, E. et al. Delivery Room Resuscitation Decisions for Extremely Low Birthweight Infants in California. J Perinatol 21, 27–33 (2001). https://doi.org/10.1038/sj.jp.7200477

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  • DOI: https://doi.org/10.1038/sj.jp.7200477

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