This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Haywood, J. L.
Right arrow Articles by Carlo, W. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Haywood, J. L.
Right arrow Articles by Carlo, W. A.
Related Collections
Right arrow Premature & Newborn
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

PEDIATRICS Vol. 102 No. 2 August 1998, p. e20

ELECTRONIC ARTICLE:
Estimation of Outcome and Restriction of Interventions in Neonates

Received Sep 12, 1997; accepted Mar 23, 1998.

James L. Haywood*, Steven B. Morse*, Robert L. GoldenbergDagger , Janet Bronstein§, Kathleen G. Nelson*, and Waldemar A. Carlo*

From the Departments of * Pediatrics, Dagger  Obstetrics and Gynecology, the School of Medicine; and § School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama.

Objective.  To learn whether pediatricians accurately estimate rates of survival and freedom from handicap in preterm infants and to learn whether their knowledge and attitude influence their choice of interventions that may enhance survival of extremely preterm infants.

Methods.  Pediatricians practicing in Alabama were surveyed using a pretested questionnaire designed to identify pediatricians' knowledge regarding survival and handicap-free rates of infants born at gestational ages between 21 and 36 weeks. For infants born at each week of gestation, they were asked if they would provide specific therapeutic interventions. Survival and handicap-free rates were compared with published national rates. Pediatricians were divided into an optimist group and a pessimist group based on how their estimates of survival compared with national published data. The rates at which each group used therapeutic interventions were compared.

Results.  The 159 (57%) responding pediatricians underestimated survival rates from 23 through 34 weeks' gestation and freedom from serious handicap from 23 through 36 weeks. Responses of the optimists approximated actual data whereas the pessimists underestimated neonatal outcome. Those pediatricians who underestimated neonatal outcome would intervene less often with invasive therapies, including mechanical ventilation, cardiopulmonary resuscitation, inotropes, and intravenous fluids, compared with those who accurately predicted outcome from 23 through 27 weeks' gestation.

Conclusion.  Pediatricians often underestimate neonatal outcome of preterm infants. Appropriate neonatal practice may be affected by this underestimation of the survival potential of preterm infants.

Key words: prematurity, survival, knowledge, attitudes, practice.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 Arch Pediatr Adolesc MedHome page
A. A. E. Verhagen, J. H. H. M. Dorscheidt, B. Engels, J. H. Hubben, and P. J. Sauer
End-of-Life Decisions in Dutch Neonatal Intensive Care Units
Arch Pediatr Adolesc Med, October 1, 2009; 163(10): 895 - 901.
[Abstract] [Full Text] [PDF]

Home page
 Arch Pediatr Adolesc MedHome page
A. Janvier, K. Barrington, M. Deschenes, E. Couture, S. Nadeau, and J. Lantos
Relationship Between Site of Training and Residents' Attitudes About Neonatal Resuscitation
Arch Pediatr Adolesc Med, June 1, 2008; 162(6): 532 - 537.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
J A F Zupancic, H Kirpalani, J Barrett, S Stewart, A Gafni, D Streiner, M L Beecroft, and P Smith
Characterising doctor-parent communication in counselling for impending preterm delivery
Arch. Dis. Child. Fetal Neonatal Ed., September 1, 2002; 87(2): F113 - 117.
[Abstract] [Full Text] [PDF]