PEDIATRICS Vol. 104 No. 4 October 1999, p. e40
ELECTRONIC ARTICLE:
Intact Survival in Extremely Low Birth Weight Infants After
Delivery Room Resuscitation
Received Jul 30, 1998; accepted Apr 26, 1999.
From the Division of Neonatology, Department of Pediatrics, University of California, San Diego, California.
Objective. None of the 20 previously reported infants weighing <750 g at birth who received cardiopulmonary resuscitation (CPR) in the delivery room (DR) survived. To clarify whether such resuscitation is futile in our center, we evaluated our experience with DR-CPR over a 4-year period.
Study Design. We retrospectively reviewed the outcomes of
all inborn infants with birth weights <1000 g at University of
California, San Digeo Medical Center from January 1993 to December
1996. Surviving infants and matched control infants were followed for
40 months' adjusted age using standardized neurodevelopmental
assessments.
Results. Of the infants with birth weight <1000 g born
during this period, 29% (51/177) died, including 44% of those <750 g
and 16% of those
750 g. Overall, 19 infants received DR-CPR, of whom 12 were <750 g. Of the infants who received DR-CPR, 79% (15/19) survived, including 10 of 13 infants <750 g and 5 of 6 infants
750
g. Of the 15 survivors, 10 were followed beyond 10 months' adjusted
age (median: 28 months). At last examination, 70% were both
neurologically and developmentally normal. Two infants had cerebral
palsy with mild cognitive and severe motor developmental delay. Of 7 infants with birth weight <750 g, 6 had normal neurodevelopmental outcomes. The mean composite mental and motor scores of DR-CPR survivors were 93 ± 10 and 89 ± 25, respectively. No
differences were found in neurologic or developmental outcome between
DR-CPR survivors and control infants matched for gestational age, sex, and year of birth.
Conclusions. Our results indicate that intact survival is possible for infants weighing <750 g at birth after DR-CPR. Key words: infant, premature, cardiopulmonary resuscitation, neurodevelopment, survival, extremely low birth weight.




