Outcome of extremely low birth weight infants who received delivery room cardiopulmonary resuscitation

Myra H. Wyckoff, Walid A. Salhab, Roy J. Heyne, Douglas E. Kendrick, Barbara J. Stoll, Abbot R. Laptook

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

Objective: To determine whether delivery room cardiopulmonary resuscitation (DR-CPR) independently predicts morbidities and neurodevelopmental impairment (NDI) in extremely low birth weight infants. Study design: We conducted a cohort study of infants born with birth weight of 401 to 1000 g and gestational age of 23 to 30 weeks. DR-CPR was defined as chest compressions, medications, or both. Logistic regression was used to determine associations among DR-CPR and morbidities, mortality, and NDI at 18 to 24 months of age (Bayley II mental or psychomotor index <70, cerebral palsy, blindness, or deafness). Data are adjusted ORs with 95% CIs. Results: Of 8685 infants, 1333 (15%) received DR-CPR. Infants who received DR-CPR had lower birth weight (708 ± 141 g versus 764 ± 146g, P <.0001) and gestational age (25 ± 2 weeks versus 26 ± 2 weeks, P <.0001). Infants who received DR-CPR had more pneumothoraces (OR, 1.28; 95% CI, 1.48-2.99), grade 3 to 4 intraventricular hemorrhage (OR, 1.47; 95% CI, 1.23-1.74), bronchopulmonary dysplasia (OR, 1.34; 95% CI, 1.13-1.59), death by 12 hours (OR, 3.69; 95% CI, 2.98-4.57), and death by 120 days after birth (OR, 2.22; 95% CI, 1.93-2.57). Rates of NDI in survivors (OR, 1.23; 95% CI, 1.02-1.49) and death or NDI (OR, 1.70; 95% CI, 1.46-1.99) were higher for DR-CPR infants. Only 14% of DR-CPR recipients with 5-minute Apgar score <2 survived without NDI. Conclusions: DR-CPR is a prognostic marker for higher rates of mortality and NDI for extremely low birth weight infants. New DR-CPR strategies are needed for this population.

Original languageEnglish (US)
JournalJournal of Pediatrics
Volume160
Issue number2
DOIs
StatePublished - Feb 2012

Fingerprint

Extremely Low Birth Weight Infant
Delivery Rooms
Cardiopulmonary Resuscitation
Birth Weight
Gestational Age
Deaf-Blind Disorders
Morbidity
Bronchopulmonary Dysplasia
Apgar Score
Mortality
Pneumothorax
Cerebral Palsy
Survivors
Cohort Studies
Thorax
Logistic Models

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Outcome of extremely low birth weight infants who received delivery room cardiopulmonary resuscitation. / Wyckoff, Myra H.; Salhab, Walid A.; Heyne, Roy J.; Kendrick, Douglas E.; Stoll, Barbara J.; Laptook, Abbot R.

In: Journal of Pediatrics, Vol. 160, No. 2, 02.2012.

Research output: Contribution to journalArticle

Wyckoff, Myra H. ; Salhab, Walid A. ; Heyne, Roy J. ; Kendrick, Douglas E. ; Stoll, Barbara J. ; Laptook, Abbot R. / Outcome of extremely low birth weight infants who received delivery room cardiopulmonary resuscitation. In: Journal of Pediatrics. 2012 ; Vol. 160, No. 2.
@article{196fd62f62a8496783e549d78f90e480,
title = "Outcome of extremely low birth weight infants who received delivery room cardiopulmonary resuscitation",
abstract = "Objective: To determine whether delivery room cardiopulmonary resuscitation (DR-CPR) independently predicts morbidities and neurodevelopmental impairment (NDI) in extremely low birth weight infants. Study design: We conducted a cohort study of infants born with birth weight of 401 to 1000 g and gestational age of 23 to 30 weeks. DR-CPR was defined as chest compressions, medications, or both. Logistic regression was used to determine associations among DR-CPR and morbidities, mortality, and NDI at 18 to 24 months of age (Bayley II mental or psychomotor index <70, cerebral palsy, blindness, or deafness). Data are adjusted ORs with 95{\%} CIs. Results: Of 8685 infants, 1333 (15{\%}) received DR-CPR. Infants who received DR-CPR had lower birth weight (708 ± 141 g versus 764 ± 146g, P <.0001) and gestational age (25 ± 2 weeks versus 26 ± 2 weeks, P <.0001). Infants who received DR-CPR had more pneumothoraces (OR, 1.28; 95{\%} CI, 1.48-2.99), grade 3 to 4 intraventricular hemorrhage (OR, 1.47; 95{\%} CI, 1.23-1.74), bronchopulmonary dysplasia (OR, 1.34; 95{\%} CI, 1.13-1.59), death by 12 hours (OR, 3.69; 95{\%} CI, 2.98-4.57), and death by 120 days after birth (OR, 2.22; 95{\%} CI, 1.93-2.57). Rates of NDI in survivors (OR, 1.23; 95{\%} CI, 1.02-1.49) and death or NDI (OR, 1.70; 95{\%} CI, 1.46-1.99) were higher for DR-CPR infants. Only 14{\%} of DR-CPR recipients with 5-minute Apgar score <2 survived without NDI. Conclusions: DR-CPR is a prognostic marker for higher rates of mortality and NDI for extremely low birth weight infants. New DR-CPR strategies are needed for this population.",
author = "Wyckoff, {Myra H.} and Salhab, {Walid A.} and Heyne, {Roy J.} and Kendrick, {Douglas E.} and Stoll, {Barbara J.} and Laptook, {Abbot R.}",
year = "2012",
month = "2",
doi = "10.1016/j.jpeds.2011.07.041",
language = "English (US)",
volume = "160",
journal = "Journal of Pediatrics",
issn = "0022-3476",
publisher = "Mosby Inc.",
number = "2",

}

TY - JOUR

T1 - Outcome of extremely low birth weight infants who received delivery room cardiopulmonary resuscitation

AU - Wyckoff, Myra H.

AU - Salhab, Walid A.

AU - Heyne, Roy J.

AU - Kendrick, Douglas E.

AU - Stoll, Barbara J.

AU - Laptook, Abbot R.

PY - 2012/2

Y1 - 2012/2

N2 - Objective: To determine whether delivery room cardiopulmonary resuscitation (DR-CPR) independently predicts morbidities and neurodevelopmental impairment (NDI) in extremely low birth weight infants. Study design: We conducted a cohort study of infants born with birth weight of 401 to 1000 g and gestational age of 23 to 30 weeks. DR-CPR was defined as chest compressions, medications, or both. Logistic regression was used to determine associations among DR-CPR and morbidities, mortality, and NDI at 18 to 24 months of age (Bayley II mental or psychomotor index <70, cerebral palsy, blindness, or deafness). Data are adjusted ORs with 95% CIs. Results: Of 8685 infants, 1333 (15%) received DR-CPR. Infants who received DR-CPR had lower birth weight (708 ± 141 g versus 764 ± 146g, P <.0001) and gestational age (25 ± 2 weeks versus 26 ± 2 weeks, P <.0001). Infants who received DR-CPR had more pneumothoraces (OR, 1.28; 95% CI, 1.48-2.99), grade 3 to 4 intraventricular hemorrhage (OR, 1.47; 95% CI, 1.23-1.74), bronchopulmonary dysplasia (OR, 1.34; 95% CI, 1.13-1.59), death by 12 hours (OR, 3.69; 95% CI, 2.98-4.57), and death by 120 days after birth (OR, 2.22; 95% CI, 1.93-2.57). Rates of NDI in survivors (OR, 1.23; 95% CI, 1.02-1.49) and death or NDI (OR, 1.70; 95% CI, 1.46-1.99) were higher for DR-CPR infants. Only 14% of DR-CPR recipients with 5-minute Apgar score <2 survived without NDI. Conclusions: DR-CPR is a prognostic marker for higher rates of mortality and NDI for extremely low birth weight infants. New DR-CPR strategies are needed for this population.

AB - Objective: To determine whether delivery room cardiopulmonary resuscitation (DR-CPR) independently predicts morbidities and neurodevelopmental impairment (NDI) in extremely low birth weight infants. Study design: We conducted a cohort study of infants born with birth weight of 401 to 1000 g and gestational age of 23 to 30 weeks. DR-CPR was defined as chest compressions, medications, or both. Logistic regression was used to determine associations among DR-CPR and morbidities, mortality, and NDI at 18 to 24 months of age (Bayley II mental or psychomotor index <70, cerebral palsy, blindness, or deafness). Data are adjusted ORs with 95% CIs. Results: Of 8685 infants, 1333 (15%) received DR-CPR. Infants who received DR-CPR had lower birth weight (708 ± 141 g versus 764 ± 146g, P <.0001) and gestational age (25 ± 2 weeks versus 26 ± 2 weeks, P <.0001). Infants who received DR-CPR had more pneumothoraces (OR, 1.28; 95% CI, 1.48-2.99), grade 3 to 4 intraventricular hemorrhage (OR, 1.47; 95% CI, 1.23-1.74), bronchopulmonary dysplasia (OR, 1.34; 95% CI, 1.13-1.59), death by 12 hours (OR, 3.69; 95% CI, 2.98-4.57), and death by 120 days after birth (OR, 2.22; 95% CI, 1.93-2.57). Rates of NDI in survivors (OR, 1.23; 95% CI, 1.02-1.49) and death or NDI (OR, 1.70; 95% CI, 1.46-1.99) were higher for DR-CPR infants. Only 14% of DR-CPR recipients with 5-minute Apgar score <2 survived without NDI. Conclusions: DR-CPR is a prognostic marker for higher rates of mortality and NDI for extremely low birth weight infants. New DR-CPR strategies are needed for this population.

UR - http://www.scopus.com/inward/record.url?scp=84855641375&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84855641375&partnerID=8YFLogxK

U2 - 10.1016/j.jpeds.2011.07.041

DO - 10.1016/j.jpeds.2011.07.041

M3 - Article

C2 - 21930284

AN - SCOPUS:84855641375

VL - 160

JO - Journal of Pediatrics

JF - Journal of Pediatrics

SN - 0022-3476

IS - 2

ER -