Neonatal Resuscitation in the Delivery Room from a Tertiary Level Hospital: Risk Factors and Outcome

Objective: timely identification and prompt resuscitation of newborns in the delivery room may cause a decline in neonatal morbidity and mortality. we try to identify risk factors in mother and fetus that result in birth of newborns needing resuscitation at birth. methods: case notes of all deliveries and neonates born from april 2010 to march 2011 in mahdieh medical center (tehran, iran), a level iii neonatal intensive care unit, were reviewed; relevant maternal, fetal and perinatal data was extracted and analyzed. findings: during the study period, 4692 neonates were delivered; 4522 (97.7%) did not require respiratory assistance. one-hundred seven (2.3%) newborns needed resuscitation with bag and mask ventilation in the delivery unit, of whom 77 (1.6%) babies responded to bag and mask ventilation while 30 (0.65%) neonates needed endotracheal intubation and 15 (0.3%) were given chest compressions. epinephrine/volume expander was administered to 10 (0.2%) newborns. in 17 patients resuscitation was continued for >10 mins. there was a positive correlation between the need for resuscitation and following risk factors: low birth weight, preterm labor, chorioamnionitis, pre-eclampsia, prolonged rupture of membranes, abruptio placentae, prolonged labor, meconium staining of amniotic fluid, multiple pregnancy and fetal distress. on multiple regression; low birth weight, meconium stained liquor and chorioamnionitis revealed as independent risk factors that made endotracheal intubation necessary. conclusion: accurate identification of risk factors and anticipation at the birth of a high-risk neonate would result in adequate preparation and prompt resuscitation of neonates who need some level of intervention and thus, reducing neonatal morbidity and mortality.