Delivery room resuscitation and adverse outcomes among very low birth weight preterm infants

Objective:to evaluate risk factors and impact of delivery room cardiopulmonary resuscitation (dr-cpr) on very low birth weight (vlbw) preterm infants.study design:a national, population-based, observational study evaluating risk factors and short-term neonatal outcomes associated with dr-cpr among vlbw, extremely preterm infants (epis, 24 to 27 weeks’ gestation) and very preterm infants (vpi, 28 to 31 weeks’ gestation) born in 1995 to 2010.results:among 17 564 vlbw infants, 636 (3.6%) required dr-cpr. in the group of 6478 epi, 412 (6.4%) received dr-cpr compared with 224 of 11 086 infants (2.0%) in the vpi group. epi who underwent dr-cpr had higher odds ratios (ors (95% confidence interval)) for mortality compared to epi not requiring dr-cpr (or 3.32 (2.58, 4.29)), grades 3 to 4 intraventricular hemorrhage (ivh) (or 1.59 (1.20, 2.10)) and periventricular leukomalacia (or 1.81 (1.17, 2.82)). dr-cpr among vpi was associated with higher ors for mortality (or 4.99 (3.59, 6.94)), early sepsis (or 2.07 (1.05, 4.09)), grades 3 to 4 ivh (or 3.74 (2.55, 5.50)) and grades 3 to 4 retinopathy of prematurity (rop) (or 2.53 (1.18, 5.41)) compared to vpi not requiring dr-cpr. only 11% of infants in the epi dr-cpr group had favorable outcomes compared with 44% in the vpi dr-cpr group. significantly higher ors for mortality, ivh and rop were found in the vpi compared to the epi group.conclusion:preterm vlbw infants requiring dr-cpr were at increased risk of adverse outcomes compared to those not requiring cpr. this effect was more pronounced in the vpi group.