Resuscitation of infants born at 22 weeks gestation: a 20-year retrospective

Objective:to compare the characteristics of infants born at 22 weeks gestational age (ga) who were resuscitated at birth with those of infants who were not resuscitated.study design:we reviewed records of all the infants with a ga of 22 0/7 through 22 6/7 weeks who were born alive at william beaumont hospital from 1990 through 2009. deliveries were attended by a neonatologist if they were in the hospital at the time of delivery or requested by the obstetrician and otherwise were attended by a pediatric resident or neonatal nurse practitioner.result:there were 85 infants born alive at 22 weeks ga during the study period. thirty-six were intubated in the delivery room and defined as having been resuscitated. two of them survived. on multivariate analysis, a higher birth weight (odds ratio 2.39 per 100 g increase, 95% confidence interval 1.21 to 4.73) and the presence of a neonatologist at delivery (odds ratio 6.72, 95% confidence interval 1.72 to 26.2) were each associated with an increased likelihood of resuscitation.conclusion:infants born at 22 weeks ga were more likely to be resuscitated if they were larger or if the delivery was attended by a neonatologist. we encourage neonatal groups to follow the recommendations of the american academy of pediatrics committee on the fetus and newborn regarding initiation of resuscitation in these infants: inform parents that a good outcome is very unlikely and respect the parents’ choice of whether resuscitation should be initiated.