Article Text

Download PDFPDF
Short-term outcome of treatment limitation discussions for newborn infants, a multicentre prospective observational cohort study


Objective To determine the short-term outcomes of babies for whom clinicians or parents discussed the limitation of life-sustaining treatment (LST).

Design Prospective multicentre observational study.

Setting Two level 3, six level 2 and one level 1 neonatal units in the North-East London Neonatal Network.

Participants A total of 87 babies including 68 for whom limiting LST was discussed with parents and 19 babies died without discussion of limiting LST in the labour ward or neonatal unit.

Outcome measures Final decision reached after discussions about limiting LST and neonatal unit outcomes (death or survived to discharge) for babies.

Results Withdrawing LST, withholding LST and do not resuscitate (DNR) order was discussed with 48, 16 and 4 parents, respectively. In 49/68 (72%) cases decisions occurred in level 3 and 19 cases in level 2 units. Following the initial discussions, 34/68 parents made the decision to continue LST. In 33/68 cases, a second opinion was obtained. The parents of 14/48 and 2/16 babies did not agree to withdraw and withhold LST, respectively. Forty-seven out of 87 babies (54%) died following limitation of LST, 28/87 (32%) died receiving full intensive care support, 5/87 (6%) survived following a decision to limit LST and 7/87 (8%) babies survived following decision to continue LST.

Conclusions A significant proportion of parents chose to continue treatment following discussions regarding limiting LST for their babies, and a proportion of these babies survived to neonatal unit discharge. The long-term outcomes of babies who survive following limiting LST discussion need to be investigated.

  • Withdrawal of life sustaining treatment
  • DNR Order
  • Newborn baby
  • Neonatal death
  • Limitation of life sustaining treatment

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • Editorial
    Annie Janvier Barbara Farlow Eduard Verhagen Keith Barrington
  • Original article
    Xavier Durrmeyer Claire Scholer-Lascourrèges Laurence Boujenah Pierre Bétrémieux Olivier Claris Micheline Garel Monique Kaminski Laurence Foix-L'Helias Laurence Caeymaex the EPIPAGE-2 Extreme Prematurity Writing Group the EPIPAGE-2 Extreme Prematurity Writing Group Elie Azria Alain Beuchée Pascal Boileau Frédérique Charlot Anaëlle Coquelin Caroline Diguisto Laurence Foix L'Hélias Pierre Kuhn Cerise Levaillant Florence Rouget Umberto Simeoni Barthélemy Tosello Patrick Truffert
  • Fantoms
    Ben Stenson