@article {PerlbargF384, author = {J Perlbarg and P Y Ancel and B Khoshnood and M Durox and P Boileau and M Garel and M Kaminski and F Goffinet and L Foix-L{\textquoteright}H{\'e}lias and the Epipage-2 Ethics group}, editor = {, and Kuhn, Pierre and Langer, Bruno and Mazille, Nadia and Lecomte, B{\'e}n{\'e}dicte and Bellot, Anne and Dupont-Chauvet, Peggy and Betremieux, Pierre and Beuch{\'e}e, Alain and Charlot, Fr{\'e}d{\'e}rique and Rouget, Florence and Thiriez, G{\'e}rard and Anselem, Olivia and Azria, Elie and Boujenah, Laurence and Caeymaex, Laurence and Jarreau, Pierre-Henri and Magny, Jean-Fran{\c c}ois and Mokhtari, Mostafa and Jacquot, Aur{\'e}lien and Lema{\^\i}tre, Anne and Miler, Caroline and Vieux, Rachel and Arnaud, Catherine and Truffert, Patrick and Simeoni, Umberto and Bouderlique-Collin, Claude and Chauty, Anne and Savagner, Christophe and Claris, Olivier and Coquelin, Ana{\"e}lle}, title = {Delivery room management of extremely preterm infants: the EPIPAGE-2 study}, volume = {101}, number = {5}, pages = {F384--F390}, year = {2016}, doi = {10.1136/archdischild-2015-308728}, publisher = {BMJ Publishing Group}, abstract = {Objective To analyse the delivery room management of babies born between 22 and 26 weeks of completed gestational age and to identify the factors associated with the withholding or withdrawal of intensive care.Study design Population-based cohort study.Patients and methods Our study population comprised 2145 births between 22 and 26 completed weeks enrolled in the EPIPAGE-2 study, a French cohort of very preterm infants born in 2011. The primary outcome measure was withholding or withdrawal of intensive care in the delivery room.Results Among infants born alive at 22{\textendash}23 weeks, intensive care was withheld or withdrawn for \>90\%. At 24 weeks, resuscitative measures were withheld or withdrawn for 38\%, at 25 weeks for 8\% and at 26 weeks for 3\%. Other factors besides gestational age at birth associated with this withholding or withdrawal for infants born at 24{\textendash}26 weeks were birth weight \<600 g, emergency delivery (within 24 h of the mother{\textquoteright}s admission) and singleton pregnancy. Although rates of withholding or withdrawal of intensive care varied substantially between maternity units (from 0\% to 100\%), the variability was primarily explained by differences in distributions of gestational age at birth.Conclusions Although gestational age is only one factor predicting survival of preterm infants, practices in France appear to be based primarily on this factor, which thus has direct effects on the survival of extremely preterm infants. The ethical implications of basing life and death decisions only on gestational age before 25 weeks require further examination.}, issn = {1359-2998}, URL = {https://fn.bmj.com/content/101/5/F384}, eprint = {https://fn.bmj.com/content/101/5/F384.full.pdf}, journal = {Archives of Disease in Childhood - Fetal and Neonatal Edition} }