RT Journal Article
SR Electronic
T1 Risk factors for advanced resuscitation in term and near-term infants: a case–control study
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP F44
OP F50
DO 10.1136/archdischild-2015-309525
VO 102
IS 1
A1 Juan Pablo Berazategui
A1 Adriana Aguilar
A1 Marilyn Escobedo
A1 Douglas Dannaway
A1 Ruth Guinsburg
A1 Maria Fernanda Branco de Almeida
A1 Firas Saker
A1 Ariel Fernández
A1 Guadalupe Albornoz
A1 Mariana Valera
A1 Daniel Amado
A1 Gabriela Puig
A1 Fernando Althabe
A1 Edgardo Szyld
YR 2017
UL http://fn.bmj.com/content/102/1/F44.abstract
AB Objective (1) To determine which antepartum and/or intrapartum factors are associated with the need for advanced neonatal resuscitation (ANR) at birth in infants with gestational age (GA) ≥34 weeks. (2) To develop a risk score for the need for ANR in neonates with GA ≥34 weeks.Design Prospective multicentre, case–control study. In total, 16 centres participated in this study: 10 in Argentina, 1 in Chile, 3 in Brazil and 2 in the USA.Results A case–control study conducted from December 2011 to April 2013. Of a total of 61 593 births, 58 429 were reported as an GA ≥34 weeks, and of these, only 219 (0.37%) received ANR. After excluding 23 cases, 196 cases and 784 consecutive birth controls were included in the analysis. The final model was generated with three antepartum and seven intrapartum factors, which correctly classified 88.9% of the observations. The area under the receiver operating characteristic (AROC) performed to evaluate discrimination was 0.88, 95% CI 0.62 to 0.91. The AROC performed for external validity testing of the model in the validation sample was 0.87 with 95% CI 0.58 to 0.92.Conclusions We identified 10 risk factors significantly associated with the need for ANR in newborns ≥34 weeks. We developed a validated risk score that allows the identification of newborns at higher risk of need for ANR. Using this tool, the presence of specialised personnel in the delivery room may be designated more appropriately.