RT Journal Article
SR Electronic
T1 Outcome of infants with 10 min Apgar scores of 0–1 in a low-resource setting
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 421
OP 424
DO 10.1136/archdischild-2021-322545
VO 107
IS 4
A1 Tylleskär, Thorkild
A1 Cavallin, Francesco
A1 Höök, Susanna Myrnerts
A1 Pejovic, Nicolas J
A1 Lubulwa, Clare
A1 Byamugisha, Josaphat
A1 Nankunda, Jolly
A1 Trevisanuto, Daniele
A1 ,
YR 2022
UL http://fn.bmj.com/content/107/4/421.abstract
AB Background In high-resource settings, postponing the interruption of cardiopulmonary resuscitation from 10 to 20 min after birth has been recently suggested, but data from low-resource settings are lacking. We investigated the outcome of newborns with Apgar scores of 0–1 at 10 min of resuscitative efforts in a low-resource setting.Methods This observational substudy from the NeoSupra trial included all 49 late preterm/full-term newborns with Apgar scores of 0–1 at 10 min of resuscitation. The study was carried out at Mulago National Referral Hospital (Kampala, Uganda) between May 2018 and August 2019. Outcome measures were mortality and hypoxic-ischaemic encephalopathy in the first week of life. All resuscitations were video recorded and daily reviewed by trial researchers.Results Median duration of resuscitation was 32 min (IQR 17–37). Advanced resuscitation was provided to 21/49 neonates (43%). Overall, 48 neonates (98%) died within 2 days of life (44 in the delivery room, three on the first day and one on the second day) and one survived at 1 week with severe hypoxic-ischaemic encephalopathy.Conclusion Our study adds information from a low-resource setting to the recent evidence from high-resource settings about prolonging the resuscitation in infants with Apgar scores of 0–1 at 10 min. The vast majority died in the delivery room despite prolonged resuscitative efforts. We confirm that duration of resuscitation should be tailored to the setting, while the focus in low-resource settings should be improving the quality of antenatal and immediately after birth care.Data are available upon reasonable request.