title: Changes in resuscitation practice at birth.
abstract: OBJECTIVE
  To investigate secular changes in neonatal resuscitation at birth.
  
  
  METHODS
  Single centre observational study of 17 890 infants born between May 1993 and April 1997. T-piece ventilation was introduced in April 1995.
  
  
  METHODS
  Rates and modes of ventilatory resuscitation, early neonatal encephalopathy, neonatal convulsions, and meconium aspiration syndrome; 1 and 5 min Apgar scores; maternal age and method of delivery; paediatric attendance at delivery and resuscitation.
  
  
  RESULTS
  The rate of all forms of ventilatory resuscitation fell during the four year period from 11.0% to 8.9%. The rate of intubation fell from 2.4% to 1.2%. A reduced rate of intubation was seen at all gestations of 30 weeks and above. There was no difference in rates of relevant neonatal problems during the period except for a reduction in neonatal convulsions. The introduction of T-piece ventilation did not contribute to the reduction in intubation in a logistic regression model that included time trend.
  
  
  CONCLUSIONS
  A marked reduction in the rate of intubation was observed, without any reduction in the efficacy of resuscitation. This may reflect improvements and changing emphasis in resuscitation training.
authors.affiliation: Derriford Hospital, Plymouth, UK.
authors.forename: A C L
authors.initials: AC
authors.lastname: Allwood
authors.forename: R J
authors.initials: RJ
authors.lastname: Madar
authors.forename: J H
authors.initials: JH
authors.lastname: Baumer
authors.forename: L
authors.initials: L
authors.lastname: Readdy
authors.forename: D
authors.initials: D
authors.lastname: Wright
mesh_terms: D000328:Adult; D001034:Apgar Score; D001927:Brain Diseases / Q000453:epidemiology; D016009:Chi-Square Distribution; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D004630:Emergencies / Q000453:epidemiology; D004739:England / Q000453:epidemiology; D020936:Epilepsy, Benign Neonatal / Q000453:epidemiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007442:Intubation, Intratracheal / Q000592:standards / Q000706:statistics & numerical data / Q000639:trends*; D008423:Maternal Age; D008471:Meconium Aspiration Syndrome / Q000453:epidemiology; D018743:Perinatal Care / Q000379:methods / Q000592:standards / Q000639:trends*; D011364:Professional Practice / Q000592:standards / Q000639:trends*; D012044:Regression Analysis; D012121:Respiration, Artificial / Q000379:methods / Q000706:statistics & numerical data / Q000639:trends*