Attitudes of Level II obstetricians towards the care of the extremely premature infant: a national survey.
OBJECTIVE
To explore the opinions of non-tertiary obstetricians towards the care and outcome of extremely premature infants.


METHODS
A structured questionnaire was mailed nationally to 232 obstetricians affiliated to maternity facilities with Level II nurseries.


RESULTS
The overall response rate was 75% (n = 174) after two mailings. This included 14 obstetricians who declined to participate. The median birthweight and gestation for active resuscitation was 500 g (350-800) and 24 weeks (22-26), respectively. Factors influencing decision to transfer were: better outcomes for infants born at perinatal centres (74%), paediatric advice (10%), personal beliefs (5%), parental wishes (4%), hospital policy (3%), legal repercussions (2.5%) and past history of infertility (2%). Obstetricians in Victoria and Western Australia (WA) would transfer at 22 weeks whilst the median gestation for transfer in other states was 24 weeks (P = 0.001). Most respondents underestimated intact and infant survival rates but WA and Victorian obstetricians were less pessimistic.


CONCLUSIONS
Most obstetricians in non-tertiary facilities who responded to our survey considered 500 g and 24 weeks to be the median birthweight and gestation for active resuscitation. This is similar to recent surveys of neonatologists and obstetricians in perinatal centres. There is significant underestimation of intact and infant survival at the extremes of prematurity when compared to available Australian data. Differences towards antenatal transfer between States may represent influences of local perinatal centres.
Gooi
A
A
Department of Newborn Care, The Royal Hospital for Women, Randwick, New South Wales, Australia.
Oei
J
J
Lui
K
K
D000328:Adult; D001291:Attitude of Health Personnel; D001724:Birth Weight; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D008875:Middle Aged; D009774:Obstetrics; D011247:Pregnancy; D011795:Surveys and Questionnaires