title: Attitudes of obstetric and pediatric health care providers toward resuscitation of infants who are born at the margins of viability.
abstract: OBJECTIVE
  The objective of this study was to determine the attitudes of a variety of health care providers toward the recommendations that should be made to parents regarding the resuscitation of infants who are born at the margins of viability.
  
  
  METHODS
  A written questionnaire was distributed to the medical and nursing staff at 4 tertiary perinatal centers. For each of 5 weekly gestational age intervals from 22 weeks to 26 weeks, 6 days, the health care providers were asked to describe on a scale from 1 to 5 whether they would strongly discourage through strongly encourage resuscitation. They also were queried regarding their comfort with counseling regarding these issues. The attitudes of various groups of providers were compared across weekly intervals.
  
  
  RESULTS
  A total of 204 physicians and 539 nurses completed the survey. The majority would strongly discourage, either discourage or strongly discourage, be neutral or recommend, recommend or strongly recommend, and strongly recommend resuscitation during the 23rd, 24th, 25th, 26th, and 27th weeks of gestation, respectively. Obstetric caregivers were slightly less likely than pediatric caregivers to strongly discourage resuscitation from 22 weeks to 22 weeks, 6 days and 23 weeks to 23 weeks, 6 days. There were no significant differences in the recommendations of obstetricians and pediatricians. Pediatric nurses were more likely to strongly recommend resuscitation from 26 weeks to 26 weeks, 6 days and more likely either to discourage or to strongly discourage resuscitation from 23 weeks to 23 weeks, 6 days and to strongly discourage resuscitation from the 22 weeks to 22 weeks, 6 days than their obstetric counterparts. Obstetric nurses were slightly less likely than obstetricians to strongly recommend resuscitation at 26 weeks to 26 weeks, 6 days and less likely to strongly discourage resuscitation from 22 weeks to 22 weeks, 6 days.
  
  
  CONCLUSIONS
  The caregivers' recommendations seem to be based logically on the current literature regarding survival and morbidity that is experienced by infants who are born at the threshold of viability. Although there are minor differences, there was a relatively consistent approach among professional groups.
authors.affiliation: Division of Maternal Fetal Medicine, Akron Children's Hospital, Akron, OH 44308, USA. akstork@yahoo.com
authors.forename: Justin P
authors.initials: JP
authors.lastname: Lavin
authors.forename: Anand
authors.initials: A
authors.lastname: Kantak
authors.forename: Judy
authors.initials: J
authors.lastname: Ohlinger
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Kaempf
authors.forename: Mark
authors.initials: M
authors.lastname: Tomlinson
authors.forename: Betty
authors.initials: B
authors.lastname: Campbell
authors.forename: Ona
authors.initials: O
authors.lastname: Fofah
authors.forename: William
authors.initials: W
authors.lastname: Edwards
authors.forename: Kathy
authors.initials: K
authors.lastname: Allbright
authors.forename: Erik
authors.initials: E
authors.lastname: Hagen
authors.forename: Gautham
authors.initials: G
authors.lastname: Suresh
authors.forename: Janice
authors.initials: J
authors.lastname: Schriefer
mesh_terms: D001291:Attitude of Health Personnel; D003376:Counseling; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D015931:Intensive Care, Neonatal; D009773:Obstetric Nursing; D009774:Obstetrics; D010371:Pediatric Nursing; D010372:Pediatrics; D012151:Resuscitation; D011795:Surveys and Questionnaires; D014481:United States