Decision-making in the delivery room: a survey of neonatologists.
OBJECTIVE
To examine influences on neonatologists' decision-making regarding resuscitation of extremely premature infants.


METHODS
A mailed survey of Illinois neonatologists evaluated influences on resuscitation. Personal and parentally opposed (that is, acting against parental wishes) gray zones of resuscitation were defined, with the lower limit (LL) the gestational age at or below which resuscitation would be consistently withheld and the upper limit (UL) above which resuscitation was mandatory.


RESULTS
Among the 85 respondents, LL and UL of the personal and parentally opposed gray zones were median 22 and 25 weeks, respectively. Neonatologists with an UL personal gray zone <25 completed weeks were significantly more fearful of litigation, more likely to have received didactic/continuing medical education teaching, and less likely to always consider parents' opinions in resuscitation decisions. Neonatologists with an UL parentally opposed gray zone <25 completed weeks were more fearful of litigation.


CONCLUSIONS
Neonatologists perceive a 'gray zone' of resuscitative practices and should understand that external influences may affect their delivery room resuscitation practices.
Weiss
A R
AR
Pediatrics, Children's Memorial Hospital, Chicago, IL, USA. arweiss@partners.org
Binns
H J
HJ
Collins
J W
JW
deRegnier
R-A
RA
D001291:Attitude of Health Personnel; D003657:Decision Making; D003696:Delivery Rooms; D005260:Female; D005865:Gestational Age; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D009359:Neonatology; D016414:Resuscitation Orders; D011795:Surveys and Questionnaires