title: Outcome of extremely low birth weight infants who received delivery room cardiopulmonary resuscitation.
abstract: OBJECTIVE
  To determine whether delivery room cardiopulmonary resuscitation (DR-CPR) independently predicts morbidities and neurodevelopmental impairment (NDI) in extremely low birth weight infants.
  
  
  METHODS
  We conducted a cohort study of infants born with birth weight of 401 to 1000 g and gestational age of 23 to 30 weeks. DR-CPR was defined as chest compressions, medications, or both. Logistic regression was used to determine associations among DR-CPR and morbidities, mortality, and NDI at 18 to 24 months of age (Bayley II mental or psychomotor index <70, cerebral palsy, blindness, or deafness). Data are adjusted ORs with 95% CIs.
  
  
  RESULTS
  Of 8685 infants, 1333 (15%) received DR-CPR. Infants who received DR-CPR had lower birth weight (708±141 g versus 764±146g, P<.0001) and gestational age (25±2 weeks versus 26±2 weeks, P<.0001). Infants who received DR-CPR had more pneumothoraces (OR, 1.28; 95% CI, 1.48-2.99), grade 3 to 4 intraventricular hemorrhage (OR, 1.47; 95% CI, 1.23-1.74), bronchopulmonary dysplasia (OR, 1.34; 95% CI, 1.13-1.59), death by 12 hours (OR, 3.69; 95% CI, 2.98-4.57), and death by 120 days after birth (OR, 2.22; 95% CI, 1.93-2.57). Rates of NDI in survivors (OR, 1.23; 95% CI, 1.02-1.49) and death or NDI (OR, 1.70; 95% CI, 1.46-1.99) were higher for DR-CPR infants. Only 14% of DR-CPR recipients with 5-minute Apgar score <2 survived without NDI.
  
  
  CONCLUSIONS
  DR-CPR is a prognostic marker for higher rates of mortality and NDI for extremely low birth weight infants. New DR-CPR strategies are needed for this population.
authors.affiliation: Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX 75390-9063, USA. myra.wyckoff@utsouthwestern.edu
authors.forename: Myra H
authors.initials: MH
authors.lastname: Wyckoff
authors.forename: Walid A
authors.initials: WA
authors.lastname: Salhab
authors.forename: Roy J
authors.initials: RJ
authors.lastname: Heyne
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Kendrick
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Stoll
authors.forename: Abbot R
authors.initials: AR
authors.lastname: Laptook
mesh_terms: D001724:Birth Weight; D016887:Cardiopulmonary Resuscitation / Q000401:mortality* / Q000706:statistics & numerical data; D015331:Cohort Studies; D003696:Delivery Rooms / Q000706:statistics & numerical data; D002658:Developmental Disabilities / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D052577:Infant, Extremely Low Birth Weight / Q000254:growth & development; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome