title: Resuscitation of infants born at 22 weeks gestation: a 20-year retrospective.
abstract: OBJECTIVE
  To compare the characteristics of infants born at 22 weeks gestational age (GA) who were resuscitated at birth with those of infants who were not resuscitated.
  
  
  METHODS
  We reviewed records of all the infants with a GA of 22 0/7 through 22 6/7 weeks who were born alive at William Beaumont Hospital from 1990 through 2009. Deliveries were attended by a neonatologist if they were in the hospital at the time of delivery or requested by the obstetrician and otherwise were attended by a pediatric resident or neonatal nurse practitioner.
  
  
  RESULTS
  There were 85 infants born alive at 22 weeks GA during the study period. Thirty-six were intubated in the delivery room and defined as having been resuscitated. Two of them survived. On multivariate analysis, a higher birth weight (odds ratio 2.39 per 100 g increase, 95% confidence interval 1.21 to 4.73) and the presence of a neonatologist at delivery (odds ratio 6.72, 95% confidence interval 1.72 to 26.2) were each associated with an increased likelihood of resuscitation.
  
  
  CONCLUSIONS
  Infants born at 22 weeks GA were more likely to be resuscitated if they were larger or if the delivery was attended by a neonatologist. We encourage neonatal groups to follow the recommendations of the American Academy of Pediatrics Committee on the Fetus and Newborn regarding initiation of resuscitation in these infants: inform parents that a good outcome is very unlikely and respect the parents' choice of whether resuscitation should be initiated.
authors: Department of Pediatrics, Beaumont Children's Hospital, Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA. paul.holtrop@beaumont.edu
authors: P
authors: P
authors: Holtrop
authors: T
authors: T
authors: Swails
authors: T
authors: T
authors: Riggs
authors: D
authors: D
authors: De Witte
authors: J
authors: J
authors: Klarr
authors: C
authors: C
authors: Pryce
mesh_terms: D000328:Adult; D001034:Apgar Score; D001724:Birth Weight; D003657:Decision Making; D005260:Female; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D008297:Male; D015999:Multivariate Analysis; D009359:Neonatology; D011247:Pregnancy; D011256:Pregnancy Outcome; D012151:Resuscitation / Q000706:statistics & numerical data*; D012189:Retrospective Studies