title: Post-resuscitation care for neonates receiving positive pressure ventilation at birth.
abstract: OBJECTIVE
  To investigate if postresuscitation care (PRC) is indicated for all infants ≥35 weeks' gestation who receive positive pressure ventilation (PPV) at birth, explore the aspects of this care and the factors most predictive of it.
  
  
  METHODS
  Our hospital admits any infant who requires PPV at birth to special (intermediate/intensive) neonatal care unit (SNCU) for observation for at least 6 hours. All infants ≥35 weeks' gestation born between 1994 and 2013, who received PPV at birth, were reviewed. We examined perinatal factors that could predict the need for PRC after short (<1 minute) and prolonged (≥1 minute) PPV, admission course, neonatal morbidities, and the aspects of care given.
  
  
  RESULTS
  Among 87 464 infants born, 3658 (4.2%) had PPV at birth with 3305 (90%) admitted for PRC. Of those, 1558 (42.6%) were in the short PPV group and 2100 (57.4%) in the prolonged PPV group. Approximately 59% of infants who received short PPV stayed in the SNCU for ≥1 day. Infants who received prolonged PPV were more likely to have morbidities and require special neonatal care. Multiple logistic regression analysis revealed the risk factors of placental abruption, assisted delivery, small-for-dates, gestational age <37 weeks, low 5-minute Apgar score, and need for intubation at birth to be independent predictors for SNCU stay ≥1 day and need for assisted ventilation, central lines, and parenteral nutrition.
  
  
  CONCLUSIONS
  Our data support the need for PRC even for infants receiving short PPV at birth.
authors.affiliation: Division of Neonatal Perinatal Medicine, Department of Pediatrics, and.
authors.forename: Olusegun
authors.initials: O
authors.lastname: Akinloye
authors.affiliation: Perinatal Epidemiology Research Unit, Departments of Obstetrics & Gynecology and Pediatrics, Dalhousie University, Halifax, Canada.
authors.forename: Colleen
authors.initials: C
authors.lastname: O'Connell
authors.affiliation: Division of Neonatal Perinatal Medicine, Department of Pediatrics, and Perinatal Epidemiology Research Unit, Departments of Obstetrics & Gynecology and Pediatrics, Dalhousie University, Halifax, Canada.
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Allen
authors.affiliation: Division of Neonatal Perinatal Medicine, Department of Pediatrics, and walid.el-naggar@iwk.nshealth.ca.
authors.forename: Walid
authors.initials: W
authors.lastname: El-Naggar
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology; D007236:Infant, Small for Gestational Age / Q000502:physiology; D015931:Intensive Care, Neonatal / Q000379:methods / Q000639:trends*; D008297:Male; D009674:Nova Scotia / Q000453:epidemiology; D011175:Positive-Pressure Respiration / Q000009:adverse effects / Q000639:trends*; D011247:Pregnancy; D012151:Resuscitation / Q000009:adverse effects / Q000639:trends*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: birth; infant; positive-pressure ventilation; resuscitation