title: A retrospective comparison of VLBW outcomes before and after implementing new delivery room guidelines at a regional tertiary care center.
abstract: OBJECTIVE
  To evaluate the impact of implemented protocol changes on delivery room interventions and very low birth weight (VLBW) health outcomes.
  
  
  METHODS
  Retrospective study comparing birth characteristics, interventions and health outcomes of VLBW infants born in a tertiary care center before (calendar years 2008 to 2009) and after (calendar years 2012 to 2013) implementing new protocols using Chi-square analyses.
  
  
  RESULTS
  Four hundred and nine were born before and 303 after changes were implemented. Postimplementation infants had more use of antenatal steroids (P=0.02), gestational age ⩽24 weeks (P=0.03) and birth weights between 501 and 750 g (P=0.04) and less oxygen administration (P=0.002), face mask ventilation (P=0.0001), surfactant use (P=0.0001), chest compressions (P=0.0001), intubation (P=0.002), epinephrine use (P=0.011), hypothermia (P=0.0001) and discharges home on supplemental oxygen (P=0.05).
  
  
  CONCLUSIONS
  Changes creating a new delivery team, adopting new delivery practice guidelines and updating delivery room equipment resulted in positive outcomes for delivery room practices and patient outcomes.
authors.affiliation: Department of Pediatrics, Neonatal-Perinatal Section, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: A
authors.initials: A
authors.lastname: Wlodaver
authors.affiliation: Department of Pediatrics, Neonatal-Perinatal Section, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: M
authors.initials: M
authors.lastname: Blunt
authors.affiliation: Department of Pediatrics, Neonatal-Perinatal Section, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: K
authors.initials: K
authors.lastname: Satnes
authors.affiliation: Department of Pediatrics, Neonatal-Perinatal Section, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: M
authors.initials: M
authors.lastname: Escobedo
authors.affiliation: Department of Pediatrics, Sections of Genetics and Neonatology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: G
authors.initials: G
authors.lastname: Hallford
authors.affiliation: Department of Pediatrics, Neonatal-Perinatal Section, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: E
authors.initials: E
authors.lastname: Szyld
mesh_terms: D001724:Birth Weight; D016009:Chi-Square Distribution; D003696:Delivery Rooms / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D005865:Gestational Age; D006776:Hospitals, Pediatric / Q000458:organization & administration; D006801:Humans; D007223:Infant; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D009825:Oklahoma; D010100:Oxygen / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011256:Pregnancy Outcome; D011663:Pulmonary Surfactants / Q000627:therapeutic use; D012189:Retrospective Studies; D062606:Tertiary Care Centers / Q000458:organization & administration*
chemical_list: D011663:Pulmonary Surfactants; D010100:Oxygen