title: The Successful Immediate Neonatal Transition to Extrauterine Life.
abstract: OBJECTIVE
  To define and describe the processes underlying the successful neonatal transition to extrauterine life and methods to assess the transition.
  
  
  METHODS
  Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Web of Science, and Google Scholar were searched using a combination of the key words neonate, neonatal, newborn, transition, respiratory OR pulmonary, cardiac, metabolic, pH, umbilical cord, and assessment. Articles in English and German were reviewed. The final sample of articles consisted of one randomized controlled trial, 30 observational studies using human neonates, one observational study using rabbit pups, one secondary analysis, three systematic reviews, and 23 review articles.
  
  
  RESULTS
  The pertinent findings in regard to normal events in the respiratory, cardiovascular, and metabolic transitions are reviewed and summarized. We address the underlying factors necessary for the transition to extrauterine life, specify the consequences of a successful transition, and review common assessment approaches.
  
  
  CONCLUSIONS
  Available evidence indicates that the successful immediate transition to extrauterine life should be completed within 1-3 hr after birth, though some adaptive processes can fail as late as 24-48 hr after birth. Further research is necessary to identify a feasible, easily used, noninvasive method to assess the status of a neonate's transition to extrauterine life.
authors.affiliation: 1 College of Nursing, University of Colorado, Denver, CO, USA.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Michel
authors.affiliation: 1 College of Nursing, University of Colorado, Denver, CO, USA.
authors.forename: Nancy K
authors.initials: NK
authors.lastname: Lowe
mesh_terms: D000222:Adaptation, Physiological / Q000502:physiology*; D002320:Cardiovascular Physiological Phenomena; D036861:Delivery, Obstetric / Q000451:nursing; D005260:Female; D006801:Humans; D007231:Infant, Newborn / Q000502:physiology*; D017283:Neonatal Nursing / Q000379:methods*; D024802:Nurse's Role; D009730:Nursing Assessment; D036801:Parturition / Q000502:physiology*; D011247:Pregnancy
keywords: immediate; neonate; successful; transition