Neonatal Resuscitation in the Delivery Room from a Tertiary Level Hospital: Risk Factors and Outcome

authors:

avatar Seyyed-Abolfazl Afjeh 1 , * , avatar Mohammad-Kazem Sabzehei 2 , avatar Fatemeh Esmaili 3

Iranian Journal of Pediatrics: Vol.23, issue 6; 675-680
published online: November 27, 2013
article type: Research Article
received: November 05, 2012
accepted: June 28, 2013

how to cite: Afjeh S, Sabzehei M, Esmaili F. Neonatal Resuscitation in the Delivery Room from a Tertiary Level Hospital: Risk Factors and Outcome. Iran J Pediatr. 2013;23(6): 675-680. 

Abstract

Objective: Timely identification and prompt resuscitation of newborns in the delivery room may cause a decline in neonatal morbidity and mortality. We try to identify risk factors in mother and fetus that result in birth of newborns needing resuscitation at birth. Methods: Case notes of all deliveries and neonates born from April 2010 to March 2011 in Mahdieh Medical Center (Tehran, Iran), a Level III Neonatal Intensive Care Unit, were reviewed; relevant maternal, fetal and perinatal data was extracted and analyzed. Findings: During the study period, 4692 neonates were delivered; 4522 (97.7%) did not require respiratory assistance. One-hundred seven (2.3%) newborns needed resuscitation with bag and mask ventilation in the delivery unit, of whom 77 (1.6%) babies responded to bag and mask ventilation while 30 (0.65%) neonates needed endotracheal intubation and 15 (0.3%) were given chest compressions. Epinephrine/volume expander was administered to 10 (0.2%) newborns. In 17 patients resuscitation was continued for >10 mins. There was a positive correlation between the need for resuscitation and following risk factors: low birth weight, preterm labor, chorioamnionitis, pre-eclampsia, prolonged rupture of membranes, abruptio placentae, prolonged labor, meconium staining of amniotic fluid, multiple pregnancy and fetal distress. On multiple regression; low birth weight, meconium stained liquor and chorioamnionitis revealed as independent risk factors that made endotracheal intubation necessary. Conclusion: Accurate identification of risk factors and anticipation at the birth of a high-risk neonate would result in adequate preparation and prompt resuscitation of neonates who need some level of intervention and thus, reducing neonatal morbidity and mortality.
 

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