Proactive management of extreme prematurity: disagreement between obstetricians and neonatologists
Objective: To verify, in extremely preterm infants, if disagreement between obstetricians and neonatologists regarding proactive management is associated with early death. Study Design: Prospective cohort of 484 infants with 23 0/7 to 26 6/7 weeks, without malformations, born from January 2006 to De...
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| Veröffentlicht in: | Journal of perinatology 2012-12, Vol.32 (12), p.913-919 |
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| container_title | Journal of perinatology |
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| creator | Guinsburg, R Branco de Almeida, M F dos Santos Rodrigues Sadeck, L Marba, S T M Suppo de Souza Rugolo, L M Luz, J H de Andrade Lopes, J M Martinez, F E Procianoy, R S |
| description | Objective:
To verify, in extremely preterm infants, if disagreement between obstetricians and neonatologists regarding proactive management is associated with early death.
Study Design:
Prospective cohort of 484 infants with 23
0/7
to 26
6/7
weeks, without malformations, born from January 2006 to December 2009 in eight Brazilian hospitals. Pro-active management was defined as indication of ⩾1 dose of antenatal steroid or cesarean section (obstetrician) and resuscitation at birth according to the international guidelines (neonatologist). Main outcome was neonatal death in the first 24 h of life.
Result:
Obstetricians and neonatologists disagreed in 115 (24%) patients: only neonatologists were proactive in 107 of them. Disagreement between professionals increased 2.39 times the chance of death in the first day (95% confidence interval 1.40 to 4.09), adjusted for center and maternal/neonatal clinical conditions.
Conclusion:
In infants with 23 to 26 weeks of gestation, disagreement between obstetricians and neonatologists, translated as lack of antenatal steroids and/or vaginal delivery, despite resuscitation procedures, increases the odds of death in the first day. |
| doi_str_mv | 10.1038/jp.2012.28 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1221134361</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A311377509</galeid><sourcerecordid>A311377509</sourcerecordid><originalsourceid>FETCH-LOGICAL-c513t-b0b502ee2a7ba6076d07cbe2f6a74ca80c9294b4301ce88058d1916aeb5cae313</originalsourceid><addsrcrecordid>eNp9kl1rFTEQhoMo9li98QfIgiBS2WO-Ntn1rhSrQkEv9Dok2dltDrvJMclW--_Ncqq2KhJImMwz78zAi9BTgrcEs_b1br-lmNAtbe-hDeFS1E3D2X20wZKzumVcHKFHKe0wXpPyITqilAvccLFB5lMM2mZ3BdWsvR5hBp-rMFTwPccSVPty67xEl6_fVL1LeoxwgAzkbwC-CiZlyNFZp32qtO8rD8HrHKYwupTTY_Rg0FOCJzfvMfpy_vbz2fv64uO7D2enF7VtCMu1wabBFIBqabTAUvRYWgN0EFpyq1tsO9pxwxkmFtoWN21POiI0mMZqYIQdo5cH3X0MXxdIWc0uWZgmXeZZkiKUEsI4Eyv6_A90F5boy3SKCo4bKWnL_0cVLSwY6Vj7mxr1BMr5IeSo7dpanbLSUMoGd4Xa_oMqp4fZ2eBhcOX_TsGLWwWXoKd8mcK0ZBd8ugueHEAbQ0oRBrWPbtbxWhGsVn-o3V6t_lB0HfbZzUqLmaH_hf40RAFeHYBUUn6EeGvnv-V-AF_Pwcg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1220631938</pqid></control><display><type>article</type><title>Proactive management of extreme prematurity: disagreement between obstetricians and neonatologists</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>SpringerLink Journals - AutoHoldings</source><creator>Guinsburg, R ; Branco de Almeida, M F ; dos Santos Rodrigues Sadeck, L ; Marba, S T M ; Suppo de Souza Rugolo, L M ; Luz, J H ; de Andrade Lopes, J M ; Martinez, F E ; Procianoy, R S</creator><creatorcontrib>Guinsburg, R ; Branco de Almeida, M F ; dos Santos Rodrigues Sadeck, L ; Marba, S T M ; Suppo de Souza Rugolo, L M ; Luz, J H ; de Andrade Lopes, J M ; Martinez, F E ; Procianoy, R S ; Brazilian Network on Neonatal Research ; for the Brazilian Network on Neonatal Research</creatorcontrib><description>Objective:
To verify, in extremely preterm infants, if disagreement between obstetricians and neonatologists regarding proactive management is associated with early death.
Study Design:
Prospective cohort of 484 infants with 23
0/7
to 26
6/7
weeks, without malformations, born from January 2006 to December 2009 in eight Brazilian hospitals. Pro-active management was defined as indication of ⩾1 dose of antenatal steroid or cesarean section (obstetrician) and resuscitation at birth according to the international guidelines (neonatologist). Main outcome was neonatal death in the first 24 h of life.
Result:
Obstetricians and neonatologists disagreed in 115 (24%) patients: only neonatologists were proactive in 107 of them. Disagreement between professionals increased 2.39 times the chance of death in the first day (95% confidence interval 1.40 to 4.09), adjusted for center and maternal/neonatal clinical conditions.
Conclusion:
In infants with 23 to 26 weeks of gestation, disagreement between obstetricians and neonatologists, translated as lack of antenatal steroids and/or vaginal delivery, despite resuscitation procedures, increases the odds of death in the first day.</description><identifier>ISSN: 0743-8346</identifier><identifier>EISSN: 1476-5543</identifier><identifier>DOI: 10.1038/jp.2012.28</identifier><identifier>PMID: 22460546</identifier><language>eng</language><publisher>New York: Nature Publishing Group US</publisher><subject>692/700/1750/1747 ; Adrenal Cortex Hormones - therapeutic use ; Analysis of Variance ; Beliefs, opinions and attitudes ; Births ; Brazil ; Cardiopulmonary resuscitation ; Cardiopulmonary Resuscitation - standards ; Cardiopulmonary Resuscitation - trends ; Care and treatment ; Cesarean Section ; Cohort Studies ; Confidence Intervals ; CPR ; Death ; Delivery, Obstetric - methods ; Drug dosages ; Female ; Fetal Viability ; Fetuses ; Gestational Age ; Health aspects ; Humans ; Infant Mortality - trends ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Infants ; Infants (Premature) ; Intensive Care Units, Neonatal ; Interprofessional Relations ; Life Support Care - methods ; Logistic Models ; Male ; Medicine ; Medicine & Public Health ; Mortality ; Neonates ; Neonatologists ; Neonatology - standards ; Neonatology - trends ; Newborn babies ; Obstetricians ; Obstetrics - standards ; Obstetrics - trends ; Odds Ratio ; original-article ; Pediatric Surgery ; Pediatrics ; Practice Patterns, Physicians' - standards ; Practice Patterns, Physicians' - trends ; Pregnancy ; Premature babies ; Professionals ; Prognosis ; Prospective Studies ; Resuscitation ; Steroid hormones ; Steroids ; Steroids (Drugs) ; Treatment Outcome ; Vagina ; Ventilators</subject><ispartof>Journal of perinatology, 2012-12, Vol.32 (12), p.913-919</ispartof><rights>Nature America, Inc. 2012</rights><rights>COPYRIGHT 2012 Nature Publishing Group</rights><rights>Copyright Nature Publishing Group Dec 2012</rights><rights>Nature America, Inc. 2012.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c513t-b0b502ee2a7ba6076d07cbe2f6a74ca80c9294b4301ce88058d1916aeb5cae313</citedby><cites>FETCH-LOGICAL-c513t-b0b502ee2a7ba6076d07cbe2f6a74ca80c9294b4301ce88058d1916aeb5cae313</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/jp.2012.28$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/jp.2012.28$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22460546$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Guinsburg, R</creatorcontrib><creatorcontrib>Branco de Almeida, M F</creatorcontrib><creatorcontrib>dos Santos Rodrigues Sadeck, L</creatorcontrib><creatorcontrib>Marba, S T M</creatorcontrib><creatorcontrib>Suppo de Souza Rugolo, L M</creatorcontrib><creatorcontrib>Luz, J H</creatorcontrib><creatorcontrib>de Andrade Lopes, J M</creatorcontrib><creatorcontrib>Martinez, F E</creatorcontrib><creatorcontrib>Procianoy, R S</creatorcontrib><creatorcontrib>Brazilian Network on Neonatal Research</creatorcontrib><creatorcontrib>for the Brazilian Network on Neonatal Research</creatorcontrib><title>Proactive management of extreme prematurity: disagreement between obstetricians and neonatologists</title><title>Journal of perinatology</title><addtitle>J Perinatol</addtitle><addtitle>J Perinatol</addtitle><description>Objective:
To verify, in extremely preterm infants, if disagreement between obstetricians and neonatologists regarding proactive management is associated with early death.
Study Design:
Prospective cohort of 484 infants with 23
0/7
to 26
6/7
weeks, without malformations, born from January 2006 to December 2009 in eight Brazilian hospitals. Pro-active management was defined as indication of ⩾1 dose of antenatal steroid or cesarean section (obstetrician) and resuscitation at birth according to the international guidelines (neonatologist). Main outcome was neonatal death in the first 24 h of life.
Result:
Obstetricians and neonatologists disagreed in 115 (24%) patients: only neonatologists were proactive in 107 of them. Disagreement between professionals increased 2.39 times the chance of death in the first day (95% confidence interval 1.40 to 4.09), adjusted for center and maternal/neonatal clinical conditions.
Conclusion:
In infants with 23 to 26 weeks of gestation, disagreement between obstetricians and neonatologists, translated as lack of antenatal steroids and/or vaginal delivery, despite resuscitation procedures, increases the odds of death in the first day.</description><subject>692/700/1750/1747</subject><subject>Adrenal Cortex Hormones - therapeutic use</subject><subject>Analysis of Variance</subject><subject>Beliefs, opinions and attitudes</subject><subject>Births</subject><subject>Brazil</subject><subject>Cardiopulmonary resuscitation</subject><subject>Cardiopulmonary Resuscitation - standards</subject><subject>Cardiopulmonary Resuscitation - trends</subject><subject>Care and treatment</subject><subject>Cesarean Section</subject><subject>Cohort Studies</subject><subject>Confidence Intervals</subject><subject>CPR</subject><subject>Death</subject><subject>Delivery, Obstetric - methods</subject><subject>Drug dosages</subject><subject>Female</subject><subject>Fetal Viability</subject><subject>Fetuses</subject><subject>Gestational Age</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Infant Mortality - trends</subject><subject>Infant, Newborn</subject><subject>Infant, Premature</subject><subject>Infant, Very Low Birth Weight</subject><subject>Infants</subject><subject>Infants (Premature)</subject><subject>Intensive Care Units, Neonatal</subject><subject>Interprofessional Relations</subject><subject>Life Support Care - methods</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Neonates</subject><subject>Neonatologists</subject><subject>Neonatology - standards</subject><subject>Neonatology - trends</subject><subject>Newborn babies</subject><subject>Obstetricians</subject><subject>Obstetrics - standards</subject><subject>Obstetrics - trends</subject><subject>Odds Ratio</subject><subject>original-article</subject><subject>Pediatric Surgery</subject><subject>Pediatrics</subject><subject>Practice Patterns, Physicians' - standards</subject><subject>Practice Patterns, Physicians' - trends</subject><subject>Pregnancy</subject><subject>Premature babies</subject><subject>Professionals</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Resuscitation</subject><subject>Steroid hormones</subject><subject>Steroids</subject><subject>Steroids (Drugs)</subject><subject>Treatment Outcome</subject><subject>Vagina</subject><subject>Ventilators</subject><issn>0743-8346</issn><issn>1476-5543</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kl1rFTEQhoMo9li98QfIgiBS2WO-Ntn1rhSrQkEv9Dok2dltDrvJMclW--_Ncqq2KhJImMwz78zAi9BTgrcEs_b1br-lmNAtbe-hDeFS1E3D2X20wZKzumVcHKFHKe0wXpPyITqilAvccLFB5lMM2mZ3BdWsvR5hBp-rMFTwPccSVPty67xEl6_fVL1LeoxwgAzkbwC-CiZlyNFZp32qtO8rD8HrHKYwupTTY_Rg0FOCJzfvMfpy_vbz2fv64uO7D2enF7VtCMu1wabBFIBqabTAUvRYWgN0EFpyq1tsO9pxwxkmFtoWN21POiI0mMZqYIQdo5cH3X0MXxdIWc0uWZgmXeZZkiKUEsI4Eyv6_A90F5boy3SKCo4bKWnL_0cVLSwY6Vj7mxr1BMr5IeSo7dpanbLSUMoGd4Xa_oMqp4fZ2eBhcOX_TsGLWwWXoKd8mcK0ZBd8ugueHEAbQ0oRBrWPbtbxWhGsVn-o3V6t_lB0HfbZzUqLmaH_hf40RAFeHYBUUn6EeGvnv-V-AF_Pwcg</recordid><startdate>20121201</startdate><enddate>20121201</enddate><creator>Guinsburg, R</creator><creator>Branco de Almeida, M F</creator><creator>dos Santos Rodrigues Sadeck, L</creator><creator>Marba, S T M</creator><creator>Suppo de Souza Rugolo, L M</creator><creator>Luz, J H</creator><creator>de Andrade Lopes, J M</creator><creator>Martinez, F E</creator><creator>Procianoy, R S</creator><general>Nature Publishing Group US</general><general>Nature Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7RV</scope><scope>7T5</scope><scope>7T7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20121201</creationdate><title>Proactive management of extreme prematurity: disagreement between obstetricians and neonatologists</title><author>Guinsburg, R ; Branco de Almeida, M F ; dos Santos Rodrigues Sadeck, L ; Marba, S T M ; Suppo de Souza Rugolo, L M ; Luz, J H ; de Andrade Lopes, J M ; Martinez, F E ; Procianoy, R S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c513t-b0b502ee2a7ba6076d07cbe2f6a74ca80c9294b4301ce88058d1916aeb5cae313</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>692/700/1750/1747</topic><topic>Adrenal Cortex Hormones - therapeutic use</topic><topic>Analysis of Variance</topic><topic>Beliefs, opinions and attitudes</topic><topic>Births</topic><topic>Brazil</topic><topic>Cardiopulmonary resuscitation</topic><topic>Cardiopulmonary Resuscitation - standards</topic><topic>Cardiopulmonary Resuscitation - trends</topic><topic>Care and treatment</topic><topic>Cesarean Section</topic><topic>Cohort Studies</topic><topic>Confidence Intervals</topic><topic>CPR</topic><topic>Death</topic><topic>Delivery, Obstetric - methods</topic><topic>Drug dosages</topic><topic>Female</topic><topic>Fetal Viability</topic><topic>Fetuses</topic><topic>Gestational Age</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Infant Mortality - trends</topic><topic>Infant, Newborn</topic><topic>Infant, Premature</topic><topic>Infant, Very Low Birth Weight</topic><topic>Infants</topic><topic>Infants (Premature)</topic><topic>Intensive Care Units, Neonatal</topic><topic>Interprofessional Relations</topic><topic>Life Support Care - methods</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Neonates</topic><topic>Neonatologists</topic><topic>Neonatology - standards</topic><topic>Neonatology - trends</topic><topic>Newborn babies</topic><topic>Obstetricians</topic><topic>Obstetrics - standards</topic><topic>Obstetrics - trends</topic><topic>Odds Ratio</topic><topic>original-article</topic><topic>Pediatric Surgery</topic><topic>Pediatrics</topic><topic>Practice Patterns, Physicians' - standards</topic><topic>Practice Patterns, Physicians' - trends</topic><topic>Pregnancy</topic><topic>Premature babies</topic><topic>Professionals</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Resuscitation</topic><topic>Steroid hormones</topic><topic>Steroids</topic><topic>Steroids (Drugs)</topic><topic>Treatment Outcome</topic><topic>Vagina</topic><topic>Ventilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Guinsburg, R</creatorcontrib><creatorcontrib>Branco de Almeida, M F</creatorcontrib><creatorcontrib>dos Santos Rodrigues Sadeck, L</creatorcontrib><creatorcontrib>Marba, S T M</creatorcontrib><creatorcontrib>Suppo de Souza Rugolo, L M</creatorcontrib><creatorcontrib>Luz, J H</creatorcontrib><creatorcontrib>de Andrade Lopes, J M</creatorcontrib><creatorcontrib>Martinez, F E</creatorcontrib><creatorcontrib>Procianoy, R S</creatorcontrib><creatorcontrib>Brazilian Network on Neonatal Research</creatorcontrib><creatorcontrib>for the Brazilian Network on Neonatal Research</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of perinatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Guinsburg, R</au><au>Branco de Almeida, M F</au><au>dos Santos Rodrigues Sadeck, L</au><au>Marba, S T M</au><au>Suppo de Souza Rugolo, L M</au><au>Luz, J H</au><au>de Andrade Lopes, J M</au><au>Martinez, F E</au><au>Procianoy, R S</au><aucorp>Brazilian Network on Neonatal Research</aucorp><aucorp>for the Brazilian Network on Neonatal Research</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Proactive management of extreme prematurity: disagreement between obstetricians and neonatologists</atitle><jtitle>Journal of perinatology</jtitle><stitle>J Perinatol</stitle><addtitle>J Perinatol</addtitle><date>2012-12-01</date><risdate>2012</risdate><volume>32</volume><issue>12</issue><spage>913</spage><epage>919</epage><pages>913-919</pages><issn>0743-8346</issn><eissn>1476-5543</eissn><abstract>Objective:
To verify, in extremely preterm infants, if disagreement between obstetricians and neonatologists regarding proactive management is associated with early death.
Study Design:
Prospective cohort of 484 infants with 23
0/7
to 26
6/7
weeks, without malformations, born from January 2006 to December 2009 in eight Brazilian hospitals. Pro-active management was defined as indication of ⩾1 dose of antenatal steroid or cesarean section (obstetrician) and resuscitation at birth according to the international guidelines (neonatologist). Main outcome was neonatal death in the first 24 h of life.
Result:
Obstetricians and neonatologists disagreed in 115 (24%) patients: only neonatologists were proactive in 107 of them. Disagreement between professionals increased 2.39 times the chance of death in the first day (95% confidence interval 1.40 to 4.09), adjusted for center and maternal/neonatal clinical conditions.
Conclusion:
In infants with 23 to 26 weeks of gestation, disagreement between obstetricians and neonatologists, translated as lack of antenatal steroids and/or vaginal delivery, despite resuscitation procedures, increases the odds of death in the first day.</abstract><cop>New York</cop><pub>Nature Publishing Group US</pub><pmid>22460546</pmid><doi>10.1038/jp.2012.28</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0743-8346 |
| ispartof | Journal of perinatology, 2012-12, Vol.32 (12), p.913-919 |
| issn | 0743-8346 1476-5543 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1221134361 |
| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; SpringerLink Journals - AutoHoldings |
| subjects | 692/700/1750/1747 Adrenal Cortex Hormones - therapeutic use Analysis of Variance Beliefs, opinions and attitudes Births Brazil Cardiopulmonary resuscitation Cardiopulmonary Resuscitation - standards Cardiopulmonary Resuscitation - trends Care and treatment Cesarean Section Cohort Studies Confidence Intervals CPR Death Delivery, Obstetric - methods Drug dosages Female Fetal Viability Fetuses Gestational Age Health aspects Humans Infant Mortality - trends Infant, Newborn Infant, Premature Infant, Very Low Birth Weight Infants Infants (Premature) Intensive Care Units, Neonatal Interprofessional Relations Life Support Care - methods Logistic Models Male Medicine Medicine & Public Health Mortality Neonates Neonatologists Neonatology - standards Neonatology - trends Newborn babies Obstetricians Obstetrics - standards Obstetrics - trends Odds Ratio original-article Pediatric Surgery Pediatrics Practice Patterns, Physicians' - standards Practice Patterns, Physicians' - trends Pregnancy Premature babies Professionals Prognosis Prospective Studies Resuscitation Steroid hormones Steroids Steroids (Drugs) Treatment Outcome Vagina Ventilators |
| title | Proactive management of extreme prematurity: disagreement between obstetricians and neonatologists |
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