• Paediatr Perinat Epidemiol · May 2014

    Survival at the threshold of viability: a nationwide survey of the opinions and attitudes of physicians in a developing country.

    • Lama Charafeddine, Farah Ammous, Mariam Kayle, and Thalia Arawi.
    • Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon.
    • Paediatr Perinat Epidemiol. 2014 May 1; 28 (3): 227-34.

    BackgroundTo explore physicians' opinions and attitudes regarding resuscitation of extremely premature infants (EPIs) in a developing country with suboptimal resources.MethodsA survey was developed, revised, and pilot-tested. All 964 paediatricians registered in the Lebanese Order of Physicians were contacted; physicians involved in resuscitation of EPIs were eligible. Between February and April of 2009, anonymous surveys were mailed to consenting participants.ResultsThree hundred twenty-eight eligible physicians agreed to participate. One hundred twenty (36%) returned the survey, 45.3% of which were neonatologists. The vast majority agreed that parents would like to be informed and to participate in the resuscitation decision of an EPI. The majority of physicians considered infants at gestational age of ≤25 weeks (78%) or ≤800 g (89%) as non-viable. Physician's age, years of practice, and practising neonatal intensive care unit level were significantly associated with the choice of birthweight at which infants were considered non-viable.ConclusionsThe majority of surveyed physicians consider infants at gestational age less than or equal to 25 weeks gestation or 800 g at birth as non-viable, and therefore would not attempt their resuscitation. Factors influencing threshold of viability in developing countries need to be addressed and explored further.© 2014 John Wiley & Sons Ltd.

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