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- Elizabeth E Foglia, Erik A Jensen, Myra H Wyckoff, Taylor Sawyer, Alexis Topjian, Sarah J Ratcliffe, and American Heart Association’s Get With The Guidelines-Resuscitation Investigators.
- Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA, United States. Electronic address: foglia@email.chop.edu.
- Resuscitation. 2020 Jul 1; 152: 177-183.
AimsSurvival after delivery room cardiopulmonary resuscitation (DR-CPR) is not well characterized in full-term infants, and survival outcomes after DR-CPR have not been defined across the spectrum of gestation. The study objectives were to define gestational age (GA) specific survival following DR-CPR and to assess the association between GA and DR-CPR characteristics and survival outcomes.MethodsRetrospective cohort study of prospectively collected data in the American Heart Association Get With the Guidelines-Resuscitation registry. Newborn infants without congenital abnormalities who received greater than 1 min of chest compressions for DR-CPR were included. GA was stratified by categorical subgroups: ≥36 weeks; 33-356/7 weeks; 29-326/7 weeks; 25-286/7 weeks; 22-246/7 weeks. The primary outcome was survival to hospital discharge; the secondary outcome was return of circulation (ROC).ResultsAmong 1022 infants who received DR-CPR, 83% experienced ROC and 64% survived to hospital discharge. GA-stratified hospital survival rates were 83% (≥36 weeks), 66% (33-35 weeks), 60% (29-32 weeks), 52% (25-28 weeks), and 25% (22-24 weeks). Compared with GA ≥ 36 weeks, lower GA was independently associated with decreasing odds of survival (33-35 weeks: adjusted Odds Ratio [aOR] 0.46, 95% Confidence Interval [CI] 0.26-0.81; 29-32 weeks: aOR 0.40, 95% CI 0.23-0.69; 25-28 weeks: aOR 0.21, 95% CI 0.11-0.41; 22-24 weeks: aOR 0.06, 95% CI 0.03-0.10).ConclusionsIn this national registry of infants who received delivery room cardiopulmonary resuscitation (DR-CPR), 83% survived the event and two-thirds survived to hospital discharge. These results contribute to defining survival outcomes following DR-CPR across the continuum of gestation.Copyright © 2020 Elsevier B.V. All rights reserved.
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