| Autor: |
Georgia A. Santomartino, Douglas A. Blank, Alissa Heng, Anthony Woodward, Stefan C. Kane, Marta Thio, Graeme R. Polglase, Stuart B. Hooper, Peter G. Davis, Shiraz Badurdeen |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
European Journal of Pediatrics. 182:987-995 |
| ISSN: |
1432-1076 |
| Popis: |
To identify characteristics associated with delivery room clinical instability in at-risk infants. Prospective cohort study. Two perinatal centres in Melbourne, Australia. Infants born at ≥ 35+0 weeks’ gestation with a first-line paediatric doctor requested to attend. Clinical instability defined as any one of heart rate +4 (38+4—40+4) weeks. Eighty (17%) infants met the criteria for clinical instability. Independent risk factors for clinical instability were labour without oxytocin administration, presence of a medical pregnancy complication, difficult extraction at birth and unplanned caesarean section in labour. Decision tree analysis determined that infants at highest risk were those whose mothers did not receive oxytocin during labour (25% risk). Infants at lowest risk were those whose mothers received oxytocin during labour and did not have a medical pregnancy complication (7% risk).Conclusions: We identified characteristics associated with clinical instability that may be useful in alerting less experienced clinicians to call for senior assistance early. The decision trees provide intuitive visual aids but require prospective validation. What is Known: • First-line clinicians attending at-risk births may need to call senior colleagues for assistance depending on the infant’s condition.• Delays in effectively supporting a compromised infant at birth is an important cause of neonatal morbidity and infant-mother separation. What is New: • This study identifies risk factors for delivery room clinical instability in at-risk infants born at ≥ 35+0 weeks’ gestation.• The decision trees presented provide intuitive visual tools to aid in determining the need for senior paediatric presence. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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Full text from SpringerLink