Extensive cardiopulmonary resuscitation of preterm neonates at birth and mortality and developmental outcomes. (February 2019)

• Record Type: Journal Article
• Authors: Fischer, Nicole; Soraisham, Amuchou; Shah, Prakesh S.; Synnes, Anne; Rabi, Yacov; Singhal, Nalini; Ting, Joseph Y.; Creighton, Dianne; Dewey, Deborah; Ballantyne, Marilyn; Lodha, Abhay; Shah, Prakesh S; Kanungo, Jaideep; Ting, Joseph; Yee, Wendy; Toye, Jennifer; Fajardo, Carlos; Kalapesi, Zarin; Sankaran, Koravangattu; Daspal, Sibasis; Seshia, Mary; Alvaro, Ruben; Mukerji, Amit; Da Silva, Orlando; Nwaesei, Chuks; Lee, Kyong-Soon; Dunn, Michael; Lemyre, Brigitte; Dow, Kimberly; Pelausa, Ermelinda; Lapoint, Anie; Drolet, Christine; Piedboeuf, Bruno; Claveau, Martine; Beltempo, Marc; Bertelle, Valerie; Masse, Edith; Canning, Roderick; Makary, Hala; Ojah, Cecil; Monterrosa, Luis; Emberley, Julie; Afifi, Jehier; Kajetanowicz, Andrzej; Lee, Shoo K; Canadian Neonatal Follow-Up Network (CNFUN) Investigators, ; Pillay, Thevanisha; Synnes, Anne; Sauvé, Reg; Hendson, Leonora; Reichert, Amber; Bodani, Jaya; Sankaran, Koravangattu; Moddemann, Diane; Nwaesei, Chuks; Daboval, Thierry; Dow, Kimberly; Lee, David; Coughlin, Kevin; Ly, Linh; Kelly, Edmond; Saigal, Saroj; Church, Paige; Pelausa, Ermelinda; Riley, Patricia; Luu, Thuy Mai; Lefebvre, Francine; Demers, Charlotte; Bélanger, Sylvie; Canning, Roderick; Monterrosa, Luis; Makary, Hala; Afifi, Jehier; Vincer, Michael; Murphy, Phil;
• Is Part Of: Resuscitation. Volume 135(2019)
• Page Start: 57
• Page End: 65
• Publication Date: 2019-02
• Subjects: Neonates -- Neonatal resuscitation -- Delivery room -- Developmental outcomes -- Preterm infant; Resuscitation -- Periodicals; Resuscitation -- Periodicals; Réanimation -- Périodiques; Electronic journals; 616.025
• DOI: 10.1016/j.resuscitation.2019.01.003
• Languages: English
• ISSNs: 0300-9572

Abstract

Abstract: Objective: To compare mortality and neurodevelopmental outcomes of extremely low gestational age neonates who received delivery room extensive cardiopulmonary resuscitation (DR-CPR) to those who did not require DR-CPR. Methods: Preterm neonates born at <29 weeks' gestational age between January 2010 and September 2011 and assessed at Canadian Neonatal Follow-Up Network centers were studied. Neonates who received DR-CPR were compared to those who did not require DR-CPR using univariate and multivariable analyses. The primary outcome was a composite of mortality or any neurodevelopmental impairment at 18 to 24 months corrected age defined as the presence of any one or more of the following: cerebral palsy; Bayley-III cognitive, language, or motor composite scores <85 on any one of the components; sensorineural/mixed hearing loss or unilateral or bilateral visual impairment. Secondary outcomes were the individual components of the composite outcomes. Results: Of the 2760 neonates born, 173 were excluded and remaining 2587 eligible neonates were included in our study. Of these 2068 had outcome data (80%) of whom 190 (9.2%) received DR-CPR. DR-CPR was independently associated with mortality or neurodevelopmental impairment (adjusted odds ratio [aOR] 1.76; 95% CI 1.21–2.55) and mortality alone (aOR1.94; 95% CI 1.33–2.83). DR-CPR was also associated with increased odds of motor impairment (aOR 2.03; 95% CI 1.28–3.23). Conclusion: In extremely low gestational age neonates, DR-CPR was associated with higher odds of the composite outcome of mortality or neurodevelopmental impairment, mortality alone, and lower motor scores at 18 to 24 months' corrected age.