Article Text

EPICURE 2: ARE LOW ADMISSION RATES AT 23 WEEKS EXPLAINED BY RELUCTANCE TO RESUSCITATE?
  1. K L Costeloe1,
  2. E S Draper2,
  3. F Stacey3,
  4. J Myles4,
  5. E M Hennessy4
  1. 1Academic Unit of Child Health, Barts and The London School of Medicine and Dentistry, London, UK
  2. 2Department of Health Sciences, University of Leicester, Leicester, UK
  3. 3Homerton University Hospital, London, UK
  4. 4Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, London, UK

Abstract

Background Outcome for births <27 w gestation in England in 2006 was studied. Admission rates of liveborn babies, n = 1762 are 37%, 86%, 95% and 98% at 23, 24, 25 and 26 w gestation.

Objective To study whether low admission rate of 23 w gestation babies is related to reluctance actively to stabilise these babies at birth.

Methods The frequency of interventions in relation to gestation was analysed using chi-squared trend analysis.

Results Of 23 w gestation babies, 83% were offered active support. Good response, assessed by heart-rate at 5 minutes was associated with increasing GA; there was an inverse relationship between GA and the proportion of deaths. See table.

Conclusions These data suggest that reduced admission rates at 23 w are related to less good response to resuscitation in these extremely immature babies and not to systematic reluctance actively to resuscitate.

Costeloe et al

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