RISK FOR POST-RESUSCITATION COMPLICATIONS: ARE RECOVERED TERM NEWBORNS ALL BETTER?

Infants who had recovered by 5 minutes after resuscitation still had increased risk for complications.

Transfer to an NICU for post-resuscitation care is recommended for all newborns who require active resuscitation in the delivery room, but some infants respond rapidly and do not require further intervention. To examine whether recovered neonates should be cared for in this type of setting, researchers at one perinatal center retrospectively compared medical charts of 33 term neonates who required active intervention but who seemingly recovered by 5 minutes of age (1-minute Apgar score ⩽4, positive pressure ventilation during the first minute of life, 5-minute Apgar score ⩾8) with those of a control group consisting of the next same-sex term infant with an Apgar score ⩾8 delivered at the center.

Compared with controls, infants in the study group had significantly more perinatal risk factors. Twice as many study infants were known to be at risk and therefore had a resuscitation team in the delivery room prior to delivery. Seventeen study infants were admitted to the NICU: 4 from the delivery room and 13 from the wellborn nursery after experiencing complications. Only 1 control infant (with transient tachypnea) was admitted to the NICU. Twenty study infants had complications: 8 had hypoglycemia (5 requiring intravenous glucose), 6 had transient tachypnea, 4 had meconium aspiration, and 2 had hypermagnesemia. Two infants had pneumothorax, 1 had hyperbilirubinemia, and 1 required evaluation for sepsis.

Comment▸

The authors conclude that these findings support caring for seemingly recovered resuscitated infants …