Proactive management of extreme prematurity: disagreement between obstetricians and neonatologists

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dc.contributor.authorGuinsburg, Ruth [UNIFESP]
dc.contributor.authorBranco de Almeida, M. F. [UNIFESP]
dc.contributor.authorSantos Rodrigues Sadeck, L. dos
dc.contributor.authorMarba, S. T. M.
dc.contributor.authorSuppo de Souza Rugolo, L. M.
dc.contributor.authorLuz, J. H.
dc.contributor.authorAndrade Lopes, J. M. de
dc.contributor.authorMartinez, F. E.
dc.contributor.authorProcianoy, R. S.
dc.contributor.authorBrazilian Network Neonatal Res
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.contributor.institutionUniversidade Estadual de Campinas (UNICAMP)
dc.contributor.institutionPontificia Univ Catolica Rio Grande do Sul
dc.contributor.institutionFundaco Oswaldo Cruz
dc.contributor.institutionUniv Fed Rio Grande do Sul
dc.date.accessioned2016-01-24T14:28:06Z
dc.date.available2016-01-24T14:28:06Z
dc.date.issued2012-12-01
dc.description.abstractObjective: To verify, in extremely preterm infants, if disagreement between obstetricians and neonatologists regarding proactive management is associated with early death.Study Design: Prospective cohort of 484 infants with 23(0/7) to 26(6/7) weeks, without malformations, born from January 2006 to December 2009 in eight Brazilian hospitals. Pro-active management was defined as indication of >= 1 dose of antenatal steroid or cesarean section (obstetrician) and resuscitation at birth according to the international guidelines (neonatologist). Main outcome was neonatal death in the first 24 h of life.Result: Obstetricians and neonatologists disagreed in 115 (24%) patients: only neonatologists were proactive in 107 of them. Disagreement between professionals increased 2.39 times the chance of death in the first day (95% confidence interval 1.40 to 4.09), adjusted for center and maternal/neonatal clinical conditions.Conclusion: in infants with 23 to 26 weeks of gestation, disagreement between obstetricians and neonatologists, translated as lack of antenatal steroids and/or vaginal delivery, despite resuscitation procedures, increases the odds of death in the first day. Journal of Perinatology (2012) 32, 913-919; doi:10.1038/jp.2012.28; published online 29 March 2012en
dc.description.affiliationUniversidade Federal de São Paulo, Escola Paulista Med, Dept Pediat, BR-01410020 São Paulo, SP, Brazil
dc.description.affiliationUniv São Paulo, Fac Med, Hosp Clin São Paulo, Inst Crianca, São Paulo, Brazil
dc.description.affiliationUniv Estadual Campinas, Dept Pediat, Campinas, SP, Brazil
dc.description.affiliationUniv Estadual São Paulo Julio Mesquita Neto, Fac Med Botucatu, Dept Pediat, Botucatu, SP, Brazil
dc.description.affiliationPontificia Univ Catolica Rio Grande do Sul, Dept Pediat, Porto Alegre, RS, Brazil
dc.description.affiliationFundaco Oswaldo Cruz, Inst Fernandes Figueira, Neonatal Dept, Rio de Janeiro, Brazil
dc.description.affiliationUniv São Paulo, Fac Med Ribeirao Preto, Dept Pediat, Ribeirao Preto, Brazil
dc.description.affiliationUniv Fed Rio Grande do Sul, Dept Pediat, Porto Alegre, RS, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Escola Paulista Med, Dept Pediat, BR-01410020 São Paulo, SP, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipMinistry of Health of Brazil
dc.description.sponsorshipIDMinistry of Health of Brazil: MS/VIGISUS 1755/2000
dc.description.sponsorshipIDMinistry of Health of Brazil: MS/FNS 274
dc.description.sponsorshipIDMinistry of Health of Brazil: FIOCRUZ/PDTSP
dc.format.extent913-919
dc.identifierhttp://dx.doi.org/10.1038/jp.2012.28
dc.identifier.citationJournal of Perinatology. New York: Nature Publishing Group, v. 32, n. 12, p. 913-919, 2012.
dc.identifier.doi10.1038/jp.2012.28
dc.identifier.issn0743-8346
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/35579
dc.identifier.wosWOS:000311831700003
dc.language.isoeng
dc.publisherNature Publishing Group
dc.relation.ispartofJournal of Perinatology
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.subjectfetal viabilityen
dc.subjectsteroidsen
dc.subjectcesarean sectionen
dc.subjectcardiopulmonary resuscitationen
dc.subjectinfant newbornen
dc.subjectneonatal mortalityen
dc.titleProactive management of extreme prematurity: disagreement between obstetricians and neonatologistsen
dc.typeinfo:eu-repo/semantics/article
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