Maria Sousa Dias1, Mariana Meneses1, Mónica Calado Araújo2, Joana Moreno3, Ana Azevedo4, Sara Peixoto4, Cláudia Ferraz4.
1Department of Pediatrics, Hospital Pedro Hispano, Matosinhos, Portugal,
2Department of Gynecology/Obstetrics, Hospital Pedro Hispano, Matosinhos, Portugal,
3Department of Public Health, Serviço de Saúde da Região Autónoma da Madeira, Funchal, Portugal,
4Department of Neonatology, Hospital Pedro Hispano, Matosinhos, Portugal.
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Abstract
Transition to extrauterine life involves significant physiological changes for every newborn. Although most neonates begin breathing on their own, about 10% require assistance at birth and approximately 1% need advanced resuscitation measures. Anticipation and preparation are the first and most important steps in delivering effective care.
A retrospective case-control study conducted over 10 years at a level 2 hospital was carried out by selecting newborns requiring advanced resuscitation measures (intubation, chest compressions and/or epinephrine) as cases. The control group included randomly selected newborns without the need for advanced resuscitation, matched for gestational ages. Extreme premature newborns were excluded. Twenty-nine potentially predictive antepartum, intrapartum and neonatal characteristics, based on the risk factors described in the 2020 American Heart Association guidelines, were analyzed.
The study sample included 90 cases and 90 controls (n=180). The case group predominantly consisted of males (52.2%), very premature (median gestational age of 32 weeks) and low birth weight newborns (median birth weight of 1917 g). Four characteristics were identified as independently predictive of the need for advanced neonatal resuscitation, such as history of previous stillbirth, oligohydramnios, need for urgent or emergent cesarean section and significant intrapartum bleeding.
Knowledge and assessment of risk factors are essential for effective neonatal resuscitation. The findings of this study reinforce previous research and underscore the importance of anticipating and identifying newborns at higher risk, enabling a specialized team to assist these births and improve neonatal outcomes.
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