Characteristics and outcomes of very low birth weight infants receiving epinephrine during delivery room resuscitation

Malvi Savani, Kirtikumar Upadhyay, Ajay Talati

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background Delivery room resuscitation of very low birth weight infants can involve use of endotracheal or intravenous epinephrine. Data of the past 19 years were reviewed to identify the usage of epinephrine in delivery room and identify characteristics of these babies. Methods Neonates with ≤1500 g birthweight from January 1996 to August 2014 were reviewed. Infants born alive and admitted to NICU were eligible. Characteristics such as demographics, survival and outcomes were recorded. Variables significant at p ≤ 0.1 among neonates receiving epinephrine were further analyzed via multiple logistic regressions. Results Out of 5868 eligible neonates, 416 (7%) received epinephrine in the delivery room. The infants who received epinephrine were of lower estimated gestational age (25 vs. 28 wk) and lower birth weight (746 vs. 980 g). Gender, race and mode of delivery were comparable between the two cohorts. Survival was higher in non-epinephrine group (89.4 vs. 61.1%). Bacterial infection (24.3 vs. 18.4%) and combined grade 3 and 4 intraventricular hemorrhage (18.4 vs. 8.4%) were higher in epinephrine group. Use of epinephrine in the delivery room was associated with decreased survival even after controlling for birth weight, gestational age and low Apgar scores [Odd ratio – 0.48 with 95% CI (0.37–0.62), p < 0.001]. Conclusion Neonates with lower birth weight and younger gestational age were more likely to receive epinephrine during resuscitation at birth. Use of epinephrine in delivery room was associated with lower survival and severe intraventricular hemorrhage among very low birth weight infants.

Original languageEnglish (US)
Pages (from-to)1-4
Number of pages4
JournalResuscitation
Volume115
DOIs
StatePublished - Jun 1 2017

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Delivery Rooms
Very Low Birth Weight Infant
Resuscitation
Epinephrine
Birth Weight
Newborn Infant
Gestational Age
Hemorrhage
Apgar Score
Bacterial Infections
Logistic Models
Odds Ratio
Demography
Parturition

All Science Journal Classification (ASJC) codes

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

Cite this

Characteristics and outcomes of very low birth weight infants receiving epinephrine during delivery room resuscitation. / Savani, Malvi; Upadhyay, Kirtikumar; Talati, Ajay.

In: Resuscitation, Vol. 115, 01.06.2017, p. 1-4.

Research output: Contribution to journalArticle

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abstract = "Background Delivery room resuscitation of very low birth weight infants can involve use of endotracheal or intravenous epinephrine. Data of the past 19 years were reviewed to identify the usage of epinephrine in delivery room and identify characteristics of these babies. Methods Neonates with ≤1500 g birthweight from January 1996 to August 2014 were reviewed. Infants born alive and admitted to NICU were eligible. Characteristics such as demographics, survival and outcomes were recorded. Variables significant at p ≤ 0.1 among neonates receiving epinephrine were further analyzed via multiple logistic regressions. Results Out of 5868 eligible neonates, 416 (7{\%}) received epinephrine in the delivery room. The infants who received epinephrine were of lower estimated gestational age (25 vs. 28 wk) and lower birth weight (746 vs. 980 g). Gender, race and mode of delivery were comparable between the two cohorts. Survival was higher in non-epinephrine group (89.4 vs. 61.1{\%}). Bacterial infection (24.3 vs. 18.4{\%}) and combined grade 3 and 4 intraventricular hemorrhage (18.4 vs. 8.4{\%}) were higher in epinephrine group. Use of epinephrine in the delivery room was associated with decreased survival even after controlling for birth weight, gestational age and low Apgar scores [Odd ratio – 0.48 with 95{\%} CI (0.37–0.62), p < 0.001]. Conclusion Neonates with lower birth weight and younger gestational age were more likely to receive epinephrine during resuscitation at birth. Use of epinephrine in delivery room was associated with lower survival and severe intraventricular hemorrhage among very low birth weight infants.",
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N2 - Background Delivery room resuscitation of very low birth weight infants can involve use of endotracheal or intravenous epinephrine. Data of the past 19 years were reviewed to identify the usage of epinephrine in delivery room and identify characteristics of these babies. Methods Neonates with ≤1500 g birthweight from January 1996 to August 2014 were reviewed. Infants born alive and admitted to NICU were eligible. Characteristics such as demographics, survival and outcomes were recorded. Variables significant at p ≤ 0.1 among neonates receiving epinephrine were further analyzed via multiple logistic regressions. Results Out of 5868 eligible neonates, 416 (7%) received epinephrine in the delivery room. The infants who received epinephrine were of lower estimated gestational age (25 vs. 28 wk) and lower birth weight (746 vs. 980 g). Gender, race and mode of delivery were comparable between the two cohorts. Survival was higher in non-epinephrine group (89.4 vs. 61.1%). Bacterial infection (24.3 vs. 18.4%) and combined grade 3 and 4 intraventricular hemorrhage (18.4 vs. 8.4%) were higher in epinephrine group. Use of epinephrine in the delivery room was associated with decreased survival even after controlling for birth weight, gestational age and low Apgar scores [Odd ratio – 0.48 with 95% CI (0.37–0.62), p < 0.001]. Conclusion Neonates with lower birth weight and younger gestational age were more likely to receive epinephrine during resuscitation at birth. Use of epinephrine in delivery room was associated with lower survival and severe intraventricular hemorrhage among very low birth weight infants.

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