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Updated: Apr 11, 2026
State of the Art Cranial Ultrasound Imaging in Neonates
Published on: February 2, 2015
Dutch neonatologists have adopted a more interventionist approach to neonatal care
Jan F Koper1, Arend F Bos1, Annie Janvier2
1Department of Pediatrics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Aim:
This study investigated whether continuous improvements to neonatal care and the legalisation of newborn euthanasia in 2005 had changed end-of-life decisions by Dutch neonatologists.
Methods:
We carried out a retrospective study of foetuses and neonates of more than 22 weeks' gestation that died in the delivery room or in the neonatal intensive care unit (NICU) of a tertiary referral hospital in the Netherlands, comparing end-of-life decisions and mortality in 2001-2003 and 2008-2010, before and after euthanasia legislation was introduced.
Results:
In 2008-2010, there were more deaths in the delivery room due to termination of pregnancy than in 2001-2003 (17% versus 29%, p = 0.031), and fewer infants received comfort medication (12% versus 20%, p = 0.078). The main mode of death in the NICU was the withdrawal of life-sustaining therapy. The number of days that infants lived increased significantly between 2001-2003 (11.5 days) and 2008-2010 (18.4 days, p < 0.006). Most infants received comfort medication, and neuromuscular blocking agents were administered incidentally.
Conclusion:
Terminations increased after changes in healthcare regulations. Modes of death in the NICU remained similar over 10 years. The increased duration of NICU treatment before dying suggests a more interventionist approach to treatment in 2008-2010.
