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Delivery Room Care for Premature Infants Born after Less than 25 Weeks' Gestation-A Narrative Review

Bernhard Schwaberger1, Berndt Urlesberger1, Georg M Schmölzer2,3

  • 1Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria.

Children (Basel, Switzerland)
|October 23, 2021
PubMed

Insights

Stabilizing extremely premature infants born before 25 weeks gestation in the delivery room (DR) is critical. Proper DR care can reduce infant mortality and long-term health issues for these vulnerable newborns.

Area of Science:

  • Neonatology
  • Perinatology
  • Pediatric Critical Care

Background:

  • Infants born before 25 weeks' gestation are highly vulnerable due to immature physiology and anatomy.
  • Respiratory and hemodynamic instability are common challenges immediately after birth in extremely premature infants.
  • Delivery room (DR) management significantly impacts short-term outcomes and long-term sequelae.

Purpose of the Study:

  • To review current neonatal resuscitation guidelines for extremely premature infants.
  • To identify and address the unique challenges in DR stabilization for infants born at <25 weeks' gestation.
  • To emphasize the importance of optimal DR care at the threshold of viability.

Main Methods:

  • Review of current neonatal resuscitation guidelines.
  • Analysis of physiological and anatomical factors contributing to instability in extremely premature infants.
  • Discussion of clinical strategies for DR stabilization.

Main Results:

  • Current guidelines provide a framework for resuscitation but require adaptation for extreme prematurity.
  • Immature respiratory systems and circulatory systems pose significant stabilization challenges.
  • Suboptimal DR care is linked to increased morbidity and mortality.

Conclusions:

  • Effective DR stabilization is crucial for improving outcomes in infants born <25 weeks' gestation.
  • Addressing the specific vulnerabilities of extremely premature infants in the DR is essential.
  • Further research and guideline refinement are needed for optimal care at the threshold of viability.

Keywords:
active managementcardio-circulatory supportdecision makingpostnatal stabilizationpremature infants born afterrespiratory supportthreshold of viabilityumbilical cord management

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