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End-of-Life Care for Newborn Infants: A Multicenter Real-Life Prospective Study
Gonzalo Luis Mariani1,2, Pamela Judith Contrera3, María de Los Angeles Virasoro4
1Servicio de Neonatología Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Neonatology
|May 27, 2024
Summary
Most neonatal deaths in Argentina occur with full medical support. Redirection of care, often due to inevitable death or poor quality of life, is less common than in industrialized nations.
Area of Science:
- Neonatology
- Pediatrics
- Medical Ethics
Background:
- Most neonatal deaths in industrialized countries involve redirection of care.
- Understanding end-of-life care practices in middle-income countries is crucial.
Purpose of the Study:
- To describe neonatal death processes in Argentina, a middle-income country.
- To determine the prevalence and reasons for redirection of care in neonatal deaths.
Main Methods:
- Prospective, multicenter, cross-sectional study.
- Inclusion of 697 neonatal deaths across 97 hospitals over 6 months.
- Interviews with healthcare team members involved in end-of-life care.
Main Results:
- Main causes of death: prematurity complications (47%) and congenital anomalies (27%).
- 32% of neonates died after redirection of care; less frequent in NICU (28%) vs. delivery room (70%).
- Reasons for redirection: inevitable death (75%) and compromised quality of life (25%). Major congenital anomalies increased odds of redirection.
Conclusions:
- Neonatal deaths in Argentina predominantly occur with full medical support.
- Redirection of care is primarily driven by the prognosis of inevitable death.
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