極早産児のケアにおける意思決定と診療のばらつきに関する国際的見解：ガイドラインは必要か

To examine international perspectives on the necessity of guidelines for the care of extremely preterm infants (EPIs), what forms such guidance should take, and the extent of practice variation neonatologists find acceptable.

Anonymous, online, cross-sectional international survey among neonatologists, exploring current and preferred guidelines and hypothetical scenarios testing acceptance of practice variation in EPI decision-making.

We analyzed 127 responses from 47 countries. Most respondents (55%) preferred a guideline using gestational age (GA) alongside other prognostic factors; 13% preferred no guideline. In scenarios involving borderline viability, variation was accepted when based on parental wishes, cultural norms, or resource constraints, but not when reflecting hospitals or individual differences. Views on directive counseling were divided.

Neonatologists support flexible, structured guidelines that consider more than GA alone. Variation is acceptable when reflecting parental values, cultural norms, or resource constraints but not when driven by individual or institutional preferences.