Abstract 303: Frequency of Newborn Resuscitation and Stabilization in Three Normal-Risk Delivery Units in Norway

Introduction: Most newborn infants transition from intra- to extrauterine life without interventions; yet neonatal morbidity remains a significant health problem in both resource rich and resource poor health care systems. Although advanced resuscitation of newborn infants with chest compressions, intravenous drugs, and fluids is relatively rare, there are limited data on the frequency of neonatal stabilization and resuscitation measures in normal-risk delivery units. METHODS: Prospective, observational study conducted in the delivery units in three hospitals in Norway. All newborn infants assessed for stabilization and/or resuscitation during one month were included. After each incident, data on resuscitation measures and outcome were registered and reviewed by study personnel at every on-call team shift during the study period. Approval was obtained from department heads and institutional review boards. Results: 1507 babies were live born during the study period, mean weight 3.3 kg and gestational age 39.4 weeks.: 113 (7 %) needed resuscitation interventions beyond drying and stimulation. Suctioning of oropharynx was performed in 77 babies (5 %) and tracheal suctioning in 10 (1%). Positive pressure ventilation (PPV) was provided by a T-piece resuscitator and/or by a self-inflating bag to 58 (4 %) with 39 (3 %) receiving supplementary oxygen. In addition CPAP (but no PPV) was provided to 17 (1 %). One needed chest compressions. Tracheal intubation was accomplished in 4 infants of whom 3 were prematurely born and treated with tracheal surfactant. Intravenous access was established in 8 infants, two received saline infusions and one received epinephrine. After initial resuscitation, 64 (4 %) were admitted to the neonatal intensive care unit and two died. Twenty-one events were handled exclusively by midwifes, 244 by pediatric residents and 39 by attending neonatologists. CONCLUSION: Most newborns do not need advanced resuscitation procedures. However, even in low risk deliveries, more than 4 % of newborns required assisted ventilation. Correct assessment of need for ventilatory support and correct execution of positive pressure ventilation needs to be ensured.