CHAPEL HILL--Doctors usually resuscitate extremely premature babies at birth when they are uncertain about how the infants will fare or when they don't know parents' wishes, according to a new study. When parents say in advance what they want done following delivery, doctors tend to follow those wishes.
Resuscitation of such premature infants generally postpones death by only a few days, if death occurs, but does not contribute substantially to over-treatment, the study shows.
"Neonatologists sometimes are criticized in the media and elsewhere for over-treating extremely premature babies," said Dr. Mia W. Doron, clinical assistant professor of pediatrics at the University of North Carolina at Chapel Hill School of Medicine. "We did our study in part because of the controversy.
"We wanted to identify whether physicians' or parents' preferences primarily determine the amount of treatment, to examine what controls resuscitation decisions and to learn whether initiating intensive care significantly postpones death among the babies that don't survive."
A report on the research appears in the September issue of Pediatrics, a medical journal. Besides Doron, the first author, UNC-CH contributors were Drs. Kathleen A. Veness-Meehan and Alan D. Stiles, associate professors of pediatrics, nurse practitioner Elizabeth M. Holoman and Dr. Lewis H. Margolis, associate professor of maternal and child health.
"There is a lot of pain involved in these extraordinarily hard decisions - personal pain for the family and staff, varying amounts suffering for the babies and sometimes great expense," Doron said. "Some babies do fine, but others die within days, weeks or months or have chronic breathing or neurological handicaps such as cerebral palsy. They also can be mentally retarded or blind."
The medical scientists conducted the study exclusively at UNC Hospitals,
one of North Carolina's largest ter
Contact: David L. Williamson
University of North Carolina at Chapel Hill