Objective: To examine influences on neonatologists' decision-making regarding resuscitation of extremely premature infants.Study Design: A mailed survey of Illinois neonatologists evaluated influences on resuscitation. Personal and parentally opposed (that is, acting against parental wishes) gray zones of resuscitation were defined, with the lower limit (LL) the gestational age at or below which resuscitation would be consistently withheld and the upper limit (UL) above which resuscitation was mandatory.Result: Among the 85 respondents, LL and UL of the personal and parentally opposed gray zones were median 22 and 25 weeks, respectively. Neonatologists with an UL personal gray zone <25 completed weeks were significantly more fearful of litigation, more likely to have received didactic/continuing medical education teaching, and less likely to always consider parents' opinions in resuscitation decisions. Neonatologists with an UL parentally opposed gray zone <25 completed weeks were more fearful of litigation. Conclusion:Neonatologists perceive a 'gray zone' of resuscitative practices and should understand that external influences may affect their delivery room resuscitation practices.

SUMMARY Outcomes were compared for 31 very‐low‐birthweight children recovered from chronic lung disease and 31 very‐low‐birthweight controls. All children had been free of major abnormalities on neonatal cranial ultrasonography. At 4 to 5 years of age, children were examined by a pediatrician and tested by a psychologist who administered the Wechsler Preschool and Primary Scale of Intelligence‐Revised. Despite similar medical outcomes, the children who had had neonatal chronic lung disease had lower Full‐scale IQs (median 83 vs 87) and Performance IQs (79 vs 90). Median Verbal IQ was similar in the two groups (85 vs.87). A higher proportion of children who had had chronic lung disease had Full‐scale IQ<70 (8/31 [26%] vs 1/31 [3%]) and Performance IQ<70 (8/31 [26%] vs 0/31). These effects persisted after adjustment for confounding factors. RÉSUMÉ Devenir a I'âge de 4 on 5 aits d'enfants ayant recupere apres une maladie pulmoiiaire chronique neonatale Les devenirs ont eAté compares, pour 31 enfants de tres faible poids de naissance ayant recupere apres une affection pulmonaire chronique et 31 controles de tres faible poids de naissance. L'échographie néonatale transcranienne n'avait révélé d'anomalies chez aucun des enfants. Les enfants furent examines a 4 ou 5 ans par un pediatre et testes a l'Echelle d'intelligence revisee de Weschler pour enfants d'âge prescolaire. En depit d'un devenir medical identique, les enfants avec affection pulmonaire neonatale chronique presentaient un QI plus faible a I'echelle globale (median de 83 contre 87) et de performance (79 vs 90). Le median du QI verbal etait semblable pour les deux groupes (85 vs 87). Une plus forte proportion d'enfants ayant presente une affection pulmonaire chronique avaient un QL 70 a ľ'echelle globale (8/31 [26%] vs 1/31 [3%]) et a I'echelle de performance (8/31 [26%] vs 0/31). Ces effets persistaient apres ajustement de facteurs annexes. ZUSAMMENFASSUNG Outcome im Alter von 4 bis 5 Jahren bet Kindern. die erne neonatale chronische Lungenerkrankung hatten Per Outcome von 31 Kindern mit sehr niedrigem Geburtsgewicht, die eine chronische Lungenerkrankung hatten, wurde mit dem von 31 Kontrollkindern mit sehr niedrigem Geburtsgewicht verglichen. Alle Kinder hatten cin weitgehend unauffalliges neonatales Schadelsonogramm. Im Alter von 4 bis 5 Jahren wurden die Kinder von einem Kinderarzt untersucht und von einem Psychologen mit derWechsler Preschool and Primary Scale of Intelligence‐Revised getestet. Trotz eines ahnlichen medizinischen Outcomes hatten die Kinder mit neonataler chronischer Lungenerkrankung niedrigere Gesamt IQ Werte (Im Mittel 83 vs 87) und Handlungs‐IQs (79 vs 90). Der mittlere verbale IQ war in beiden Gruppen fast gleich (85 vs 87). Eine groBere Anzahl von Kindern, die eine chronische Lungenerkrankung gehabt haben, hatten einen Gesamt IQ<70 (8/31 [26%] vs 1/31 [3%]) und einen Handlungs‐IQ<70 (8/31 [26%] vs 0/31). Diese Befunde blieben auch nach Herausnahme unklarer Faktoren bestehen. RESUMEN Nivel alcanzado a la edad de 4 a 5 años en niños re...

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