Neonatal Resuscitation Practices in Europe: A Survey of the Union of European Neonatal and Perinatal Societies

Abstract

<b><i>Background:</i></b> We aimed to evaluate the policies and practices about neonatal resuscitation in a large sample of European hospitals. <b><i>Methods:</i></b> This was a cross-sectional electronic survey. A 91-item questionnaire focusing on the current delivery room practices in neonatal resuscitation domains was individually sent to the directors of 730 European neonatal facilities or (in 5 countries) made available as a Web-based link. A comparison was made between hospitals with ≤2,000 and those with >2,000 births/year and between hospitals in 5 European areas (Eastern Europe, Italy, Mediterranean countries, Turkey, and Western Europe). <b><i>Results:</i></b> The response rate was 57% and included participants from 33 European countries. In 2018, approximately 1.27 million births occurred at the participating hospitals, with a median of 1,900 births/center (interquartile range: 1,400–3,000). Routine antenatal counseling (<i>p</i> < 0.05), the presence of a resuscitation team at all deliveries (<i>p</i> < 0.01), umbilical cord management (<i>p</i> < 0.01), practices for thermal management (<i>p</i> < 0.05), and heart rate monitoring (<i>p</i> < 0.01) were significantly different between hospitals with ≤2,000 births/year and those with >2,000 births/year. Ethical and educational aspects were similar between hospitals with low and high birth volumes. Significant variance in practice, ethical decision-making, and training programs were found between hospitals in 5 different European areas. <b><i>Conclusions:</i></b> Several recommendations about available equipment and clinical practices recommended by the international guidelines are already implemented by centers in Europe, but a large variance still persists. Clinicians and stakeholders should consider this information when allocating resources and planning European perinatal programs.

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