Neonatal resuscitation practices in Europe: a survey of the Union of European Neonatal & Perinatal Societies

Daniele Trevisanuto, Camilla Gizzi, Luigi Gagliardi, Stefano Ghirardello, Sandra Di Fabio, ,Arthur Beke, Giuseppe Buonocore, Antonia Charitou, Manuela Cucerea, Marina Degtyareva, Boris Filipović-Grčić, Nelly Georgieva Jekova, Esin Koç, Joana Saldanha, Manuel Sanchez Luna, Dalia Stoniene, Heili Varendi, Giulia Vertecchi, Fabio Mosca, Corrado Moretti, on behalf of the Union of European Neonatal and Perinatal Societies (UENPS) Study Committee
NEONATOLOGY
(Published online: 20 Jan 2022)
https://doi.org/10.1159/000520617

Abstract

Background: We aimed to evaluate the policies and practices about neonatal resuscitation in a large sample of European hospitals.
Methods: 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).
Results: 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 (p < 0.05), the presence of a resuscitation team at all deliveries (p < 0.01), umbilical cord management (p < 0.01), practices for thermal management (p < 0.05), and heart rate monitoring (p < 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.
Conclusions: Several recommendations about available equipment and clinical practices recommended by the international guide- lines 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.