Abstract
OBJECTIVE: To provide an updated review of the clinical profile and outcomes of delivery room chest compression (DR-CC) in China. METHOD: Retrospective analysis of prospectively collected data from 23 neonatal intensive care units in Jiangsu, China (2019-2021). Antepartum, delivery room, and postpartum variables in DR-CC-receiving and no-DR-CC groups were compared using uni- and multivariate analyses. The main outcome measure was survival without major morbidities at discharge. RESULTS: Among 2120 preterm infants of <32 weeks gestational age, 112 (5.39%) received DR-CCs. Forty-two (37.50%) DR-CC-group infants survived without major morbidities at discharge, compared with 1299 (66.17%) no-DR-CC-group infants. The DR-CC group had a lower adjusted odds ratio (AOR) of survival without major morbidities (0.53 [0.31, 0.89]). In secondary outcomes, infants who received DR-CCs had more in-hospital mortality (AOR:1.95[1.12, 3.40]) and a significant increase in the rate of grade 3/4 intraventricular hemorrhage / periventricular leukomalacia or death (AOR: 2.35[1.40, 3.95]), ≥ moderate bronchopulmonary dysplasia or death (AOR: 2.02[1.21, 3.37]), ≥ stage 3 retinopathy of prematurity or death (AOR: 2.22[1.33, 3.69]), ≥ stage 2 necrotizing enterocolitis or death (AOR: 1.83[1.09, 3.07]) and late-onset sepsis or death (AOR:1.66[1.02, 2.70]). In DR-CC-group infants, use of a T-piece resuscitator, noninvasive respiratory support, and higher gestational age significantly influenced survival without morbidities. CONCLUSION: This multicenter cohort study revealed the clinical landscape of preterm infants (<32 weeks gestational age) receiving DR-CCs, showing lower survival rates without major morbidities compared to those not receiving DR-CCs.