Práticas Atuais de Reanimação Neonatal nas Salas de Partos em Portugal: Um Estudo Transversal

Abstract

Introduction: Data from previous studies have demonstrated disagreement between current evidence and delivery room resuscitation practices in developed countries. The primary aim of this study was to assess the quality of newborn healthcare and resuscitation practices in Portuguese delivery rooms, comparing current practices with the 2021 European Resuscitation Council guidelines. The secondary aim was to compare the consistency of practice between tertiary and non-tertiary centers across Portugal. Methods: An 87-question survey concerning neonatal care was sent to all physicians registered in the Portuguese Society of Neonatology via electronic mail. In order to compare practices between centers, participants were divided into two groups: Group A (level III and level IIb centers) and Group B (level IIa and I centers). Chi-square or Fisher's exact test was applied to compare categorical variables. Results: In total, 130 physicians responded to the survey. Group A included 91 (70%) and Group B 39 (30%) respondents. More than 80% of participants reported the presence of a health professional with basic newborn resuscitation training in all deliveries, essential equipment in the delivery room, such as a resuscitator with light and heat source, a pulse oximeter, and an O2 blender, and performing delayed cord clamping for all neonates born without complications. Less than 60% reported performing team briefing before deliveries, the presence of ECG sensors, end-tidal CO2 detector and CPAP in the delivery room and monitoring the neonate's temperature. Significant differences between groups were found on staff attending deliveries, education, equipment, thermal control, umbilical cord management, vital signs monitoring, prophylactic surfactant administration, and in the neonate's transportation out of the delivery room. Conclusion: This study suggests that neonatal resuscitation practices in Portuguese delivery rooms are overall compliant with international guidelines. However, differences were identified between guidelines and current practices, and between centers with different levels of care. Areas for improvement include team briefing, ethics, education, available equipment in delivery rooms, temperature control and airway management. The authors emphasize the importance of continuous education in order to ensure compliance with the most recent guidelines and ultimately improve neonatal health outcomes.