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
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.
