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.
