{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T00:08:04Z","timestamp":1764806884980,"version":"3.46.0"},"reference-count":34,"publisher":"Georg Thieme Verlag KG","issue":"06","license":[{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Geburtshilfe Neonatol"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Neonatale Todesf\u00e4lle treten gro\u00dfteils auf, nachdem eine Entscheidung,\n                    lebensunterst\u00fctzende Ma\u00dfnahmen zu beenden, getroffen wurde [1\u20137]. Neugeborene\n                    sterben selten unerwartet sondern \u00fcberwiegend nach einer Entscheidung zur\n                    Therapieziel\u00e4nderung. Der Entscheidungsweg dazu hat sich \u00fcber die Jahre deutlich\n                    gewandelt und die praktische Umsetzung variiert stark zwischen den einzelnen\n                    Neugeborenenintensivstationen [1, 8]. Ziel der Studie war es, die n\u00e4heren\n                    Umst\u00e4nde neonataler Todesf\u00e4lle einer universit\u00e4ren Neonatologie in einem\n                    definierten Zeitraum zu evaluieren und Ver\u00e4nderungen im Laufe der Zeit\n                    festzuhalten. W\u00e4hrend des 10-j\u00e4hrigen Beobachtungszeitraumes wurden am LMU\n                    Klinikum M\u00fcnchen 41\u2009543 Kinder entbunden, von diesen sind 348 Kinder peri- oder\n                    postnatal verstorben. Im Krei\u00dfsaal verstarben 248 Kinder. Auf der\n                    Neugeborenenintensivstation verstarben von den 10\u2009908 im Beobachtungszeitraum\n                    versorgten Kindern insgesamt 97. Ein zunehmend proaktiverer Ansatz hat in den\n                    letzten Jahren dazu gef\u00fchrt, dass dieprim\u00e4re Palliativversorgung\n                    Extremfr\u00fchgeborener h\u00e4ufiger abgel\u00f6st wurde durch einen Therapieversuch an der\n                    Grenze der Lebensf\u00e4higkeit. Da keine \u00c4nderung der Leitlinie zum Vorgehen bei\n                    Fr\u00fchgeburtlichkeit an der Grenze der Lebensf\u00e4higkeit w\u00e4hrend des\n                    Datenerhebungszeitraumes vorgenommen wurde, ist diese Ver\u00e4nderung eher dem\n                    Zusammenwirken elterlicher Wunsch- und Erwartungshaltung und \u00e4rztlichem Handeln\n                    zuzuschreiben.<\/jats:p>","DOI":"10.1055\/a-2685-1273","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T23:18:43Z","timestamp":1758755923000},"page":"428-435","source":"Crossref","is-referenced-by-count":0,"title":["Perinatale Palliativbetreuung im zeitlichen Wandel: eine\n                    longitudinale Beobachtungsstudie"],"prefix":"10.1055","volume":"229","author":[{"given":"Carmen Edda","family":"Jakubowicz","sequence":"additional","affiliation":[{"name":"Neonatologie der Kinderklinik am Perinatalzentrum der LMU M\u00fcnchen,\n                    Campus Gro\u00dfhadern, Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen\n                    Kinderspital am Klinikum der Universit\u00e4t, M\u00fcnchen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas Walter","family":"Flemmer","sequence":"additional","affiliation":[{"name":"Neonatologie der Kinderklinik am Perinatalzentrum der LMU M\u00fcnchen,\n                    Campus Gro\u00dfhadern, Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen\n                    Kinderspital am Klinikum der Universit\u00e4t, M\u00fcnchen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9347-8155","authenticated-orcid":false,"given":"Esther Sabine","family":"Schouten","sequence":"additional","affiliation":[{"name":"Neonatologie der Kinderklinik am Perinatalzentrum der LMU M\u00fcnchen,\n                    Campus Gro\u00dfhadern, Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen\n                    Kinderspital am Klinikum der Universit\u00e4t, M\u00fcnchen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,9,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1111\/j.1651-2227.2007.00234.x","article-title":"Neonatal end-of-life practice in a German perinatal centre","volume":"96","author":"A Schulz-Baldes","year":"2007","journal-title":"Acta Paediatr"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1159\/000153100","article-title":"Causes and circumstances of neonatal deaths in 108 consecutive cases over a\n                    10-year period at the Children\u2019s Hospital of Lucerne, Switzerland","volume":"95","author":"T M Berger","year":"2009","journal-title":"Neonatology"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"F527","DOI":"10.1136\/adc.2003.032912","article-title":"Decision making and modes of death in a tertiary neonatal 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