{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:21:46Z","timestamp":1791937306253,"version":"4.3.4"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,1,4]],"date-time":"2013-01-04T00:00:00Z","timestamp":1357257600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2013,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine the boundaries of the grey zone of discretionary resuscitation over the past 20 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>As the likelihood of survival improves over time, the <jats:styled-content style=\"fixed-case\">BW<\/jats:styled-content>\u2010 and <jats:styled-content style=\"fixed-case\">GA<\/jats:styled-content>\u2010specific boundaries of discretionary nonresuscitation should fall.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>Between 1988 and 2008 reductions in <jats:styled-content style=\"fixed-case\">BW<\/jats:styled-content>\u2010 and <jats:styled-content style=\"fixed-case\">GA<\/jats:styled-content>\u2010specific mortality would drive a parallel reduction in <jats:styled-content style=\"fixed-case\">BW<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">GA<\/jats:styled-content> boundaries of discretionary resuscitation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We determined the likelihood of resuscitation and survival to <jats:styled-content style=\"fixed-case\">NICU<\/jats:styled-content> discharge for all infants born &lt;700\u00a0g or &lt;26 gestational weeks from 1988 to 2008. In addition, for 1988, 1993, 1998, 2003 and 2008, we determined the <jats:styled-content style=\"fixed-case\">BW<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">GA<\/jats:styled-content> for the 10 smallest infants who were resuscitated, and the 10 largest infants who were not resuscitated. We excluded any infant born with congenital anomaly.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mortality fell from 80% in 1988 to 28% in 2008, and as expected, the percentage who were resuscitated rose from 63% in 1988\u201393 to 95% in 2004\u20132008. However, unexpectedly, over the 20\u2010year study period, the smallest infants who were resuscitated despite extreme immaturity did not change (450\u2013550\u00a0g and 23\u201324\u00a0weeks) and the largest infants not resuscitated did not change (600\u2013700\u00a0g and 23\u201324\u00a0weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Neither the <jats:styled-content style=\"fixed-case\">BW<\/jats:styled-content> nor <jats:styled-content style=\"fixed-case\">GA<\/jats:styled-content> boundaries of the grey zone of discretionary resuscitation have fallen over the past 20\u00a0years. Factors guiding resuscitation at the border of viability are complex and incompletely understood.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.12119","type":"journal-article","created":{"date-parts":[[2012,12,4]],"date-time":"2012-12-04T20:56:18Z","timestamp":1354654578000},"page":"258-262","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Have the boundaries of the \u2018grey zone\u2019 of perinatal resuscitation changed for extremely preterm infants over 20\u00a0years?"],"prefix":"10.1111","volume":"102","author":[{"given":"J","family":"Condie","sequence":"first","affiliation":[{"name":"Department of Pediatrics The University of Chicago Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Caldarelli","sequence":"additional","affiliation":[{"name":"Department of Pediatrics The University of Chicago Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Tarr","sequence":"additional","affiliation":[{"name":"Department of Pediatrics The University of Chicago Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Gray","sequence":"additional","affiliation":[{"name":"Department of Pediatrics The University of Chicago Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Rodriquez","sequence":"additional","affiliation":[{"name":"Department of Pediatrics The University of Chicago Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Lantos","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Children's Mercy Hospital Kansas City MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W","family":"Meadow","sequence":"additional","affiliation":[{"name":"Department of Pediatrics The University of Chicago Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,1,4]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"54","article-title":"Limits of viability: definition of the gray zone","volume":"28","author":"Condie J","year":"2008","journal-title":"J Perinatol"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-2966"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2009.01400.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2007.09.007"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2006.tb00664.x"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010-2972E"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000110867"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2007.00737.x"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1754.2007.01118.x"},{"key":"e_1_2_6_11_1","volume-title":"Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine","author":"Jonsen A"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.105.6.1216"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200008103430601"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1053\/siny.1999.0001"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2000.109143"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa041367"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0021361"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2012.02609.x"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-1520"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2008.103"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2008.00663.x"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2010.02084.x"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010-1031"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2011.02334.x"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043514"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2011.02.014"}],"container-title":["Acta Paediatrica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fapa.12119","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apa.12119","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T08:08:02Z","timestamp":1700640482000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apa.12119"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,1,4]]},"references-count":25,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2013,3]]}},"alternative-id":["10.1111\/apa.12119"],"URL":"https:\/\/doi.org\/10.1111\/apa.12119","archive":["Portico"],"relation":{},"ISSN":["0803-5253","1651-2227"],"issn-type":[{"value":"0803-5253","type":"print"},{"value":"1651-2227","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,1,4]]},"assertion":[{"value":"2012-08-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-11-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-01-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}