{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T18:54:35Z","timestamp":1770749675129,"version":"3.50.0"},"reference-count":42,"publisher":"Walter de Gruyter GmbH","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,9,25]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"j_jpm-2019-0444_abs_001_w2aab3b7c10b1b6b1aab1c16b1Aa\"><jats:title>Objectives<\/jats:title><jats:p>To identify the probability of survival and severe neurodevelopmental impairment (sNDI) at which perinatal physicians would or would not offer or recommend resuscitation at birth for extremely preterm infants.<\/jats:p><\/jats:sec><jats:sec id=\"j_jpm-2019-0444_abs_002_w2aab3b7c10b1b6b1aab1c16b2Aa\"><jats:title>Methods<\/jats:title><jats:p>A Delphi process consisting of five rounds was implemented to seek consensus (&gt;80% agreement) amongst British Columbia perinatal physicians. The first-round consisted of neonatal and maternal-fetal-medicine Focus Groups. Rounds two to five surveyed perinatal physicians, building upon previous rounds. Draft guidelines were developed and agreement sought.<\/jats:p><\/jats:sec><jats:sec id=\"j_jpm-2019-0444_abs_003_w2aab3b7c10b1b6b1aab1c16b3Aa\"><jats:title>Results<\/jats:title><jats:p>Based on 401 responses across all rounds, consensus was obtained that resuscitation should not be offered if survival probability\u00a0&lt;5%, not recommended if survival probability 5 to\u00a0&lt;10%, resuscitation recommended if survival without sNDI probability\u00a0&gt;70 to 90% and resuscitation standard care if survival without sNDI\u00a0&gt;90%.<\/jats:p><\/jats:sec><jats:sec id=\"j_jpm-2019-0444_abs_004_w2aab3b7c10b1b6b1aab1c16b4Aa\"><jats:title>Conclusions<\/jats:title><jats:p>This physician consensus-based, objective framework for the management of an anticipated extremely preterm infant is a transparent alternative to existing guidelines, minimizing gestational-ageism and allowing for individualized management utilizing up-to-date data. Further input from other key stakeholders will be required prior to guideline implementation.<\/jats:p><\/jats:sec>","DOI":"10.1515\/jpm-2019-0444","type":"journal-article","created":{"date-parts":[[2020,7,29]],"date-time":"2020-07-29T13:46:59Z","timestamp":1596030419000},"page":"751-756","source":"Crossref","is-referenced-by-count":3,"title":["An alternative approach to developing guidelines for the management of an anticipated extremely preterm infant"],"prefix":"10.1515","volume":"48","author":[{"given":"Nicholas","family":"Williams","sequence":"first","affiliation":[{"name":"Department of Paediatrics, University of British Columbia, Vancouver, BC, Canada"},{"name":"Division of Neonatology, British Columbia Women\u2019s Hospital, Vancouver, BC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Synnes","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of British Columbia, Vancouver, BC, Canada"},{"name":"Division of Neonatology, British Columbia Women\u2019s Hospital, Vancouver, BC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"O\u2019Brien","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Albersheim","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of British Columbia, Vancouver, BC, Canada"},{"name":"Division of Neonatology, British Columbia Women\u2019s Hospital, Vancouver, BC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","reference":[{"key":"ref71","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1111\/j.1651-2227.2008.00752.x","article-title":"Ethics ain\u2019t easy: do we need simple rules for complicated ethical decisions?","volume":"97","year":"2008","journal-title":"Acta Paediatr"},{"key":"ref291","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1111\/j.1651-2227.2008.00752.x","article-title":"Ethics ain\u2019t easy: do we need simple rules for complicated ethical decisions?","volume":"97","year":"2008","journal-title":"Acta Paediatr"},{"key":"ref231","doi-asserted-by":"crossref","first-page":"e955","DOI":"10.1542\/peds.2006-0206","article-title":"The International Liaison Committee on Resuscitation (ILCOR) consensus on science with treatment recommendations for pediatric and neonatal patients: pediatric basic and advanced life support","volume":"117","year":"2006","journal-title":"Pediatr"},{"key":"ref41","first-page":"F2","article-title":"Management of babies born extremely preterm at less than 26 weeks of gestation: a framework for clinical practice at the time of birth","volume":"94","year":"2009","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"ref121","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1038\/jp.2015.171","article-title":"Extremely premature birth and the choice of neonatal intensive care versus palliative comfort care: an 18-year single-center experience","volume":"36","year":"2016","journal-title":"J Perinatol"},{"key":"ref381","doi-asserted-by":"crossref","first-page":"55","DOI":"10.3389\/fped.2020.00055","article-title":"The extremely preterm infant: ethical considerations in life-and-death decision-making","volume":"8","year":"2020","journal-title":"Front. 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