{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T18:26:51Z","timestamp":1788805611243,"version":"build-2803163510"},"reference-count":20,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2007,9,1]]},"abstract":"<jats:p>OBJECTIVE. We assessed physician preferences and physician prognostic abilities regarding delivery room management of exceedingly low birth weight\/short gestation infants.<\/jats:p>\n                  <jats:p>METHODS. We surveyed US neonatologists to assess their behavior in the delivery room when confronted with infants with gestational ages of 22 to 26 weeks. We identified 102 infants in our NICU with birth weights\/gestational ages of 400 g\/23 weeks to 750 g\/26 weeks, whose follow-up care was ensured because of their participation in ongoing clinical trials. We determined 4 proxy measures for \u201chow the infant looked\u201d in the delivery room (Apgar scores at 1 and 5 minutes and heart rates at 1 and 5 minutes) and assessed the predictive value of each marker for subsequent death or neurologic morbidity.<\/jats:p>\n                  <jats:p>RESULTS. For infants with birth weights of &amp;lt;500 g and gestational ages of 23 weeks, only 4% of 666 responding neonatologists would provide full resuscitation. In contrast, for infants with birth weights of &amp;gt;600 g and gestational ages of 25 weeks, &amp;gt;90% of neonatologists considered resuscitation obligatory. For infants with birth weights of 500 to 600 g and gestational ages of 23 to 24 weeks, only one third of neonatologists responded that parental preference would determine whether they resuscitated the infant in the delivery room. The majority wanted \u201cto see what the infant looked like.\u201d For 102 infants with birth weights of \u2264750 g, Apgar scores at 1 and 5 minutes and heart rates at 1 and 5 minutes were neither sensitive nor predictive for death before discharge, survival with a neurologic abnormality, or intact neurologic survival.<\/jats:p>\n                  <jats:p>CONCLUSIONS. The \u201cgray zone\u201d for delivery room resuscitation seems to be between 500 and 600 g and 23 and 24 weeks. For infants born in that zone, neonatologists' reliance on accurate prediction of death or morbidity in the delivery room may be misplaced.<\/jats:p>","DOI":"10.1542\/peds.2006-2966","type":"journal-article","created":{"date-parts":[[2007,8,31]],"date-time":"2007-08-31T12:34:17Z","timestamp":1188563657000},"page":"519-526","source":"Crossref","is-referenced-by-count":163,"title":["Resuscitation in the \u201cGray Zone\u201d of Viability: Determining Physician Preferences and Predicting Infant Outcomes"],"prefix":"10.1542","volume":"120","author":[{"given":"Jaideep","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Pediatrics"},{"name":"MacLean Center for Clinical Medical Ethics, University of Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Fanaroff","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bree","family":"Andrews","sequence":"additional","affiliation":[{"name":"Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie","family":"Caldarelli","sequence":"additional","affiliation":[{"name":"Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Lagatta","sequence":"additional","affiliation":[{"name":"Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Plesha-Troyke","sequence":"additional","affiliation":[{"name":"Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Lantos","sequence":"additional","affiliation":[{"name":"Department of Pediatrics"},{"name":"MacLean Center for Clinical Medical Ethics, University of Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Meadow","sequence":"additional","affiliation":[{"name":"Department of Pediatrics"},{"name":"MacLean Center for Clinical Medical Ethics, University of Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2007,9,1]]},"reference":[{"key":"2021120902275696300_R1","doi-asserted-by":"crossref","unstructured":"Todres ID, Krane D, Howell MC, Shannon DC. 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