{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T04:26:22Z","timestamp":1787286382190,"version":"build-2736575974"},"reference-count":52,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Legal definitions of human viability vary worldwide. Background\/Objectives: The treatment of periviable newborns remains controversial and raises ethical concerns. However, currently, the World Health Organization (WHO) sets the lower limit of viability at 22 weeks of gestation or 500 g birth weight. The aim of our research was to determine the knowledge of healthcare practitioners in our country regarding this topic, as well as including a course after which we sought to evaluate whether their perceptions regarding the management of these cases changed. Methods: The recruitment of participants encompassed those who voluntarily took part in the survey, and 30 clinicians were included; they participated in a 30 h online course and completed a survey questionnaire before and after the course. Results: After Holm adjustment, we observed an improvement in participants\u2019 perceptions regarding recommendations concerning a multidisciplinary approach, perinatal counseling (20.0% vs. 100.0%), ethical issues (16.7% vs. 93.3%), and awareness of national guidelines (36.7% vs. 100.0%). Moreover, they recognized the importance of including parental wishes in decision-making (Holm-adjusted p = 0.0469), but with clinicians having the final word in the decision. Other factors did not change, with practitioners having knowledge about the serious outcomes of newborns in such challenging situations. Conclusions: Ethically grounded strategies to guide the management of newborns at the limit of viability is of great importance, whereby gestational age is an insufficient parameter. A collaborative, multidisciplinary process is mandatory in order to ensure the best outcomes for the newborn. The value of continuing medical education should be acknowledged.<\/jats:p>","DOI":"10.3390\/children13081111","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T14:07:34Z","timestamp":1787148454000},"page":"1111","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Decision-Making at the Limit of Viability in Newborns: Insights from a Survey of Medical Professionals"],"prefix":"10.3390","volume":"13","author":[{"given":"Claudiu","family":"Voic","sequence":"first","affiliation":[{"name":"Doctoral School, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1596-6353","authenticated-orcid":false,"given":"Melinda Ildiko","family":"Mitranovici","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Emergency County Hospital Hunedoara, 331057 Hunedoara, Romania"},{"name":"Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoran Laurentiu","family":"Popa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Clinic of Obstetrics and Gynecology, Laparoscopy, In Vitro Fertilization and Embryotransfer Research Center, Pius Brinzeu County Clinical Emergency Hospital, 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2661-8485","authenticated-orcid":false,"given":"Maria Cezara","family":"Muresan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Clinic of Obstetrics and Gynecology, Laparoscopy, In Vitro Fertilization and Embryotransfer Research Center, Pius Brinzeu County Clinical Emergency Hospital, 300723 Timisoara, Romania"},{"name":"Center for Laparoscopy, Laparoscopic Surgery and In Vitro Fertilization, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6467-6275","authenticated-orcid":false,"given":"Septimiu","family":"Voidazan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, \u201cGeorge Emil Palade\u201d University of Medicine, Pharmacy, Sciences and Technology, 540142 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1084-2714","authenticated-orcid":false,"given":"Elena Silvia","family":"Bernad","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Clinic of Obstetrics and Gynecology, Laparoscopy, In Vitro Fertilization and Embryotransfer Research Center, Pius Brinzeu County Clinical Emergency Hospital, 300723 Timisoara, Romania"},{"name":"Center for Laparoscopy, Laparoscopic Surgery and In Vitro Fertilization, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Center for Neuropsychology and Behavioral Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"ref_1","first-page":"521","article-title":"National variability in neonatal resuscitation practices at the limit of viability","volume":"31","author":"Arzuaga","year":"2014","journal-title":"Am. 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Med."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/8\/1111\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T04:18:36Z","timestamp":1787285916000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/8\/1111"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,19]]},"references-count":52,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["children13081111"],"URL":"https:\/\/doi.org\/10.3390\/children13081111","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,19]]}}}