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Resuscitation of premature newborns at 22–24 weeks in Iran: An ethical and clinical challenge: Editorial Article
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1- - , ftahery@yahoo.com
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Abstract:   (14 Views)
Advances in perinatal care have lowered the threshold of viability to 22 weeks; however, the absence of a codified national protocol in Iran has resulted in subjective decision-making, inappropriate allocation of limited resources, and futile resuscitation. The fundamental gap in the health system is the lack of a national registry and disaggregated data on infants born before 28 weeks. International comparisons reveal striking differences; survival rates at 22 and 23 weeks in Japan have been reported at 60% and 80%, respectively, whereas rates in China and even across US centers remain highly variable and lower. Decisions should therefore be based on the tiered capabilities of each center and on three approaches: active resuscitation, palliative care, and shared decision-making. Gestational age alone is insufficient; birth weight, sex, 5-minute Apgar score, maternal complications, and particularly antenatal corticosteroid administration should be integrated into prognostic models. Antenatal referral to level 3 and 4 centers is of critical importance. Finally, establishing a national registry, developing a national clinical guideline, designing a localized risk calculator, and tiering centers with defined resuscitation eligibility are recommended.
Keywords: Ethical Challenge, Neonatal Palliative Care, Neonatal Resuscitation, Premature Infant
Full-Text [PDF 405 kb]   (1 Downloads)    
Type of Study: Editorial | Subject: Pediatrics
Received: 2026/07/4 | Accepted: 2026/05/5
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