Resuscitation of likely nonviable infants: a cost-utility analysis after the Born-Alive Infant Protection Act.

Objective: The purpose of this study was to compare the effects of universal vs selective resuscitation on maternal utilities, perinatal costs, and outcomes of preterm delivery and termination of pregnancy at 20-23 weeks 6 days' gestation.

Study Design: We used studies on medical practices, prematurity outcomes, costs, and maternal utilities to construct decision-analytic models for a cohort of annual US deliveries after preterm delivery or induced termination. Outcome measures were (1) the numbers of infants who survived intact or with mild, moderate, or severe sequelae; (2) maternal quality-adjusted life years (QALYs); and (3) incremental cost-effectiveness ratios.

Resuscitation of likely nonviable newborns: would neonatology practices in California change if the Born-Alive Infants Protection Act were enforced?

Background: The effects of the Born-Alive Infants Protection Act of 2002, which defines the legal status of live-born infants have not been evaluated.

Objective: To study neonatologists' perceptions and the potential effects of the Born-Alive Infants Protection Act and subsequent Department of Health and Human Services enforcement guidelines on resuscitation and comfort care for infants born at 20 to 24 weeks' gestation.

Methods: From August 2005 to November 2005, we mailed surveys to all 354 neonatologists practicing in California.