Neonatal outcomes of fetuses diagnosed with life-limiting conditions when individualized comfort measures are proposed

J Perinatol. 2014 Jun;34(6):483-7. doi: 10.1038/jp.2014.40. Epub 2014 Mar 20.

Abstract

Objective: To describe the neonatal outcomes of a case series of infants who were prenatally diagnosed with potential life-limiting conditions and to whom individualized comfort measures were offered.

Study design: This is a retrospective analysis of the postnatal outcomes of a selected population of 49 infants prenatally diagnosed with potential life-limiting conditions whose parents were prenatally referred for counseling to the comfort care team.

Result: The prenatal diagnosis was confirmed postnatally in 45 infants. The only four survivors had a significant discrepancy between prenatal and postnatal diagnosis. Whether they were treated with individualized comfort measures (n=28) or intensive care (n=17), all the newborns died with similar median age at death (2 days).

Conclusion: Diagnostic accuracy is the main determinant of outcomes. Provision of intensive care neither prevents the death of infants affected by life-limiting conditions nor prolongs life compared with that of infants treated with individualized comfort measures.

MeSH terms

  • Congenital Abnormalities / mortality
  • Congenital Abnormalities / therapy*
  • Female
  • Fetus
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • New York
  • Palliative Care / methods*
  • Pregnancy
  • Pregnancy Outcome
  • Prenatal Diagnosis / methods*
  • Retrospective Studies
  • Survival Rate