• 1 Department of Neonatology, Children's Hospital of Hebei Province, Shijiazhuang, China
  • 2 Department of Neonatology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
  • 3 Department of Neonatology, KK Women and Children's Hospital, Singapore City, Singapore
  • 4 Centre for Big Data and School of Women's and Children's Health, University of New South Wales, Sydney, Australia
  • 5 Department of Neonatology, University of Malaya Medical Center, Kuala Lumpur, Malaysia
  • 6 Department of Neonatology, John Hunter Hospital, Newcastle, NSW, Australia
Acta Paediatr, 2019 01;108(1):70-75.
PMID: 30080290 DOI: 10.1111/apa.14533


AIM: The attitudes of neonatologists towards the active management of extremely premature infants in a developing country like China are uncertain.

METHODS: A web-based survey was sent to neonatologists from 16 provinces representing 59.6% (824.2 million) of the total population of China on October 2015 and December 2017.

RESULTS: A total of 117 and 219 responses were received in 2015 and 2017, respectively. Compared to 2015, respondents in 2017 were more likely to resuscitate infants <25 weeks of gestation (86% vs. 72%; p < 0.05), but few would resuscitate infants ≤23 weeks of gestation in either epoch (10% vs. 6%). In both epochs, parents were responsible for >50% of the costs of intensive care, but in 2017, significantly fewer clinicians would cease intensive care (75% vs. 88%; p < 0.05) and more would request for economic aid (40% vs. 20%; p < 0.05) if parents could not afford to pay. Resource availability (e.g. ventilators) was not an important factor in either initiation or continuation of intensive care (~60% in both epochs).

CONCLUSION: Cost is an important factor in the initiation and continuation of neonatal intensive care in a developing country like China. Such factors need to be taken into consideration when interpreting outcome data from these regions.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.