Responses of pediatricians to questions on extremely low birth weight infants: a cross-sectional study

BACKGROUND: In 2011, new standards of medical birth criteria were adopted in Russia, corresponding to the World Health Organization recommendations of 1975. Newborns with extremely low birth weight are at high risk of developing disabling conditions and experiencing reduced overall quality of life. AIM: The work aimed to analyze pediatricians’ opinions on issues related to the birth of extremely low birth weight infants. METHODS: A cross-sectional survey was conducted in 2023–2024 in medical organizations of Saratov using an author-designed questionnaire. A total of 106 pediatricians with over 5 years of professional experience participated. RESULTS: The study addressed decision-making regarding the need for resuscitation of extremely low birth weight infants and the permissibility of withdrawing life-support systems in cases of severe disabling conditions. The majority of pediatricians (64.7%) disagreed with the current birth criteria. A total of 32.7% of respondents opposed resuscitative efforts for such newborns. Most participants (62.3%) reported never facing unfounded accusations of negligent homicide of newborns, which they attributed to the specifics of their work. Nearly half (46.7%) of respondents believed that the survival of extremely low birth weight infants results in a sharp deterioration of pediatric population health indicators. CONCLUSION: Most pediatricians disagree with the current birth criteria. Their opinions are shaped by the uniquely high level of professional responsibility, the complexity of decision-making, unpredictable outcomes, and experiences of unjust accusations in the death of extremely low birth weight infants. The respondents emphasized the necessity for both parents to participate in decision-making regarding resuscitation, palliative care, and withdrawal of life-support systems in the event of disabling conditions in extremely low birth weight infants.