Neonatal Golden Hour: A survey of Australian and New Zealand Neonatal Network units' early stabilisation practices for very preterm infants
Bibliographic record
Abstract
AIM: To identify current 'Golden Hour' practices for initial stabilisation of very preterm infants <32 weeks' gestational age (GA) within tertiary neonatal intensive care units (NICUs) in the Australian and New Zealand Neonatal Network (ANZNN). METHODS: A 76-question survey regarding delivery room (DR) and NICU stabilisation practices was distributed electronically to directors of tertiary perinatal NICUs in the ANZNN in January 2019. Responses were categorised into GA subgroups: 23-24, 25-27 and 28-31 weeks' GA. RESULTS: The response rate was 100% (24/24 units). Delayed cord clamping (DCC) was practised 'always' or 'often' by 21 units (88%). All units used oximetry to target oxygen saturations, and 23/24 (96%) commenced resuscitation in <40% oxygen. Ten units (42%) routinely used DR electrocardiography monitoring. CPAP was preferred as primary respiratory support in one-third of units for infants born 23-24 weeks' GA, compared with 19 units (79%) at 25-27 weeks' GA and 23 units (96%) at 28-31 weeks' GA. DR skin-to-skin care was uncommon, particularly at lower GAs. Five units (21%) used minimally invasive surfactant therapy for non-intubated infants at 23-24 weeks' GA, 13 units (54%) at 25-27 weeks' GA and 16 units (67%) at 28-31 weeks' GA. CONCLUSIONS: Most Golden Hour stabilisation practices align with international guidelines. Consistency exists with respect to DCC, oxygen saturation targeting and primary CPAP use for infants 25 weeks' GA and above. Where evidence is less certain, practices vary across ANZNN NICUs. Time targets for stabilisation measures may help standardise practice for this population.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".