Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2006 Jul;91(4):F268-71.
doi: 10.1136/adc.2005.074971.

Death in the neonatal intensive care unit: changing patterns of end of life care over two decades

D J Wilkinson  1 , J J Fitzsimons, P A Dargaville, N T Campbell, P M Loughnan, P N McDougall, J F Mills
Affiliations

Death in the neonatal intensive care unit: changing patterns of end of life care over two decades

D J Wilkinson et al. Arch Dis Child Fetal Neonatal Ed. 2006 Jul.

Abstract

Background: Death remains a common event in the neonatal intensive care unit, and often involves limitation or withdrawal of life sustaining treatment.

Objective: To document changes in the causes of death and its management over the last two decades.

Methods: An audit of infants dying in the neonatal intensive care unit was performed during two epochs (1985-1987 and 1999-2001). The principal diagnoses of infants who died were recorded, as well as their apparent prognoses, and any decisions to limit or withdraw medical treatment.

Results: In epoch 1, 132 infants died out of 1362 admissions (9.7%), and in epoch 2 there were 111 deaths out of 1776 admissions (6.2%; p<0.001). Approximately three quarters of infants died after withdrawal of life sustaining treatment in both epochs. There was a significant reduction in the proportion of deaths from chromosomal abnormalities, and from neural tube defects in epoch 2.

Conclusions: There have been substantial changes in the illnesses leading to death in the neonatal intensive care unit. These may reflect the combined effects of prenatal diagnosis and changing community and medical attitudes.

PubMed Disclaimer

Conflict of interest statement

Competing interests: none declared

References

    1. Duff R S, Campbell A G. Moral and ethical dilemmas in the special‐care nursery. N Engl J Med 1973289890–894. - PubMed
    1. Whitelaw A. Death as an option in neonatal intensive care. Lancet 19862328–331. - PubMed
    1. Hazebroek F W, Tibboel D, Mourik M.et al Withholding and withdrawal of life support from surgical neonates with life‐threatening congenital anomalies. J Pediatr Surg 1993281093–1097. - PubMed
    1. Ryan C A, Byrne P, Kuhn S.et al No resuscitation and withdrawal of therapy in a neonatal and a pediatric intensive care unit in Canada. J Pediatr 1993123534–538. - PubMed
    1. Kelly N P, Rowley S R, Harding J E. Death in neonatal intensive care. J Paediatr Child Health 199430419–422. - PubMed