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Provider perspectives on counseling and resuscitation at 22 weeks gestation and their impact on decision-making: what do providers think?

Journal of Perinatology (2026)Cite this article

Subjects

Abstract

Objective

To evaluate perceptions of providers regarding the best course of action for resuscitation of infants born at 22 weeks gestational age (GA).

Study design

Anonymous survey of providers caring for infants born at 220/7 to 226/7weeks GA at the University of Texas Southwestern Medical Center including: Parkland Health and Hospital System (PHHS), Clements University Hospital (CUH), and Texas Health Dallas (THD).

Results

Neonatal nurses were more likely to favor comfort care at 22 weeks GA than neonatologists (36% vs 4.3%; P < 0.05). Providers at PHHS were more likely to think comfort care at 22 weeks GA was appropriate than providers at CUH (35% vs 17%; P <0.05). Providers at THD were more likely to think deferral to parental wishes was appropriate for infants born at 22 weeks than providers at PHHS (71% vs 48%; P < 0.05).

Conclusion

Provider perspectives on decision-making surrounding resuscitation at 22 weeks GA vary significantly by healthcare profession and practicing hospital.

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Fig. 1: Frequency of active interventions that providers felt should be offered to infants at 22 weeks gestation based on healthcare profession.
Fig. 2: Violin plots of personal opinions of providers regarding how much the following factors should affect the decision-making for a parent whether to resuscitate an infant at 22 weeks GA.

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Data availability

The datasets that support the findings of this study are available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Pediatrics, Division of Neonatal-Perinatal Medicine, University of Michigan Health System, Ann Arbor, MI, USA

    Kaitlyn Arbour

  2. Pediatrics, Division of Neonatal-Perinatal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Kaitlyn Arbour, Luc P. Brion, Christina Chan, Becky Ennis & Julide Sisman

Authors
  1. Kaitlyn Arbour
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  2. Luc P. Brion
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  3. Christina Chan
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  4. Becky Ennis
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  5. Julide Sisman
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Contributions

KA: conceptualization, data gathering, analyzed results, created tables and figures, writing-original draft, edited and approved final manuscript. LPB: conceptualization, formal statistical analysis, analyzed results, edited and approved final manuscript. CC: conceptualization, data gathering, edited and approved final manuscript. BE: conceptualization, data gathering, edited and approved final manuscript. JS: conceptualization, analyzed results, writing-original draft, edited and approved final manuscript.

Corresponding author

Correspondence to Julide Sisman.

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Competing interests

The authors declare no competing interests.

Ethics

The study was approved by the Institutional Review Board of UTSW (STU-2021-1154) and was performed in accordance with the relevant guidelines and regulations. The requirement for obtaining a written consent from the participants was waived.

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Arbour, K., Brion, L.P., Chan, C. et al. Provider perspectives on counseling and resuscitation at 22 weeks gestation and their impact on decision-making: what do providers think?. J Perinatol (2026). https://doi.org/10.1038/s41372-025-02540-6

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