AimThis study investigated whether continuous improvements to neonatal care and the legalisation of newborn euthanasia in 2005 had changed end-of-life decisions by Dutch neonatologists.
MethodsWe carried out a retrospective study of foetuses and neonates of more than 22weeks' gestation that died in the delivery room or in the neonatal intensive care unit (NICU) of a tertiary referral hospital in the Netherlands, comparing end-of-life decisions and mortality in 2001-2003 and 2008-2010, before and after euthanasia legislation was introduced.
ResultsIn 2008-2010, there were more deaths in the delivery room due to termination of pregnancy than in 2001-2003 (17% versus 29%, p=0.031), and fewer infants received comfort medication (12% versus 20%, p=0.078). The main mode of death in the NICU was the withdrawal of life-sustaining therapy. The number of days that infants lived increased significantly between 2001-2003 (11.5days) and 2008-2010 (18.4days, p
ConclusionTerminations increased after changes in healthcare regulations. Modes of death in the NICU remained similar over 10years. The increased duration of NICU treatment before dying suggests a more interventionist approach to treatment in 2008-2010.
- Delivery room
- End-of-life decisions
- Modes of death
- Neonatal intensive care unit
- GRONINGEN PROTOCOL