The Golden Hour for Infants with Congenital Anomalies: Experience of the Special Delivery Unit
In brief
99.8% of infants with congenital anomalies survive the first hour after birth
In a 10-year review of 4,437 newborns with surgical, medical or heart defects, more than 5% required intubation and over 3% needed CPR or epinephrine, yet 99.8% were alive after the "golden hour" and over 80% survived to discharge. The data highlight the need for tailored delivery-room preparation based on the specific anomaly.
- Journal
- The Journal of pediatrics (Q1)
- Published
- 15 September 2026
- Study design
- Retrospective cohort
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- K Taylor Wild, Rebecca Josowitz, Natalie E Rintoul, Holly L Hedrick, Anne M Ades, Juliana S Gebb, et al.
- PMID
- 42744152
- DOI
- 10.1016/j.jpeds.2026.115323
Why clinicians should know about it
- Picked for Pediatric Surgery (paper of the day, 16 September 2026): Golden hour survival in infants with congenital anomalies
Abstract
OBJECTIVE: To summarize the frequency and intensity of delivery room resuscitation for infants with congenital anomalies. STUDY DESIGN: This was a retrospective, single-center cohort study of infants born in the Garbose Family Special Delivery Unit at the Children's Hospital of Philadelphia from 2013-2024. We assessed the frequency and intensity of delivery room resuscitation interventions. Main outcome measures included hospital survival and length of stay. RESULTS: There were 4,437 infants who met the study inclusion criteria including 2,670 with surgical/medical diagnoses and 1,767 with congenital heart disease. Median gestational age at delivery was 38.1 weeks. Advanced respiratory interventions were common, with intubation occurring in >5% across most diagnoses. Cardiopulmonary resuscitation (CPR) and epinephrine use were rare overall but occurred in >3% of infants with select diagnoses. Differences in advanced respiratory interventions and CPR were seen across diagnosis groups. Despite high rates of delivery room interventions, golden hour survival was 99.8% overall and survival to discharge was >80% across most diagnoses. CONCLUSIONS: Infants with congenital anomalies experience relatively high rates of delivery room resuscitation, including advanced airway interventions. Need and intensity of resuscitation vary based on underlying anomaly. These results may inform delivery room preparation and planning for infants with prenatally diagnosed congenital anomalies.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.