What is a strong indicator for discontinuing resuscitative efforts in newborns?

The indication for discontinuing resuscitative efforts in newborns is most strongly associated with the confirmed absence of a heart rate after 10 minutes. In the context of neonatal resuscitation, the heart rate is a critical indicator of the newborn's viability. If there is no detectable heart rate after a prolonged period, such as 10 minutes, it suggests that the baby is unlikely to recover despite ongoing resuscitation efforts.

During resuscitation, if a heart rate is not detected after this time frame, it typically reflects a severe level of hypoxia or other underlying issues that have not been reversible with the measures taken. This lack of heart rate indicates that the baby's body is not responding to interventions, and continuation of resuscitation efforts may not be beneficial.

In contrast, other options refer to either earlier assessments of heart rate or indicators of spontaneous breathing, which do not provide as definitive a criterion for making the decision to discontinue resuscitation. The absence of a detectable heart rate at 5 minutes suggests a need for continued intervention, and a heart rate below 60 beats per minute would indicate the need for ongoing resuscitation measures and would not justify cessation. Similarly, the presence of spontaneous breathing is a positive sign and does not indicate