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Published on: November 20, 2015
Long-term outcome of infants at the margin of viability
M H LeBlanc1, G R Graves, T W Rawson
1Department of Pediatrics, University of Mississippi Medical Center, Jackson 39216, USA.
Insights
Survival without disability for extremely preterm infants (22-26 weeks gestation) exceeded 50% at 25 weeks gestation. These findings inform clinical decisions for high-risk newborns, offering hope for positive outcomes.
Area of Science:
- Neonatalogy
- Perinatology
- Developmental Pediatrics
Background:
- Clinical decisions for extremely preterm infants (22-26 weeks gestation) are significantly influenced by their predicted outcomes.
- Understanding survival and disability rates is crucial for managing these high-risk neonates.
Purpose of the Study:
- To evaluate survival and disability rates in infants born at extremely short gestational ages (22-26 weeks).
- To establish benchmarks for survival without disability based on gestational age and birth weight.
Main Methods:
- Retrospective analysis of 246 infants born between 1992-1996, with average weight for gestational age.
- Follow-up evaluations included pediatric assessment, physical therapy for cerebral palsy, blindness, deafness, and psychological assessment using the Bayley II scale.
Main Results:
- Survival without disability exceeded 50% for live-born infants at 25 weeks gestation (700-800g birth weight).
- Overall survival exceeded 50% for live-born infants at 24 weeks gestation (600-700g birth weight).
- Intact survival reached 50% among survivors at 23 weeks gestation (400-500g birth weight).
Conclusions:
- A significant proportion of extremely preterm infants can survive without major disabilities.
- Gestational age and birth weight are critical predictors of outcomes for neonates born at the limits of viability.
- These data support improved clinical decision-making and counseling for parents of extremely preterm infants.
Abstract:
The outcome of babies at extremely short gestational age (22 to 26 weeks) effects our clinical decisions regarding their care. We looked at survival and presence of disability at 25 +/- 11 months of age in 246 of these infants born at our hospital between 1992 and 1996 who were average weight for gestational age. Babies were evaluated in our follow up clinic by a pediatrician, and a physical therapist for cerebral palsy, blindness and deafness, and by a psychologist with the Bayley II. Chances for survival without disability exceeded 50% of live born infants at 25 weeks gestation or a birth weight of 700 to 800 grams. Chances for survival exceeded 50% of live born infants at 24 weeks gestation or a birth weight of 600 to 700 grams. Chances for intact survival reached 50% of survivors at 23 weeks gestation or a birth weight of 400 to 500 grams.
