Related Experiment Video
Updated: Jun 21, 2026
Preterm EEG: A Multimodal Neurophysiological Protocol
Published on: February 18, 2012
Single-centre vs. population-based outcome data of extremely preterm infants at the limits of viability
Patrizia Kutz1, Sandra Horsch, Lisa Kühn
1Department of Neonatology and Paediatric Intensive Care, Vest Children's Hospital, University Witten-Herdecke, Datteln, Germany.
Insights
Improved survival and reduced disability were seen in extremely preterm infants born later. However, survival without disability at 23-24 weeks gestational age did not significantly improve.
Area of Science:
- Neonatalogy
- Perinatology
- Pediatric Outcomes Research
Background:
- The EPICure study (2000) reported disappointing outcomes for extremely preterm infants.
- There is a need to assess contemporary outcomes for infants born at the threshold of viability.
Purpose of the Study:
- To compare the outcomes of infants born between 22 0/7 and 25 6/7 weeks of gestational age (GA) in a single tertiary center (2000-2004) with the historical EPICure cohort.
- To evaluate improvements in survival and neurodevelopmental outcomes.
Main Methods:
- Utilized EPICure study's definitions and tools, including Bayley Scales of Infant Development at 30 months corrected age.
- Retrospective comparison of a single-center cohort with the population-based EPICure cohort.
Main Results:
- Infants born <26 weeks GA in the later cohort had higher intensive care admission rates (82% vs 68%) and significantly improved survival to discharge (57% vs 26%).
- Survival without severe disability (41% vs 20%) and overall disability (22% vs 13%) was significantly higher in the later cohort.
- However, for infants at the border of viability (23-24 weeks GA), survival without overall disability showed no significant improvement (13% vs 9%).
Conclusions:
- A single-center cohort of extremely preterm infants born 5-8 years after the EPICure study demonstrated improved survival and reduced disability rates.
- Despite overall improvements, enhanced survival without disability was not observed in the most vulnerable infants born at 23-24 weeks GA.
Aim:
In response to the disappointing outcome data of the population-based EPICure study published in 2000, we compared the outcome of infants 22 0/7 to 25 6/7 weeks of gestational age (GA) in a single tertiary care centre 2000-2004 with that of EPICure.
Methods:
EPICure tools and definitions, including 30 months' Bayley Scales.
Results:
Of 83 infants <26 weeks born alive, more were admitted to intensive care--82% vs. 68% (p < 0.0001)--and more infants survived to discharge (57% vs. 26%, p < 0.0001; 69% vs. 39%, p < 0.01, of those admitted to intensive care). More infants, as a percentage of live births, survived without severe (41%, 34/83 vs. 20%, 233/1185, p < 0.0001) or overall disability (22%, 18/83 vs. 13%, 155/1185, p = 0.03). However, at the border of viability--GA 23 and 24 weeks--the rate of infants surviving without overall disability was not significantly higher (13%, 6/45 vs. 9%, 56/623).
Conclusion:
In infants <26 weeks of GA, increased rates of survival and survival without disability were observed in a single-centre inborn cohort born 5-8 years later than the EPICure cohort. This did not translate into increased survival without overall disability in infants of 23-24 weeks of GA.
Related Concept Videos
01:12Analysis of Population Pharmacokinetic Data
01:24Kaplan-Meier Approach
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast, controlled...