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Survival and major disability rate in infant born at 22-25 weeks of gestation
Carlo Dani1, Chiara Poggi, Costantino Romagnoli
1Department of Surgical and Medical Critical Care, Section of Neonatology, Careggi University Hospital of Florence, Florence, Italy. cdani@unifi.It
Insights
Survival rates for preterm infants born between 22-25 weeks gestational age (GA) vary significantly by study type. While survival improves with GA, severe disability data is limited, underscoring the need for more research.
Area of Science:
- Neonatalogy
- Perinatology
- Pediatric Survival Rates
Background:
- Extremely preterm infants (22-25 weeks gestational age) face significant survival challenges.
- Understanding survival and disability is crucial for clinical decision-making and parental counseling.
Purpose of the Study:
- To systematically review and synthesize existing literature on survival and severe disability rates.
- To compare outcomes between population-based and center-based studies for preterm infants at 22-25 weeks GA.
Main Methods:
- A comprehensive literature search identified 33 relevant studies.
- Data on survival and severe disability rates were extracted and analyzed.
- Outcomes were stratified by gestational age (22-25 weeks) and study type (population-based vs. center-based).
Main Results:
- Survival rates increased with gestational age across both study types.
- Center-based studies generally reported higher survival rates than population-based studies.
- Severe disability rates showed minimal differences between study types, with limited data for comprehensive evaluation.
Conclusions:
- Survival for infants born at 22 weeks GA remains uncommon.
- Survival rates are significant for infants born at 23, 24, and 25 weeks GA.
- Further research is needed to adequately assess trends in severe disability rates due to data limitations.
Abstract:
Our aim was to evaluate the literature on survival and major disability rate in preterm infants born at 22- 25 weeks of gestational age (GA). Thirty-three studies were identified and reviewed. Survival was lower in population-based studies (2% at 22, 13% at 23, 35% at 24, and 56% at 25 weeks) than in center-based study (15% at 22, 41% at 23, 58% at 24, and 74% at 25 weeks). The severe disability rate was slightly higher in population-based studies than in center-based studies at 23 (29 vs. 32%) and at 24 (30 vs. 27%) week of GA, whereas it was similar in population and center-based studies at 25 (21 vs. 22%) weeks of GA. Survival rate seems to improve with time, whereas the change of severe disability rate cannot be adequately evaluated due to the paucity of available data. We conclude that the survival of infants born at 22 weeks is still an uncommon event, whereas the survival of infants born at 23, and mostly at 24 and 25 weeks of GA is significant in the majority of studies.
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