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Updated: Jun 12, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Five-year survival without major disability of extremely preterm infants born at 22-27 weeks' gestation admitted to a
B Zlatohlávková1, J Kytnarová, Aa Kuběna
1Division of Neonatology, Department of Obstetrics and Gynaecology, General University Hospital and First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic. b.zlatohlavkova@seznam.cz
Aim:
To compare the 5-year survival without major disability in infants born at the threshold of viability at 22-25 weeks who were actively treated in the delivery room and admitted to a NICU to that of those born at 26-27 weeks of gestation.
Methods:
All infants between 22(+0) and 27(+6) weeks of gestation admitted to a regional intensive care unit during 1999-2003 were enrolled prospectively. The survival and major disability at 5 years of age were analysed by gestational age.
Results:
Of 242 treated infants, 202 survived (83.5%). Although the overall survival rate was significantly higher in the 25-27 weeks' gestation infants than the 22-24 weeks' gestation infants (p < 0.001), the survival rate among infants 22-24 weeks (63.6%, 63.6%, and 70%) did not significantly differ, likewise infants 25-27 weeks (88.7%, 90.6%, and 92%) had similar results. Overall, 28 children (14.4% of assessed) had major disability. Both survival and survival without major disability were positively influenced by increasing gestational age, increasing birth weight, being born at 25-27 weeks and being female child.
Conclusion:
With an active approach in treatment, the outcome of infants born at 25 weeks is comparable to those born at 26-27 weeks. Thus, the 'grey zone' in which the risk of adverse outcome is high narrows to 22-24 weeks.
