One hundred consecutive infants born at 23 weeks and resuscitated

Area of Science:

• Neonatology
• Perinatal Medicine
• Pediatric Critical Care

Background:

• Infants born at the threshold of viability (23 weeks gestational age) present significant resuscitation challenges.
• Outcomes for this extremely premature population are highly variable and require detailed documentation.

Purpose of the Study:

• To determine the in-hospital survival rate for infants born alive at 23 weeks gestational age (GA) with universal resuscitation.
• To analyze the timing and causes of death in this cohort.

Main Methods:

• A prospective cohort study was conducted on 100 consecutive infants born alive at 23 weeks GA.
• All deliveries were attended by neonatologists, and resuscitation was universally attempted.
• Causes of death were determined by attending neonatologists.

Main Results:

• Overall in-hospital survival was 40% (40 out of 100 infants).
• Mortality was highest in the delivery room (10%) and within the first 4 days (28%), primarily from respiratory distress syndrome (RDS) and its complications.
• Late deaths (after day 4) were attributed to respiratory failure, necrotizing enterocolitis, and sepsis.

Conclusions:

• Universal resuscitation efforts at 23 weeks GA achieved a 40% survival rate in this cohort.
• Respiratory failure is the leading cause of mortality in the early neonatal period for extremely premature infants.
• Further research is needed to improve outcomes for this vulnerable population.