Neurodevelopmental outcomes at 18 months' corrected age of infants born at 22 weeks of gestation
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Updated: May 31, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Tokio Sugiura1, Masanori Kouwaki, Yasuko Togawa
1Department of Pediatrics, Toyohashi Municipal Hospital, Aichi, Japan. tokio@med.nagoya-cu.ac.jp
Insights
Infants born at 22 weeks gestation who received neonatal intensive care unit (NICU) treatment showed promising survival rates. While some experienced developmental delays, all NICU-admitted infants survived and were discharged. This suggests 22-week infants may be candidates for active treatment.
Area of Science:
- Neonatalogy
- Perinatology
- Developmental Pediatrics
Background:
- Survival rates for extremely preterm infants, especially those born at 22 weeks gestation, remain poor.
- Despite advances, prognoses for 22-week infants are challenging.
Purpose of the Study:
- To assess the long-term outcomes and developmental trajectories of infants born at 22 weeks gestation.
- To evaluate the efficacy of neonatal intensive care unit (NICU) interventions for extremely preterm infants.
Main Methods:
- Retrospective analysis of 7 infants born at 22 weeks gestation (2005-2008).
- One stillbirth occurred; 6 infants were admitted to the NICU.
- Developmental assessments conducted at 18 months corrected age.
Main Results:
- Overall survival rate was 85.7% (6/7), with 100% survival for NICU admissions (6/6).
- No infants experienced severe complications like sepsis, necrotizing enterocolitis, or severe intraventricular hemorrhage.
- At 18 months corrected age, 50% of survivors showed normal development, while 50% exhibited developmental delay.
Conclusions:
- All infants admitted to the NICU at 22 weeks gestation survived and were discharged.
- Findings suggest 22-week gestation infants may warrant consideration for active treatment in Japan.
- Further research with larger cohorts is needed to confirm generalizability.
Background:
Increased survival rates for extremely low birth weight infants have been reported. However, survival rates and prognoses of extremely preterm infants, such as infants born at 22 weeks of gestation, are still poor.
Objective:
To investigate such infants' long-term outcomes, developmental assessments were performed.
Methods:
Seven infants with gestational age of 22 weeks were delivered in our hospital from 2005 to 2008. One infant was a stillbirth despite resuscitation in the delivery room. Six infants, 4 boys and 2 girls, with a gestational age of 22 weeks (range 22(3/7)-22(6/7) weeks), were admitted to the neonatal intensive care unit (NICU). Birth weights ranged from 514 to 710 g. None of the infants suffered from sepsis, necrotizing enterocolitis, or severe intraventricular hemorrhage.
Results:
The survival rate was 85.7% (6/7) as a percentage of deliveries and 100% (6/6) as a percentage of NICU admissions. None of the infants suffered from deafness, blindness, cerebral palsy, or epilepsy. Six infants were available for developmental assessments at 18 months' corrected age. Three infants showed normal developmental quotients, and 3 infants showed developmental delay.
Conclusion:
In our study, all infants admitted to the NICU at a gestational age of 22 weeks were discharged from the hospital alive. This might suggest that infants after 22 weeks' gestation be considered eligible for active treatment in Japan, though considering the size of the material, generalizibility of the results cannot be considered guaranteed.
