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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
"Early" versus "late" 23-week infant outcomes.
Thinh P Nguyen1, Erol Amon, Mohamad Al-Hosni
1Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Women's Health, Saint Louis University School of Medicine, St. Louis, MO, USA.
American Journal of Obstetrics and Gynecology
|July 27, 2012
Summary
Infants born between 23 weeks and 4 days gestation ("late") had significantly better survival rates (56%) than those born earlier (25%). A delay of just 24-96 hours in delivery may improve outcomes for extremely premature infants.
Area of Science:
- Neonatalogy
- Perinatology
- Obstetrics
Background:
- Extremely premature infants born at 23 weeks gestation face significant survival challenges.
- The precise gestational age within the 23-week range may influence neonatal outcomes.
Purpose of the Study:
- To compare survival rates between infants born in the early part of 23 weeks gestation (23 0/7–23 3/7 weeks) and the late part (23 4/7–23 6/7 weeks).
Main Methods:
- Retrospective analysis of 126 liveborn infants delivered between 23 0/7 and 23 6/7 weeks gestation (2001-2010).
- Data sourced from the Vermont Oxford Network database.
- Clinical characteristics and survival were compared between "early" and "late" gestational age groups using multivariate analyses.
Main Results:
- Survival rates were 25% for early 23-week infants and 56% for late 23-week infants (P < .001).
- The early group received fewer antenatal steroids (43% vs 65%) and had lower mean birthweight (547g vs 596g).
- No significant changes in survival were observed over the study period for either group.
Conclusions:
- Infants born in the later part of 23 weeks gestation demonstrate significantly improved survival.
- Even a short delay in delivery (24-96 hours) may enhance survival for infants born at 23 weeks gestation.
