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Published on: November 20, 2015
Survival of Infants Born at Periviable Gestational Ages
Ravi Mangal Patel1, Matthew A Rysavy2, Edward F Bell3
1Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Emory University School of Medicine, 2015 Uppergate Drive Northeast, 3rd Floor, Atlanta, GA 30322, USA.
Insights
Survival rates for periviable births (20–25 weeks gestation) vary significantly. This review examines historical and current survival data, influencing factors, and care approaches for these vulnerable infants.
Area of Science:
- Perinatology
- Neonatology
- Public Health
Background:
- Periviable births, occurring between 20 0/7 and 25 6/7 weeks of gestation, present complex challenges in obstetric and neonatal care.
- Significant disparities in care and outcomes exist for periviable infants globally and within developed countries.
Purpose of the Study:
- To provide a historical overview of survival rates for periviable births.
- To summarize current gestational age-specific survival data and trends.
- To identify key factors influencing survival and inform clinical practice and family counseling.
Main Methods:
- Literature review of historical and contemporary studies on periviable birth outcomes.
- Analysis of gestational age-specific survival rates.
- Examination of factors impacting survival, such as medical interventions and socioeconomic determinants.
Main Results:
- Survival rates for periviable births have shown gradual improvement over time, but significant variations persist based on gestational age and geographic location.
- Key factors influencing survival include gestational age at birth, access to specialized neonatal care, maternal health, and socioeconomic status.
- Data highlights the need for standardized approaches to care and counseling for families facing periviable birth.
Conclusions:
- Understanding evolving survival data is crucial for optimizing care strategies for periviable infants.
- Evidence-based guidelines and equitable access to care can improve outcomes for periviable births.
- Improved communication and shared decision-making with families are essential when managing periviable pregnancies.
Abstract:
Periviable births are those occurring from 20 0/7 through 25 6/7 weeks of gestation. Among and within developed nations, significant variation exists in the approach to obstetric and neonatal care for periviable birth. Understanding gestational age-specific survival, including factors that may influence survival estimates and how these estimates have changed over time, may guide approaches to the care of periviable births and inform conversations with families and caregivers. This review provides a historical perspective on survival following periviable birth, summarizes recent and new data on gestational age-specific survival rates, and addresses factors that have a significant impact on survival.
