Split-week gestational age model provides valuable information on outcomes in extremely preterm infants

Area of Science:

• Perinatal Medicine
• Neonatal Research
• Biostatistics

Background:

• Accurate gestational age (GA) assessment is critical for evaluating neonatal outcomes.
• Traditional methods use completed weeks of GA, potentially oversimplifying maturity at the margins.
• A split-week model offers a more granular approach to GA assessment.

Purpose of the Study:

• To compare composite outcomes of neonatal mortality or morbidity.
• To evaluate a split-week gestational age (GA) model against the standard completed weeks GA model.
• To analyze neonatal outcomes for infants born at 23-26 weeks gestation.

Main Methods:

• Retrospective cohort study of 1345 infants born at 23-26 weeks GA.
• Compared outcomes using a split-week GA model (early 0-3 days, late 4-6 days) to completed weeks GA.
• Analyzed differences between the late split of one week and the early split of the next.

Main Results:

• Significant outcome differences observed between early and late splits at 24, 25, and 26 weeks GA.
• No significant differences found at 23 weeks GA.
• No significant differences between the late split of week X and the early split of week X+1.

Conclusions:

• Neonatal outcome estimates differ when using a split-week GA model versus completed weeks.
• The split-week model provides a more nuanced understanding of risk at specific GA thresholds.
• This highlights the importance of precise GA definition in neonatal research and clinical practice.