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Updated: Nov 9, 2025
Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
Micro-premature infants in New Jersey show improved mortality and morbidity from 2000-2018
1Department of Pediatrics, Children's Hospital of New Jersey, Newark, NJ, USA.
Insights
Outcomes for extremely low gestational age newborns (ELGANs) improved significantly from 2000-2018. The most premature infants (≤25 weeks) saw greater improvements in mortality and morbidity, validating care efforts.
Area of Science:
- Neonatalogy
- Perinatal Medicine
- Public Health
Background:
- Extremely low gestational age newborns (ELGANs) born at ≤25 weeks gestation face high mortality and morbidity.
- While outcomes for ELGANs ≤29 weeks have improved, data for the most premature infants (≤25 weeks) is limited.
Purpose of the Study:
- To analyze trends in mortality and morbidity for ELGANs born in New Jersey between 2000 and 2018.
- To compare outcomes between two subgroups: gestational age (GA) 23-25 weeks (E1) and GA 26-29 weeks (E2).
Main Methods:
- Retrospective analysis of de-identified data from 13 New Jersey Neonatal Intensive Care Units (NICUs).
- Inclusion of 12,707 ELGANs, categorized into E1 (3,957 infants) and E2 (8,750 infants).
- Calculation of mortality and morbidity rates over the study period.
Main Results:
- Mortality significantly decreased in both groups: E1 from 43.2% to 30.2% and E2 from 7.6% to 4.5%.
- The rate of improvement in mortality was significantly greater for the E1 group compared to E2.
- Survival without morbidity increased substantially in both groups, from 14.5% to 30.7% in E1 and 47.2% to 69.9% in E2.
Conclusions:
- Significant improvements in both mortality and morbidity were observed for ELGANs over two decades.
- The most immature ELGANs (GA 23-25 weeks) experienced greater rates of improvement in several outcomes than the more mature group.
- Despite persistent high rates, these findings support the efficacy of current interventions for micro-premature infants.
Background:
Micro-premature newborns, gestational age (GA) ≤ 25 weeks, have high rates of mortality and morbidity. Literature has shown improving outcomes for extremely low gestational age newborns (ELGANs) GA ≤ 29 weeks, but few studies have addressed outcomes of ELGANs ≤ 25 weeks.
Objective:
To evaluate the trends in outcomes for ELGANs born in New Jersey, from 2000 to 2018 and to compare two subgroups: GA 23 to 25 weeks (E1) and GA 26 to 29 weeks (E2).
Methods:
Thirteen NICUs in NJ submitted de-identified data. Outcomes for mortality and morbidity were calculated.
Results:
Data from 12,707 infants represents the majority of ELGANs born in NJ from 2000 to 2018. There were 3,957 in the E1 group and 8,750 in the E2 group. Mortality decreased significantly in both groups; E1, 43.2% to 30.2% and E2, 7.6% to 4.5% over the 19 years. The decline in E1 was significantly greater than in E2. Most morbidities also showed significant improvement over time in both groups. Survival without morbidity increased from 14.5% to 30.7% in E1s and 47.2% to 69.9% in E2s. Similar findings held for 501-750 and 751-1000g birth weight strata.
Conclusions:
Significant declines in both mortality and morbidity have occurred in ELGANs over the last two decades. These rates of improvements for the more immature ELGANs of GA 230 to 256 weeks were greater than for the more mature group in several outcomes. While the rates of morbidity and mortality remain high, these results validate current efforts to support the micro-premature newborn.
