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Updated: Nov 2, 2025
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Published on: December 31, 2015
Care practices and outcomes of extremely preterm neonates born at 22-24 weeks - A single centre experience
V V Ramaswamy1, V I Oommen1, A Gupta1
1Newborn Services, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
Insights
Survival rates for extremely preterm infants (22-24 weeks) vary. Severe respiratory issues in the first 72 hours increased mortality and major brain injury (MBI) risk, but MBI was low among survivors.
Area of Science:
- Neonatal Intensive Care
- Perinatal Medicine
- Pediatric Neurology
Background:
- Significant variation exists in care and outcomes for neonates born at 22+0 - 24+6 weeks gestation.
- This vulnerable group faces diverse postnatal risks affecting morbidity and mortality.
- Understanding regional differences in care practices is crucial for improving outcomes.
Purpose of the Study:
- To identify postnatal risk factors for morbidity and mortality in extremely preterm neonates.
- To compare care practices and short-term outcomes of this cohort with other centers.
- To analyze the incidence of major brain injury (MBI) in survivors.
Main Methods:
- Retrospective study conducted in a UK level 3 neonatal intensive care unit.
- Inclusion criteria: neonates born between 22+0 and 24+6 weeks gestation.
- Data collected over a 4-year period (2016-2019).
Main Results:
- Survival to discharge was 51.1% overall (44% for 22-23 wks, 59.1% for 24 wks).
- Survival with no major brain injury (MBI) was 38.3% (32% for 22-23 wks, 45.4% for 24 wks).
- Neonates needing significant respiratory support or high-frequency ventilation within 72 hours had a higher risk of mortality or MBI (aOR 7.17 and 4.76, respectively).
Conclusions:
- Observed survival rates differed from those reported in other centers.
- Major brain injury (MBI) incidence was low among neonates who survived to discharge.
- Severe early respiratory disease significantly increased the risk of death or MBI.
Background:
Wide variation in the care practices and survival rates of neonates born at peri-viable gestational ages of 22+0 - 24+6 weeks. This study elucidates the postnatal risk factors for morbidity/mortality, contrasts the care practices and short-term outcomes of this vulnerable group of preterm neonates from a single center with others.
Methods:
Retrospective study of neonates born at 22+0 -24+6 weeks in a level 3 neonatal intensive care unit in UK, over a period of 4 years (2016-2019).
Results:
94 neonates given active care were studied. Survival until discharge was 51.1%(22-23 wks -44%, 24 wks -59.1%) and survival with no major brain injury (MBI) [grade III/IV IVH, cystic periventricular leukomalacia] was 38.3%(22-23 wks -32%, 24 wks -45.4%). Of those who survived until discharge, 75%had no MBI (22-23 wks -72.7%, 24 wks -76.9%). Neonates requiring significant respiratory support within first 72 hours as well as needing rescue high frequency ventilation had significantly high risk of mortality or MBI [aOR -7.17 (2.24-25.79), p = 0.00; 4.76 (1.43-20.00), p = 0.01].
Conclusions:
Survival rate differed from other centres. MBI was low amongst survivors. Severe respiratory disease in the initial days was associated with a higher risk of death or MBI.
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