Does a Split-Week Gestational Age Model Provide Valuable Information on Neurodevelopmental Outcomes in Extremely...

Area of Science:

• Neonatal Medicine
• Developmental Pediatrics
• Perinatal Research

Background:

• Standard gestational age (GA) categorization may not fully capture nuanced developmental trajectories.
• Accurate prediction of neurodevelopmental outcomes is crucial for early intervention in preterm infants.

Purpose of the Study:

• To compare neurodevelopmental outcomes using a split-week gestational age model (early vs. late half of the week) versus standard completed weeks GA.
• To evaluate the utility of a split-week GA model for counseling infants born between 23-26 weeks gestation.

Main Methods:

• A cohort of 1012 infants was analyzed.
• Neurodevelopmental outcomes were assessed using both a split-week (early 0-3 days, late 4-6 days) and completed weeks GA categorization.
• Statistical analysis compared outcomes between the different GA models, particularly focusing on 23 weeks gestation.

Main Results:

• At 23 weeks gestation, infants in the late split-week group (days 4-6) had significantly better neurodevelopmental outcomes (54.5% no impairment) compared to the early group (13.3% no impairment; p=0.034).
• No significant differences were observed between split-week groups for 24, 25, and 26 weeks gestation.
• A trend of improved neurodevelopmental outcomes was noted with increasing gestational age.

Conclusions:

• The split-week GA model provides valuable prognostic information for infants at 23 weeks gestation, highlighting benefits for those born in the latter half of the week.
• The split-week model did not offer additional predictive value for infants between 24-26 weeks gestation.
• This model can aid in more precise counseling for parents of extremely preterm infants.