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Updated: Jun 27, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neurological outcomes and associated perinatal factors in infants born between 22 and 25 weeks with active care
Yu Ariyoshi1, Takayuki Iriyama2, Takahiro Seyama1
1Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Insights
Active care (AC) for periviable infants born at 22-25 weeks shows high survival rates and 55% normal neurodevelopmental outcomes. Early postnatal acidemia is linked to impaired development.
Area of Science:
- Neonatalogy
- Perinatal Medicine
- Developmental Pediatrics
Background:
- Periviable infants (22-25 weeks gestation) face significant mortality and morbidity risks.
- Active care (AC) strategies aim to improve outcomes for this vulnerable population.
- Understanding factors influencing neurodevelopmental outcomes is crucial for optimizing care.
Purpose of the Study:
- To determine the survival and neurodevelopmental outcomes of periviable infants receiving active care.
- To identify perinatal factors associated with neurodevelopmental outcomes in this cohort.
Main Methods:
- Retrospective, single-center study of infants born between 22-25 weeks gestation who received active care.
- Neurodevelopmental assessment using developmental quotient (DQ) ≥ 85 at corrected 18 months as normal.
- Analysis of perinatal factors, including acidemia within 6 hours of birth.
Main Results:
- Survival rates at discharge ranged from 83% to 93% across gestational ages (22-25 weeks).
- Overall, 55% (26/47) of infants achieved a normal developmental quotient.
- Early postnatal acidemia (within 6 hours of birth) was significantly associated with subnormal neurodevelopmental outcomes.
Conclusions:
- Active care can lead to high survival rates and potentially favorable neurodevelopmental outcomes in periviable infants.
- Early postnatal acidemia following initial resuscitation is a key factor linked to impaired neurodevelopmental outcomes.
- Further research into mitigating the effects of acidemia is warranted to improve long-term outcomes.
Objectives:
To elucidate the outcomes of periviable infants receiving active care (AC) and explore perinatal factors associated with neurodevelopmental outcomes.
Methods:
This is a single-center retrospective study on infants born at 22-25 weeks of gestation, all of whom received AC. A developmental quotient (DQ) ≥ 85 at corrected 18 months was judged as normal.
Results:
Fifty-seven infants were included in the study. The survival rates at discharge were 83%, 86%, 93%, and 93% at 22, 23, 24, and 25 gestational weeks, respectively. The overall percentage of normal DQ was 26/47 (55%). Acidemia in the arterial blood gas measured within 6 h after birth was identified as a factor significantly associated with subnormal DQ.
Conclusions:
Not only high survival rates, but also favorable neurodevelopmental outcomes may be achieved by AC in periviable infants. Moreover, impaired neurodevelopmental outcomes may be associated with early postnatal acidemia following initial resuscitation.
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