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Published on: September 6, 2017
Most babies born at a French hospital before 26 weeks survived with good outcomes
Heloise Abello1, Marine Vincent1, Pierre Pradat2
1Department of neonatology, Croix-Rousse University Hospital, Hospices civils de Lyon, Lyon, France.
Insights
Infants born at the limit of viability show high survival and excellent neurodevelopmental outcomes at two years corrected age. Local data is crucial for life-saving treatment decisions in extremely preterm infants.
Area of Science:
- Neonatalogy
- Perinatal Medicine
- Developmental Pediatrics
Background:
- Infants born at the limit of viability (22-25 weeks gestation) face significant risks.
- Accurate assessment of outcomes is vital for clinical and ethical decision-making.
Purpose of the Study:
- To determine neonatal morbidity, mortality, and neurodevelopmental outcomes at 2 years corrected age for infants born at the limit of viability.
- To compare these outcomes with national and international data.
Main Methods:
- Retrospective analysis of 294 infants born between 22-25 weeks gestation (2010-2019).
- Assessment of survival, neonatal morbidity, and neurodevelopmental impairment at 2 years corrected age.
- Comparison with contemporary French and international cohort studies.
Main Results:
- 60.5% survival to discharge, with rates varying by gestational age.
- 90.4% of survivors assessed at 2 years corrected age were free of moderate to severe neurodevelopmental impairment.
- Survival rates exceeded a French national cohort and aligned with international data.
Conclusions:
- High rates of survival and favorable neurodevelopmental outcomes are achievable for infants born at the limit of viability.
- Local outcome data is essential for informing ethical decisions regarding life-saving interventions.
Aim:
The aim of this French study was to determine the neonatal morbidity, mortality and neurodevelopmental outcomes when infants born at the limit of viability reached 2 years of corrected age. We then compared the results with national and international cohorts.
Methods:
This study focused on 294 French infants born from 22 to 25 weeks of gestation in a single tertiary perinatal centre from January 2010 to December 2019. We used data on neonatal mortality and morbidity to calculate the survival rates of infants without moderate to severe neurodevelopmental and sensory deficits at 2 years of corrected age. These outcomes were compared with data from contemporary epidemiological studies of similar populations.
Results:
Nearly two-thirds (60.5%) of the infants survived to discharge, with varying rates based on their gestational ages, and 57.3% had no severe neonatal morbidity. The vast majority (90.4%) of the 166 alive and available at 2 years of corrected age were free of moderate to severe neurodevelopmental impairment. Our survival rates exceeded a national French cohort study, but were closely aligned with international cohorts.
Conclusion:
These findings highlight the importance of incorporating local data into ethical decision-making about life-saving treatment for infants at the limit of viability.
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