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The impact of standardization of care for neonates born at 22-23 weeks gestation
Faris N Al Gharaibeh1,2, DonnaMaria E Cortezzo3,4,5,6, Amy T Nathan7,8
1Division of Neonatology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. faris.algharaibeh@cchmc.org.
Objective:
Determine the impact of standardization of care and counseling on survival and morbidities of neonates born at 22-23 weeks gestation.
Design:
Retrospective cohort study of 244 neonates born at 22-23 weeks gestation between 2015 and 2023 in a large healthcare system. The primary outcome was survival of neonates receiving intensive care to NICU discharge. Secondary outcomes included morbidities and resource utilization.
Results:
Neonates born at 22-23 weeks received more intensive care after care standardization (OR 5.4 (95% CI 2.3-12.6), p < 0.0001). Survival remained stable (aOR 0.93 (95% CI 0.32-2.7), p = 0.89) despite more neonates born at 22 weeks receiving intensive care. Resource utilization remained stable.
Conclusions:
Standardizing counseling and care increased the provision of antenatal steroids and intensive care for neonates born at 22 weeks gestation. This allowed neonates born at 22 weeks to survive to discharge without increasing morbidity and resource utilization.
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