The case for improving care for patients and families affected by birth at <25 weeks' gestation

Area of Science:

• Neonatal intensive care
• Perinatology
• Extremely premature infant medicine

Background:

• Management of infants born before 25 weeks gestation is highly complex and controversial.
• Significant variability exists in clinical care and outcomes despite advances in neonatal intensive care.
• Infants born at 22-24 weeks gestation represent a substantial burden on healthcare resources and outcomes, yet lack robust evidence-based guidelines.

Purpose of the Study:

• To propose strategies for improving the medical management and outcomes of infants born before 25 weeks gestation.
• To address the lack of evidence and clinical trial representation for this vulnerable population.
• To enhance specialized approaches and collaborative care for extremely premature infants.

Main Methods:

• Reviewing international experience and emerging data on the care of infants <25 weeks gestation.
• Proposing three key strategies to guide future care and research.
• Emphasizing the need for collaborative networks and family partnerships.

Main Results:

• Identification of unique physiological characteristics requiring specialized approaches for infants <25 weeks gestation.
• Proposal for generating evidence through collaborative networks to inform clinical practice.
• Advocacy for systematic partnerships with families and former patients to guide care and research.

Conclusions:

• Improved care for infants born before 25 weeks gestation requires a multi-faceted approach.
• Specialized physiological understanding, collaborative evidence generation, and family engagement are crucial.
• These strategies aim to reduce mortality and improve outcomes for the most vulnerable premature infants.