Related Experiment Videos
Factors affecting survival and outcome at 3 years in extremely preterm infants
1Department of Child Health, University of Liverpool.
Insights
Survival rates for extremely preterm infants improved over time, but major disabilities remained a concern. Cerebral ultrasound findings were key predictors of later disability in survivors.
Area of Science:
- Neonatalogy
- Perinatology
- Developmental Pediatrics
Background:
- Infants born at extremely preterm gestations (≤28 weeks) face significant risks of mortality and long-term neurodevelopmental impairment.
- Understanding factors influencing survival and disability in this vulnerable population is crucial for improving outcomes.
Purpose of the Study:
- To analyze survival rates and the incidence of major and lesser disabilities in infants born at ≤28 weeks' gestation.
- To identify independent predictors of survival and later disability in this cohort.
Main Methods:
- Retrospective analysis of 823 infants born at ≤28 weeks' gestation admitted between 1980-1989.
- Assessment of disabilities at 3 years of age for surviving infants.
- Logistic regression modeling to determine factors associated with survival and disability.
Main Results:
- Survival to discharge was 56.5%.
- Of survivors assessed at 3 years, 19% had major disabilities (9% severe) and 9% had lesser disabilities; 63% appeared to function normally.
- Predictors of survival included gestational age, birthweight ratio, and year of birth; male sex and cerebral hemorrhage/infarction were inversely related.
- Cerebral ultrasound findings were the sole independent predictor of later disability in survivors.
Conclusions:
- Survival rates for extremely preterm infants have improved, influenced by gestational age, birthweight, and year of birth.
- Cerebral ultrasound findings are critical for predicting neurodevelopmental outcomes in survivors.
- Targeted interventions based on early ultrasound assessment may mitigate long-term disabilities.
Abstract:
A total of 823 infants born at 28 weeks' gestation or less were admitted to a regional referral unit between 1980 and 1989. Four hundred and sixty five (56.5%) survived to be discharged home. Twenty one subsequently died and two were lost to follow up. Four hundred and forty two (53.7%) were assessed for disabilities at the age of 3 years. Eighty four (19%) had major disabilities, of which 40 (9%) were severe. A further 39 (9%) had lesser disabilities. Three hundred and nineteen (63%) survivors appeared to be functioning normally. Logistic regression showed the likelihood of survival to be independently related to gestational age, birthweight ratio, and more recent year of birth, and inversely related to male sex and ultrasound evidence of cerebral haemorrhage or infarction. The likelihood of later disability in survivors was only independently related to cerebral ultrasound appearances.