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Infants with gestational age 28 weeks or less

K W Holmsgaard1, S Petersen

  • 1Department of Neonatology, Juliane Marie Center for Women, Children and Reproduction, The National University Hospital (Rigshospitalet), Copenhagen.

Danish Medical Bulletin
|February 1, 1996
PubMed
Summary

Neonatal survival and disabilities in extremely premature infants were evaluated. Over 70% survived to discharge, but many experienced long-term impairments, highlighting the need for improved care strategies.

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Area of Science:

  • Neonatalogy
  • Perinatal Medicine
  • Pediatric Neurology

Background:

  • Extremely low gestational age infants (ELGA) face significant risks of mortality and disability.
  • Understanding the impact of perinatal events and neonatal treatments is crucial for improving outcomes.

Purpose of the Study:

  • To evaluate neonatal survival and subsequent disabilities in infants born at extremely low gestational age (≤28 weeks).
  • To identify perinatal factors and neonatal interventions associated with adverse outcomes in this vulnerable population.

Main Methods:

  • Retrospective follow-up study of 197 infants with gestational age ≤28 weeks admitted between 1987-1990.
  • Data collected from medical records, parental questionnaires, and health authority recordings.
  • Outcomes assessed included mortality, healthy survival, and disabled survival at a mean corrected age of 48 months.

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Main Results:

  • Mortality rate was 29%, with higher mortality in infants born at 24-25 weeks (49%) compared to 26-28 weeks (24%).
  • At follow-up, 54% had no impairments, 22% had minor impairments, and 23% had moderate to severe disabilities.
  • Significant risk factors for adverse outcomes included low Apgar score, low birth weight (<1000g), male sex, and birth at a non-specialized hospital.

Conclusions:

  • Infants born at extremely low gestational age have a substantial risk of mortality and long-term disability.
  • Perinatal factors and neonatal complications like intracranial hemorrhage significantly influence survival and functional outcomes.
  • The findings underscore the need for specialized care and targeted interventions for ELGA infants to improve neurodevelopmental outcomes.