¡°Early¡± versus ¡°late¡± 23-week infant outcomes

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• 作者：Thinh P. Nguyen ; MD^a ; ^{tnguye81@slu.edu} ; Erol Amon ; MD ; JD^a ; Mohamad Al-Hosni ; MD^c ; Jeffrey A. Gavard ; PhD^b ; Gilad Gross ; MD^a ; Thomas D. Myles ; MD^a
• 关键词：extremely preterm birth ; extremely low birthweight ; limits of viability ; neonatal and infant survival ; Vermont Oxford Network
• 刊名：American Journal of Obstetrics and Gynecology
• 出版年：2012
• 出版时间：September, 2012
• 年：2012
• 卷：207
• 期：3
• 页码：226.e1-226.e6
• 全文大小：239 K

文摘

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Objective

To determine whether survival is different in ¡°early¡± (23^0/7-23^3/7 weeks) vs ¡°late¡± (23^4/7-23^6/7 weeks) infants.

Study Design

Records of 126 consecutive liveborn infants delivered at 23^0/7 to 23^6/7 weeks' gestation from 2001-2010 were examined using the Vermont Oxford Network database. Infants born at 23 0/7 to 23 3/7 weeks were grouped into ¡°early¡± and those at 23 4/7 to 23 6/7 weeks were ¡°late.¡± Clinical characteristics were compared between groups and multivariate analyses were used to predict survival.

Results

Seventy-two infants were early and 54 were late. Survival was 25 % vs 56 % , respectively (P < .001). The early group was less likely to receive steroids (43 % vs 65 % ; P = .016) and had a lower mean birthweight (547 g vs 596 g; P < .001). No difference in other factors was seen between groups. No change in survival was observed during the study period in either group.

Conclusion

Late 23-week infants have improved survival compared with early infants. Delaying delivery as little as 24-96 hours may improve survival for 23-week infants.