Neonatal Outcome and Treatment Perspectives of Preterm Infants at the Border of Viability
Decision-making at the border of viability remains challenging for the expectant parents and the medical team. The preterm infant is dependent on others making the decision that will impact them for a lifetime in hopefully their best interest. Besides survival and survival without neurodevelopmental...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-02-01
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| Series: | Children |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2227-9067/9/3/313 |
| _version_ | 1827649636772347904 |
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| author | Rahel Schuler Ivonne Bedei Frank Oehmke Klaus-Peter Zimmer Harald Ehrhardt |
| author_facet | Rahel Schuler Ivonne Bedei Frank Oehmke Klaus-Peter Zimmer Harald Ehrhardt |
| author_sort | Rahel Schuler |
| collection | DOAJ |
| description | Decision-making at the border of viability remains challenging for the expectant parents and the medical team. The preterm infant is dependent on others making the decision that will impact them for a lifetime in hopefully their best interest. Besides survival and survival without neurodevelopmental impairment, other relevant outcome measures, such as the quality of life of former preterm infants and the impact on family life, need to be integrated into prenatal counselling. Recommendations and national guidelines continue to rely on arbitrarily set gestational age limits at which treatment is not recommended, can be considered and it is recommended. These guidelines neglect other individual prognostic outcome factors like antenatal steroids, birth weight and gender. Besides individual factors, centre-specific factors like perinatal treatment intensity and the attitude of healthcare professionals significantly determine the futures of these infants at the border of viability. A more comprehensive approach regarding treatment recommendations and relevant outcome measures is necessary. |
| first_indexed | 2024-03-09T20:00:29Z |
| format | Article |
| id | doaj.art-ef27a71912264cac8ec978631f110d62 |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-09T20:00:29Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-ef27a71912264cac8ec978631f110d622023-11-24T00:46:21ZengMDPI AGChildren2227-90672022-02-019331310.3390/children9030313Neonatal Outcome and Treatment Perspectives of Preterm Infants at the Border of ViabilityRahel Schuler0Ivonne Bedei1Frank Oehmke2Klaus-Peter Zimmer3Harald Ehrhardt4Department of General Pediatrics and Neonatology, Justus-Liebig-University, Feulgenstrasse 12, 35392 Giessen, GermanyDepartment of Obstetrics and Gynecology, Justus-Liebig-University, Klinikstrasse 33, 35392 Giessen, GermanyDepartment of Obstetrics and Gynecology, Justus-Liebig-University, Klinikstrasse 33, 35392 Giessen, GermanyDepartment of General Pediatrics and Neonatology, Justus-Liebig-University, Feulgenstrasse 12, 35392 Giessen, GermanyDepartment of General Pediatrics and Neonatology, Justus-Liebig-University, Feulgenstrasse 12, 35392 Giessen, GermanyDecision-making at the border of viability remains challenging for the expectant parents and the medical team. The preterm infant is dependent on others making the decision that will impact them for a lifetime in hopefully their best interest. Besides survival and survival without neurodevelopmental impairment, other relevant outcome measures, such as the quality of life of former preterm infants and the impact on family life, need to be integrated into prenatal counselling. Recommendations and national guidelines continue to rely on arbitrarily set gestational age limits at which treatment is not recommended, can be considered and it is recommended. These guidelines neglect other individual prognostic outcome factors like antenatal steroids, birth weight and gender. Besides individual factors, centre-specific factors like perinatal treatment intensity and the attitude of healthcare professionals significantly determine the futures of these infants at the border of viability. A more comprehensive approach regarding treatment recommendations and relevant outcome measures is necessary.https://www.mdpi.com/2227-9067/9/3/313extremely preterm infantborder of viabilitydecision-makingoutcome measuressurvivalsurvival without disability |
| spellingShingle | Rahel Schuler Ivonne Bedei Frank Oehmke Klaus-Peter Zimmer Harald Ehrhardt Neonatal Outcome and Treatment Perspectives of Preterm Infants at the Border of Viability Children extremely preterm infant border of viability decision-making outcome measures survival survival without disability |
| title | Neonatal Outcome and Treatment Perspectives of Preterm Infants at the Border of Viability |
| title_full | Neonatal Outcome and Treatment Perspectives of Preterm Infants at the Border of Viability |
| title_fullStr | Neonatal Outcome and Treatment Perspectives of Preterm Infants at the Border of Viability |
| title_full_unstemmed | Neonatal Outcome and Treatment Perspectives of Preterm Infants at the Border of Viability |
| title_short | Neonatal Outcome and Treatment Perspectives of Preterm Infants at the Border of Viability |
| title_sort | neonatal outcome and treatment perspectives of preterm infants at the border of viability |
| topic | extremely preterm infant border of viability decision-making outcome measures survival survival without disability |
| url | https://www.mdpi.com/2227-9067/9/3/313 |
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