Care practices and outcomes of extremely preterm neonates born at 22-24 weeks - a single centre experience

<p><strong>BACKGROUND:</strong> Wide variation in the care practices and survival rates of neonates born at peri-viable gestational ages of 22+0 – 24+6 weeks. This study elucidates the postnatal risk factors for morbidity/mortality, contrasts the care practices and short-term outco...

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Bibliographic Details
Main Authors: Ramaswamy, VV, Oommen, VI, Gupta, A, Weerapperuma, N, Zivanovic, S, Roehr, CC
Format: Journal article
Language:English
Published: IOS Press 2021
Description
Summary:<p><strong>BACKGROUND:</strong> Wide variation in the care practices and survival rates of neonates born at peri-viable gestational ages of 22+0 – 24+6 weeks. This study elucidates the postnatal risk factors for morbidity/mortality, contrasts the care practices and short-term outcomes of this vulnerable group of preterm neonates from a single center with others.</p> <p><strong>METHODS:</strong> Retrospective study of neonates born at 22+0 –24+6 weeks in a level 3 neonatal intensive care unit in UK, over a period of 4 years (2016–2019). RESULTS:94 neonates given active care were studied. Survival until discharge was 51.1%(22–23 wks –44%, 24 wks –59.1%) and survival with no major brain injury (MBI) [grade III/IV IVH, cystic periventricular leukomalacia] was 38.3%(22–23 wks –32%, 24 wks –45.4%). Of those who survived until discharge, 75%had no MBI (22–23 wks –72.7%, 24 wks –76.9%). Neonates requiring significant respiratory support within first 72 hours as well as needing rescue high frequency ventilation had significantly high risk of mortality or MBI [aOR –7.17 (2.24–25.79), p = 0.00; 4.76 (1.43–20.00), p = 0.01].</p> <p><strong>CONCLUSIONS:</strong> Survival rate differed from other centres. MBI was low amongst survivors. Severe respiratory disease in the initial days was associated with a higher risk of death or MBI.</p>