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Gestational age in the literature
  1. B V Pai,
  2. V A Pai
  1. Royal Sussex Count Hospital, Brighton, Sussex, UK; binapaihotmail.com

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    In neonatology, the correct gestational age (GA) is extremely important, as the viability and survival of the premature baby depend on it. A difference of a few hours or a day can have a substantial impact on the survival and long term morbidity of premature babies.

    Doctors are trained to report the GA of a premature baby in exact days—for example, 26+4 (GA = 26 completed weeks and 4 days). Reporting the GA in this format helps in understanding and assessing the postnatal and maturational age of premature babies. One would therefore expect GA to be reported exactly in the literature, especially in articles, studies, and trials dealing with survival and morbidity in premature babies. In fact, descriptions of GA are extremely ambiguous in most articles. An example of this ambiguity is survival at 26 weeks GA is 26%.1 This description of GA is open to interpretation. It could mean 25+1 to 26+1 or 26+1 to 26+6. Every extra day improves the survival of the premature baby by 2%. Therefore, for the above GA, survival could change by 12% on either side of 26%. This could have a large effect not only on survival but also on long term morbidity.

    Many large studies and articles published on survival, viability, and ethical issues of resuscitation in extremely premature babies have used this ambiguous description of GA. The EPICure study is a good example of a large, important study that uses the ambiguous description GA.1 Such large studies have a major impact on doctors and parents, as the results and interpretation are used by neonatologist for counselling, teaching, and research.

    For those dealing with ethical issues, especially resuscitation in extremely premature babies, exact GA can be of immense help.2,3 As the limits of viability and survival are stretched, doctors need to be very clear in their minds about the exact age of the premature baby.

    In view of the above, we propose that the reporting of GA in the literature should be uniform. It should be described in exact days—that is, weeks+extra days.

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