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Outcomes of a uniformly active approach to infants born at 22–24 weeks of gestation
  1. Fanny Söderström,
  2. Erik Normann,
  3. Maria Jonsson,
  4. Johan Ågren
  1. Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
  1. Correspondence to Dr Fanny Söderström, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; fanny.soderstrom{at}kbh.uu.se

Abstract

Objective To determine survival and outcomes in infants born at 22–24 weeks of gestation in a centre with a uniformly active approach to management of extremely preterm infants.

Study design Single-centre retrospective cohort study including infants born 2006–2015. Short-term morbidities assessed included retinopathy of prematurity, necrotising enterocolitis, patent ductus arteriosus, intraventricular haemorrhage, periventricular malacia and bronchopulmonary dysplasia. Neurodevelopmental outcomes assessed included cerebral palsy, visual impairment, hearing impairment and developmental delay.

Results Total survival was 64% (143/222), ranging from 52% at 22 weeks to 70% at 24 weeks. Of 133 (93%) children available for follow-up at 2.5 years corrected age, 34% had neurodevelopmental impairment with 11% classified as moderately to severely impaired. Treatment-requiring retinopathy of prematurity, severe bronchopulmonary dysplasia, visual impairment and developmental delay correlated with lower gestational age.

Conclusions A uniformly active approach to all extremely preterm infants results in survival rates that are not distinctly different across the gestational ages of 22–24 weeks and more than 50% survival even in infants at 22 weeks. The majority were unimpaired at 2.5 years, suggesting that such an approach does not result in higher rates of long-term adverse neurological outcome.

  • neonatology
  • neurology

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Footnotes

  • Contributors FS was responsible for data collection, participated in data analysis and interpretation and drafted the initial manuscript. MJ assisted in data collection and interpretation and reviewed and revised the manuscript. EN assisted in data collection and interpretation and reviewed and revised the manuscript. JA was supervising the project, participated in data analysis and interpretation and drafted the initial manuscript. All authors have reviewed the latest version of the manuscript and approve of the submission.

  • Funding This study was supported by funding from Gillbergska stiftelsen and Födelsefonden.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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