PT - JOURNAL ARTICLE AU - Söderström, Fanny AU - Normann, Erik AU - Jonsson, Maria AU - Ågren, Johan TI - Outcomes of a uniformly active approach to infants born at 22–24 weeks of gestation AID - 10.1136/archdischild-2020-320486 DP - 2021 Jul 01 TA - Archives of Disease in Childhood - Fetal and Neonatal Edition PG - 413--417 VI - 106 IP - 4 4099 - http://fn.bmj.com/content/106/4/413.short 4100 - http://fn.bmj.com/content/106/4/413.full SO - Arch Dis Child Fetal Neonatal Ed2021 Jul 01; 106 AB - 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.All data relevant to the study are included in the article or uploaded as supplementary information.