Prognosis for infants born at 23 to 28 weeks' gestation.

Abstract

The survival and neurodevelopmental outcome of 356 extremely preterm infants born at 23 to 28 weeks' gestation were reported by week of gestation. Their corrected 1 year survival improved from 7% at 23 weeks to 75% at 28 weeks. The overall incidence of impairment was 19% and of major disability 12%. Boys had a significantly lower normal survival than girls. Multiple births had a significantly lower survival and higher incidence of impairment than singleton births. Predictions of outcome were made before delivery, after resuscitation, and at 1 week to aid the development of guidelines on when perinatal intensive care is justified, whether obstetric intervention for fetal reasons is warranted, and what initial and ongoing prognoses to give to parents.Intensive care for progressively smaller and more immature infants, many of whom were previously considered non-viable, needs to be carefully monitored by every perinatal centre.

Comparison of Mortality and Morbidity in Multiple versus Singleton Very Low Birth Weight Infants in A Neonatal Intensive Care Unit

“…However, it is not certain whether perinatal outcomes of the multiples are also worse than the singletons in VLBWI subpopulation. Some authors reported multiple VLBWI had higher rate of mortality and neurodevelopmental morbidity than singleton VLBWI (10,12). In other studies, no significant SGA, small for gestational age; RDS, respiratory distress syndrome; PDA, patent ductus arteriosus; BPD, bronchopulmonary dysplasia; IVH, intraventricular hemorrhage; ROP, retinopathy of prematurity; PVL, periventricular leukomalacia; BAEP, brainstem auditory evoked potential.…”

“…Some authors noted multiple very low birth weight infant (VLBWI) had higher mortality and morbidity than singleton (3)(4)(5)(6)(7)(8)(9)(10), while others found no differences between two groups (11)(12)(13)(14)(15). So, it is not clear whether multiple VLBWI suffer higher mortality and morbidity than comparable singletons.…”

The neurodevelopmental basis of sex differences in schizophrenia

“…Geschwind & Galaburda (1985) claim that males are more prone to obstetric hazards, but the evidence is flimsy. Certainly, males are more susceptible to both the short- (Yu et al 1986) and long-term (Hadders-Algra et al 1986) consequences of such hazards. For example, low birth weight males are more likely than their female equivalents to (a) develop intra-and peri-ventricular haemorrhage (Amato et al 1987), and (b) experience long-term adverse neurological deficit (Rantakallio & von Wendt, 1985); in rats at least, males are more likely to have behavioural/learning problems after perinatal insult (Grimm & Freider, 1985).…”

Factors affecting survival and outcome at 3 years in extremely preterm infants.

“…This paper explores these issues by examining the survival and status at 3 years of all infants of less than 29 weeks' gestation admitted to a regional neonatal intensive care unit over a 10 year period. major disability by gestation, birthweight ratio,9 10 and cranial ultrasound groups"l were compared and are shown in figs 1 and 2 and tables 4 and 5. The birthweight ratio is the infant's birth weight divided by the mean birth weight at that gestational age.…”