Survival and disability in babies less than 26 weeks' gestation

Yu, V. Y. H.; Doyle, Lex W.

doi:10.1016/s1084-2756(96)80045-5

Cited by 13 publications

(2 citation statements)

References 37 publications

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“…Studies from level 3 hospitals reporting survival rates by gestational age for infants <26 weeks born in the 1980s and early 1990s have recently been reviewed (1). These studies vary considerably in the infants included and excluded, the years in which the infants were born and the age at which survival was determined.…”

Section: Discussionmentioning

confidence: 99%

Changes Over Time in Attitudes to Treatment and Survival Rate for Extremely Preterm Infants (23–27 Weeks' Gestational Age)

Gultom

Doyle

Davis

et al. 1997

Aust NZ J Obst Gynaeco

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We determined the changes over time in attitude to treatment of very preterm infants (23-27 weeks of gestational age) born at the Royal Women's Hospital, Melbourne, and their survival rate. The subjects were consecutive livebirths at 23-27 weeks' gestational age born from 1983-1994, inclusive. The main outcomes measured were the proportions of livebirths treated intensively and survival rates to hospital discharge, both excluding lethal abnormalities. Over the 12 years of the study there were 788 livebirths free of lethal abnormalities born at 23-27 week's gestational age. Overall 669 (85%) were treated intensively; the proportions treated intensively rose significantly over time from 74% in 1983-1985 to 91% in 1992-1994, and with increasing gestational age, from 19% at 23 weeks to 100% at 27 weeks. Overall 439 (56%) survived their primary hospitalization; the survival rate rose significantly over time, from 43% in 1983-1985 to 70% in 1992-1994, and with increasing gestational age, from 3% at 23 weeks to 78% at 27 weeks. In 1992-1994, the survival rates were 11% at 23 weeks, 53% at 24 weeks, 70% at 25 weeks, 81% at 26 weeks, and 87% at 27 weeks. For infants treated intensively, the survival rate rose significantly from 53% in 1983-1985 to 76% in 1992-1994. The largest increases in survival have occurred in the 1990s, and at 24 and 25 weeks' gestational age. The proportions of very preterm infants treated intensively and their survival rates have increased over time, and have always been higher with increasing gestational age.

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Section: Discussionmentioning

confidence: 99%

Changes Over Time in Attitudes to Treatment and Survival Rate for Extremely Preterm Infants (23–27 Weeks' Gestational Age)

Gultom

Doyle

Davis

et al. 1997

Aust NZ J Obst Gynaeco

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“…Survivors without these handicaps have an increased risk, compared with infants born at term, of non‐optimal performance in school, decreased ability for abstract thinking and mathematical skill. The prognosis for infants born after extreme preterm birth (<26 weeks) or with extremely low birthweight has been evaluated extensively in recent reviews 2–4 …”

Section: Introductionmentioning

confidence: 99%

Combination therapy

Ingemarsson

2005

BJOG

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Population Twenty-five women (13 cases with intact membranes and 12 cases with ruptured) with threatened preterm labour and advanced cervical status before 26 completed weeks of gestation. Methods A combination of different drugs was used. Atosiban, an oxytocin antagonist, was the first line drug and was given as an infusion for several days as required. Supportive therapy was also given to most women with subcutaneous injections of the h-receptor agonist terbutaline (0.25 mg up to six times a day); sulindac, a prostaglandin synthetase inhibitor (200 mg one to two times a day up to a week); and broadspectrum antibiotics (metronidazole and cefuroxime intravenously for three days and thereafter oral therapy). Main outcome measures Prolongation of pregnancy more than 48 hours or 7 days. Neonatal survival.Results Prolongation of pregnancy for more than 48 hours to enable administration of corticosteroid therapy was obtained in all but three cases. Eight women were delivered after more than a week from admission. Three neonates died at birth due to obstetric complication or sepsis. The other neonates had normal pH in cord or venous blood at birth. No severe side effects were recorded and in no case did the treatment have to be discontinued due to side effects. Conclusion The policy described here is not evidence based, relating only to clinical observations, and as such is of very limited value. However, it seems that with this combined approach to management, some days can be gained by achieving full effect of corticosteroid treatment and prolongation of the pregnancy, hopefully reducing time in the neonatal intensive care in these critical cases. No severe side effects were reported.

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Regionalized long-term follow-up

Doyle

2004

Seminars in Neonatology

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Survival and disability in babies less than 26 weeks' gestation

Cited by 13 publications

References 37 publications

Changes Over Time in Attitudes to Treatment and Survival Rate for Extremely Preterm Infants (23–27 Weeks' Gestational Age)

Changes Over Time in Attitudes to Treatment and Survival Rate for Extremely Preterm Infants (23–27 Weeks' Gestational Age)

Combination therapy

Regionalized long-term follow-up

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