Survival and neurodevelopmental outcomes in extremely preterm infants 22–24 weeks of gestation born in Western Australia

Abstract

At these gestations, survival figures varied markedly with the chosen population denominator. Regional data are essential for valid population comparison. While many developmental difficulties occurred in these children, 78% were free from moderate or severe impairment at ages 3-5 years.

Neonatal intensive care at 22–24 weeks’ gestation: How low should we go?

“…8 In the WA study, 152 of 159 (96%) survivors were seen in follow-up at a median age of 59 months. 9 Rates of severe physical disability were relatively low, with only three (2%) children experiencing moderate to severe cerebral palsy (GMFCS 111-V) and two (1.3%) children with blindness. In contrast, 27 (18%) children were identified with moderate or severe cognitive disability (IQ more than 2SD below the mean), and 9 (5.9%) children were diagnosed with autism.…”

“…Sharp and colleagues provide important outcome data for infants born alive at 22–24 weeks’ gestation in Western Australia (WA) . A major strength of this study is the provision of denominators for survival for all live births and not just those who received neonatal intensive care.…”

“…In the WA study, 152 of 159 (96%) survivors were seen in follow‐up at a median age of 59 months . Rates of severe physical disability were relatively low, with only three (2%) children experiencing moderate to severe cerebral palsy (GMFCS 111‐V) and two (1.3%) children with blindness.…”

“…8 Sharp and colleagues provide important outcome data for infants born alive at 22-24 weeks' gestation in Western Australia (WA). 9 A major strength of this study is the provision of denominators for survival for all live births and not just those who received neonatal intensive care. Perinatal services in WA are unique with a single centre, the King Edward Memorial Hospital (KEMH) in Perth, providing centralised tertiary obstetric and neonatal services for a population spread across a vast area of 2.5 million km 2 .…”

Understanding long-term neurodevelopmental outcomes of very and extremely preterm infants: A clinical review

“…Sharp et al reported that >50% of preterm infants born at <24 weeks of gestation in Western Australia showed no major disability, including cerebral palsy and ASD. 33 The median age at diagnosis was 59 months. 33 The study did not examine the risk of mild disability and school problems.…”