Format

Send to

Choose Destination
Pediatrics. 2019 Feb;143(2). pii: e20180933. doi: 10.1542/peds.2018-0933.

Survival and Impairment of Extremely Premature Infants: A Meta-analysis.

Author information

1
Norwegian Institute of Public Health, Oslo, Norway; himy@fhi.no.
2
Norwegian Institute of Public Health, Oslo, Norway.
3
VID Specialized University, Oslo, Norway; and.
4
Department of Clinical Science, University of Bergen and Innlandet Hospital Trust, Bergen, Norway.

Abstract

CONTEXT:

Survival of infants born at the limit of viability varies between high-income countries.

OBJECTIVE:

To summarize the prognosis of survival and risk of impairment for infants born at 22 + 0/7 weeks' to 27 + 6/7 weeks' gestational age (GA) in high-income countries.

DATA SOURCES:

We searched 9 databases for cohort studies published between 2000 and 2017 in which researchers reported on survival or neurodevelopmental outcomes.

STUDY SELECTION:

GA was based on ultrasound results, the last menstrual period, or a combination of both, and neurodevelopmental outcomes were measured by using the Bayley Scales of Infant Development II or III at 18 to 36 months of age.

DATA EXTRACTION:

Two reviewers independently extracted data and assessed the risk of bias and quality of evidence.

RESULTS:

Sixty-five studies were included. Mean survival rates increased from near 0% of all births, 7.3% of live births, and 24.1% of infants admitted to intensive care at 22 weeks' GA to 82.1%, 90.1%, and 90.2% at 27 weeks' GA, respectively. For the survivors, the rates of severe impairment decreased from 36.3% to 19.1% for 22 to 24 weeks' GA and from 14.0% to 4.2% for 25 to 27 weeks' GA. The mean chance of survival without impairment for infants born alive increased from 1.2% to 9.3% for 22 to 24 weeks' GA and from 40.6% to 64.2% for 25 to 27 weeks' GA.

LIMITATIONS:

The confidence in these estimates ranged from high to very low.

CONCLUSIONS:

Survival without impairment was substantially lower for children born at <25 weeks' GA than for those born later.

PMID:
30705140
DOI:
10.1542/peds.2018-0933
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center