Care practices and outcomes of extremely preterm neonates born at 22–24 weeks – A single centre experience

Abstract

BACKGROUND:

Wide variation in the care practices and survival rates of neonates born at peri-viable gestational ages of 22⁺⁰ – 24⁺⁶ weeks. This study elucidates the postnatal risk factors for morbidity/mortality, contrasts the care practices and short-term outcomes of this vulnerable group of preterm neonates from a single center with others.

METHODS:

Retrospective study of neonates born at 22⁺⁰ –24⁺⁶ weeks in a level 3 neonatal intensive care unit in UK, over a period of 4 years (2016–2019).

RESULTS:

94 neonates given active care were studied. Survival until discharge was 51.1%(22–23 wks –44%, 24 wks –59.1%) and survival with no major brain injury (MBI) [grade III/IV IVH, cystic periventricular leukomalacia] was 38.3%(22–23 wks –32%, 24 wks –45.4%). Of those who survived until discharge, 75%had no MBI (22–23 wks –72.7%, 24 wks –76.9%). Neonates requiring significant respiratory support within first 72 hours as well as needing rescue high frequency ventilation had significantly high risk of mortality or MBI [aOR –7.17 (2.24–25.79), p = 0.00; 4.76 (1.43–20.00), p = 0.01].

CONCLUSIONS:

Survival rate differed from other centres. MBI was low amongst survivors. Severe respiratory disease in the initial days was associated with a higher risk of death or MBI.