Abstract
Objective The objective of this study was to examine survival, morbidity, and resource use in a large cohort of extremely preterm infants.
Study Design We examined all (n = 754) neonatal intensive care unit admissions born at < or =25 weeks' gestation and inborn deliveries (n = 949) between 22 and 25 weeks' gestation at 17 Canadian neonatal intensive care units.
Results The overall survival rate was 63%, with a range from 14% at 22 weeks' gestation to 76% at 25 weeks' gestation. There was a high incidence of chronic lung disease (33%-51%), > or =grade 3 intraventricular hemorrhage (0%-16%), necrotizing enterocolitis (0%-14%), > or =stage 3 retinopathy of prematurity (27%-55%), nosocomial infection (25%-39%), and multiple gestation (18%-46%). Extremely preterm infants comprise 4% of neonatal intensive care unit admissions but account for 22% of deaths, 20%-60% of major morbidities, 11% of patient days, and 10%-35% of major procedures. Outborn infants had a higher incidence of chronic lung disease, severe retinopathy of prematurity, and intraventricular hemorrhage.
Conclusion Extremely preterm infants have a high incidence of mortality and morbidity and consume disproportionate amounts of neonatal intensive care unit resources.
extremely preterm infant survival morbidity NICU resource use, 22 to 25 weeks gestational age neonatal outcomes Canada, periviable infant survival chronic lung disease IVH, Chan Ohlsson extremely preterm infant outcomes cohort, neonatal intensive care unit preterm 25 weeks mortality, retinopathy prematurity necrotizing enterocolitis extreme prematurity, outborn vs inborn extremely preterm infant morbidity, NICU resource utilization extremely low gestational age neonates, preterm birth 22 23 24 25 weeks survival rates, Canadian neonatal network extremely preterm infant outcomes
Keywords
Canada/epidemiology, Cerebral Hemorrhage/epidemiology, Chronic Disease, Cross Infection/epidemiology, Enterocolitis, Necrotizing/epidemiology, Female, Gestational Age, Humans, Infant Mortality, Infant, Newborn, Infant, Premature, Intensive Care, Neonatal, Lung Diseases/epidemiology, Male, Morbidity, Pregnancy, Pregnancy, Multiple, Retinopathy of Prematurity/epidemiology, Survival Rate