Survival and major neonatal complications in infants born between 22 0/7 and 24 6/7 weeks of gestation (1999-2003)

Objective: This study was undertaken to compare survival and morbidity until discharge in infants born after 22-23 versus 24 weeks' gestational age (GA). Study design: Cohort study of all infants 25 weeks or less, born in 3 tertiary perinatal centers (1999-2003). Results: Of a total of 336 infants, 133 (40%) died before or immediately after birth without the provision of life support, 203 (60%) received active neonatal treatment. Infants with life support (n = 82 at 22 to 23 weeks, n = 121 at 24 weeks) differed with respect to antenatal steroid prophylaxis (44% vs 62%) and cesarean section rate (51% vs 71%). Survival was 67% compared with 82% (P = .016). The incidence of intraventricular hemorrhage III or greater or periventricular leukomalacia (15/15%), severe retinopathy of prematurity (18/15%), and chronic lung disease (40/47%) was similar in both GA groups. Conclusions: The provision of life support for extremely preterm infants increases their chance of survival without more neonatal morbidity. (c) 2006 Mosby, Inc. All rights reserved.