Neurodevelopmental Outcomes at 18 Months’ Corrected Age of Infants Born at 22 Weeks of Gestation

Abstract

Background: Increased survival rates for extremely low birth weight infants have been reported. However, survival rates and prognoses of extremely preterm infants, such as infants born at 22 weeks of gestation, are still poor. Objective: To investigate such infants’ long-term outcomes, developmental assessments were performed. Methods: Seven infants with gestational age of 22 weeks were delivered in our hospital from 2005 to 2008. One infant was a stillbirth despite resuscitation in the delivery room. Six infants, 4 boys and 2 girls, with a gestational age of 22 weeks (range 22³/₇–22⁶/₇ weeks), were admitted to the neonatal intensive care unit (NICU). Birth weights ranged from 514 to 710 g. None of the infants suffered from sepsis, necrotizing enterocolitis, or severe intraventricular hemorrhage. Results:The survival rate was 85.7% (6/7) as a percentage of deliveries and 100% (6/6) as a percentage of NICU admissions. None of the infants suffered from deafness, blindness, cerebral palsy, or epilepsy. Six infants were available for developmental assessments at 18 months’ corrected age. Three infants showed normal developmental quotients, and 3 infants showed developmental delay. Conclusion: In our study, all infants admitted to the NICU at a gestational age of 22 weeks were discharged from the hospital alive. This might suggest that infants after 22 weeks’ gestation be considered eligible for active treatment in Japan, though considering the size of the material, generalizibility of the results cannot be considered guaranteed.

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

“…The survival and disability-free outcomes compared favourably to recently published results from Sweden, 8 North America 9 as well as single-centre studies from Japan. 26,27 More locally, survival following NICU admissions in WA (44/78 or 56% at 23 weeks and 112/139 or 81% at 24 weeks) is higher than reported survival from NSW and ACT (11/41 or 27% at 23 weeks and 110/186 or 59% at 24 weeks) over a similar time period, 2007-2011, 13 and is similar to reported survival from NICU admissions in Victoria from 2010 to 2011 (11/16 or 69% at 23 weeks and 41/71 or 58% at 24 weeks). 14 The major findings from this study provide a challenge to commonly held beliefs about survival and long-term outcomes of children born at the limits of viability, before 25 weeks of gestation.…”

Survival and Neurodevelopmental Outcome of Preterm Infants Born at 22-24 Weeks of Gestational Age

“…We did not have enough infants in our single institute to evaluate survival and neurodevelopmental outcome at GA 22, 23 and 24 weeks. There are a few reports on the neurological outcome of survivors at GA 22 weeks [6,16]. The cohort study of the Neonatal Research Network, Japan, revealed that the proportion of unimpaired or minimally impaired was 12.0% at GA 22 weeks and 20.0% at GA 23 weeks [17].…”

End-of-Life Care and Survival without Major Brain Damage in Newborns at the Limit of Viability

“…A recent study showed an increase over time in the survival of infants born at 22-24 weeks' GA, without improvement in the neurological outcome [25]. Another, however, reported a survival rate of 100% for patients with a GA of 22 weeks admitted to the NICU, without cerebral palsy at 18 months' corrected age and with normal developmental quotients in 50% of them [26]. In addition, the EPICure study, with evaluations of survivors at 6 years of age, showed that although there appeared to be a reduction in the cognitive performance scores of infants from 23 to 25 weeks' GA, after adjusting for sex this trend was not significant [27].…”