Survival Rate and Short-Term Outcomes of Periviable Preterm Infants: A Single-Center Experience From the United Arab Emirates

Abstract

The limit of periviability is constantly changing as infants born at 22-25 weeks of gestation increasingly survive. The data from our region are limited due to the small numbers of these infants among the NICU population. In this study, we evaluated the survival rates and short-term outcomes among preterm neonates between 22 and 24 weeks of gestation admitted to Tawam Hospital, United Arab Emirates. Our retrospective analysis included 100 cohorts of newborns from 22 to 25 weeks of gestation throughout the eight-year period in our level 3 NICU. We evaluated the use and effects of prenatal steroids and intrapartum antibiotics, in addition to perinatal complications, and examined their outcomes (survival, length of stay, and major morbidities). The survival rate of our periviable neonates was 18% (N = 18/100). Only one 22-week infant out of 32 cases (3%) survived during the study period in 2023. In contrast, the survival rate of infants of 23- and 24-week gestational age was 10% (N = 4/40) and 46% (N = 13/28), respectively. Although our focus in this study was to evaluate the survival of neonates who were born at around the limits of viability, we also reported the short-term outcomes at our single center, including intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), and necrotizing enterocolitis (NEC). Our data demonstrate that the trend of increasing survival with higher gestational age continues to improve over time. However, there was a significant risk of short-term co-morbidities for those who survived. Further studies are required to have robust data on short and long-term outcomes for this population. The information provided by this study could be essential for counseling parents, enabling them to participate actively in formulating their infants' care plans. It may also help parents and healthcare professionals reach a more informed and collaborative decision regarding active resuscitation and subsequent care plans for these periviable neonates.