THE ESSENTIAL
- When infants are born at the 22nd or 23rd week, almost all organs are immature. The lungs and brain are among the systems most at risk.
- Of the 2,458 infants who had a full assessment, 48.7% had no or mild neurodevelopmental impairment at follow-up, 29.3% had moderate neurodevelopmental impairment, and 21.2% had a severe neurodevelopmental disability.
Good news: very preterm infants, i.e. infants born before the 28th week of pregnancy, are more likely to survive today. This was revealed by researchers from an American team in a study published in the journal JAMA Network last January 18. To reach this conclusion, the scientists relied on data from 19 medical centers collected between January 1, 2013 and December 31, 2018. They analyzed information from 10,877 babies born between the 22nd and 28th week of pregnancy. The data was compared to a similar cohort of infants born from 2008 to 2012.
An increase in survival rates in very preterm infants
According to the results, 78.3% of very preterm infants survived until they were discharged from the hospital. This figure has increased from a historical rate of 76% for infants born between 2008 and 2012. According to the work, survival to discharge from the health facility was 10.9% for infants born in the 22nd week of pregnancy and 94% for babies born at the 28th week. Survival in actively treated neonates was 30% at week 22 of pregnancy and 55.8% at week 23. Among infants born before the 27th week of pregnancy who survived and were followed for two years, 49.9% were re-hospitalized and 21.2% presented with serious neurodevelopmental disorders.
A collective improvement of care
According to Carl D’Angio, co-author of the study, this improvement in outcomes for very preterm infants can be attributed to multiple factors. “Academic medical centers have adopted best practices, applied them and shared them with an increasingly large group at the national level. (…) There are elements where we have collectively progressed, such as ventilation, nutrition and hydration, he said in a statement. “The imminent delivery of an extremely premature child is an intense stressor for families. To help parents deal with this situation, it is important to present them with the data we have and let them know what long-term expectation”, developed Carl D’Angio.
