Short-term Survival and Morbidity of Extremely premature Infants Born between 20 Weeks and 24 Weeks+6 Days Gestation

Abstract

Objective: To evaluate the morbidity and mortality of extremely premature infants (EPIs) born between 20 weeks and 24 weeks+6 days gestation at hospital discharge. Methods: This was a retrospective study that included all extremely preterm births between 2006 and 2012 at a tertiary maternity care centre with a neonatal intensive care unit. Results: Seventy-eight EPIs were born during the study period out of 30,000 deliveries (0.26%). Thirty-nine EPIs (50%) survived and had a mean length of hospital stay of 43 days. The mean weight of EPIs was 723 ± 179 g. The rate of survival of EPIs increases with gestational age. Forty-nine EPIs (62%) exhibited neonatal respiratory distress (NNRD), which evolved into a bronchopulmonary dysplasia in 28 cases (35%); 33 EPIs (42%) had a maternofetal infection, while 20 (26%) experienced ventricular hemorrhage. Ten EPI (13%) displayed enterocolitis and 17 (22%) had retinopathy. No EPIs born before 22 weeks gestation survived Twenty-four EPIs left the hospital with their mothers after being scheduled for a routine paediatric follow-up visit and 15 were transferred to another hospital: 10 for surgical treatment of patent ductus arteriosus and 5 to be closer to their mothers. Conclusion: The survival rates of EPIs between 20 and 24 weeks of gestation are high. NNRD, infections, and neurological and retinal complications were the main causes of morbidity. The results of this active management study of extremely preterm births were satisfactory at the short follow-up visits. Antenatal corticosteroids and magnesium sulfate administration should be discussed beginning at 22 weeks of gestation.