Ying Xin Li, Yan Ling Hu, Xi Huang, Jie Li, Xia Li, Ze Yao Shi, Ru Yang, Xiujuan Zhang, Yuan Li, Qiong Chen
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Paired reviewers independently extracted data and assessed the risk of bias and quality of evidence. Data pooling was achieved using random-effects meta-analyses.</p><p><strong>Results: </strong>Sixty-nine studies from 25 countries were included, covering 56,526 live births and 59,104 neonatal intensive care unit (NICU) admissions. Survival rates for infants born between 22 and 25 weeks of GA ranged from 7% (95% CI 5-10; 22 studies, <i>n</i> = 5,658; low certainty) to 68% (95% CI 63-72; 35 studies, <i>n</i> = 21,897; low certainty) when calculated using live births as the denominator, and from 30% (95% CI 25-36; 31 studies, <i>n</i> = 3,991; very low certainty) to 74% (95% CI 70-77; 48 studies, <i>n</i> = 17,664, very low certainty) for those admitted to NICUs. 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Continued research and collaborative efforts are imperative to further improve the global survival and long-term outcomes of periviable infants, especially those in Low- and Middle-Income Countries.</p><p><strong>Systematic review registration: </strong>PROSPERO, CRD42022376367, available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022376367.</p>","PeriodicalId":12548,"journal":{"name":"Frontiers in Public Health","volume":"12 ","pages":"1454433"},"PeriodicalIF":3.0000,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726316/pdf/","citationCount":"0","resultStr":"{\"title\":\"Survival outcomes among periviable infants: a systematic review and meta-analysis comparing different income countries and time periods.\",\"authors\":\"Ying Xin Li, Yan Ling Hu, Xi Huang, Jie Li, Xia Li, Ze Yao Shi, Ru Yang, Xiujuan Zhang, Yuan Li, Qiong Chen\",\"doi\":\"10.3389/fpubh.2024.1454433\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Periviable infants are a highly vulnerable neonatal group, and their survival rates are considerably affected by patient-, caregiver-, and institution-level factors, exhibiting wide variability across different income countries and time periods. 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引用次数: 0
摘要
背景：围生期婴儿是一个非常脆弱的新生儿群体，他们的存活率在很大程度上受到患者、护理者和机构层面因素的影响，在不同收入国家和不同时期表现出很大的差异。本研究旨在系统回顾有关围生期婴儿存活率的文献，并比较不同收入水平和不同时期国家的存活率。方法：通过MEDLINE、Embase、CENTRAL和Web of Science进行综合检索。队列研究报告了22 + 0和25 + 6 妊娠周之间出生的围生儿按胎龄（GA）的生存结果。配对审稿人独立提取数据并评估偏倚风险和证据质量。采用随机效应荟萃分析实现数据汇集。结果：纳入了来自25个国家的69项研究，涵盖了56,526例活产和59,104例新生儿重症监护病房（NICU）入院。出生在GA 22 - 25 周的婴儿存活率为7% (95% CI 5-10；22项研究，n = 5,658；低确定性)至68% (95% CI 63-72；35项研究，n = 21897；低确定性)，从30% (95% CI 25-36；31项研究，n = 3,991；极低确定性)至74% (95% CI 70-77；48项研究，n = 17,664，非常低的确定性)。在研究的二十年中，存活率有所提高；然而，不同收入水平的国家之间存在明显的鲜明对比。结论：尽管在过去二十年中，围产期婴儿的存活率有所提高，但在不同的经济环境中仍然存在巨大差异，突出了全球围产期健康的不平等。持续的研究和合作努力对于进一步改善全球生存和围产期婴儿的长期预后至关重要，特别是在低收入和中等收入国家。系统评价注册：PROSPERO， CRD42022376367，可从https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022376367获得。
Survival outcomes among periviable infants: a systematic review and meta-analysis comparing different income countries and time periods.
Background: Periviable infants are a highly vulnerable neonatal group, and their survival rates are considerably affected by patient-, caregiver-, and institution-level factors, exhibiting wide variability across different income countries and time periods. This study aims to systematically review the literature on the survival rates of periviable infants and compare rates among countries with varied income levels and across different time periods.
Methods: Comprehensive searches were conducted across MEDLINE, Embase, CENTRAL, and Web of Science. Cohort studies reporting survival outcomes by gestational age (GA) for periviable infants born between 22 + 0 and 25 + 6 weeks of gestation were considered. Paired reviewers independently extracted data and assessed the risk of bias and quality of evidence. Data pooling was achieved using random-effects meta-analyses.
Results: Sixty-nine studies from 25 countries were included, covering 56,526 live births and 59,104 neonatal intensive care unit (NICU) admissions. Survival rates for infants born between 22 and 25 weeks of GA ranged from 7% (95% CI 5-10; 22 studies, n = 5,658; low certainty) to 68% (95% CI 63-72; 35 studies, n = 21,897; low certainty) when calculated using live births as the denominator, and from 30% (95% CI 25-36; 31 studies, n = 3,991; very low certainty) to 74% (95% CI 70-77; 48 studies, n = 17,664, very low certainty) for those admitted to NICUs. The survival rates improved over the two decades studied; however, stark contrasts were evident across countries with varying income levels.
Conclusion: Although the survival rates for periviable infants have improved over the past two decades, substantial disparities persist across different economic settings, highlighting global inequalities in perinatal health. Continued research and collaborative efforts are imperative to further improve the global survival and long-term outcomes of periviable infants, especially those in Low- and Middle-Income Countries.
Systematic review registration: PROSPERO, CRD42022376367, available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022376367.
期刊介绍：
Frontiers in Public Health is a multidisciplinary open-access journal which publishes rigorously peer-reviewed research and is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians, policy makers and the public worldwide. The journal aims at overcoming current fragmentation in research and publication, promoting consistency in pursuing relevant scientific themes, and supporting finding dissemination and translation into practice.
Frontiers in Public Health is organized into Specialty Sections that cover different areas of research in the field. Please refer to the author guidelines for details on article types and the submission process.
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