National cohort of infants born before 24 gestational weeks showed increased survival rates but no improvement in neonatal morbidity
Journal article, 2022
Aim: To describe survival and neonatal morbidities in infants born before 24 weeks of gestation during a 12-year period. Methods: Data were retrieved from national registries and validated in medical files of infants born before 24 weeks of gestation 2007–2018 in Sweden. Temporal changes were evaluated. Results: In 2007–2018, 282 live births were recorded at 22 weeks and 460 at 23 weeks of gestation. Survival to discharge from hospital of infants born alive at 22 and 23 weeks increased from 20% to 38% (p = 0.006) and from 45% to 67% (p < 0.001) respectively. Caesarean section increased from 12% to 22% (p = 0.038) for infants born at 22 weeks. Neonatal morbidity rates in infants alive at 40 weeks of postmenstrual age (n = 399) were unchanged except for an increase in necrotising enterocolitis from 0 to 33% (p = 0.017) in infants born at 22 weeks of gestation. Bronchopulmonary dysplasia was more common in boys than girls, 90% versus 82% (p = 0.044). The number of infants surviving to 40 weeks doubled over time. Conclusion: Increased survival of infants born before 24 weeks of gestation resulted in increasing numbers of very immature infants with severe neonatal morbidities likely to have a negative impact on long-term outcome.
proactive approach
extremely preterm
necrotising enterocolitis
neonatal morbidities
survival rates
Author
Pia Lundgren
University of Gothenburg
Eva Morsing
Lund University
Anna Lena Hård
University of Gothenburg
Alexander Rakow
Karolinska University Hospital
Lena Hellström-Westas
Uppsala University
Lena Jacobson
University of Gothenburg
Karolinska University Hospital
Mats Johnson
University of Gothenburg
Gerd Holmström
Uppsala University
Staffan Nilsson
University of Gothenburg
Chalmers, Mathematical Sciences, Applied Mathematics and Statistics
Lois E.H. Smith
Harvard Medical School
Karin Sävman
Sahlgrenska University Hospital
University of Gothenburg
Ann Hellström
University of Gothenburg
Acta Paediatrica, International Journal of Paediatrics
0803-5253 (ISSN) 1651-2227 (eISSN)
Vol. 111 8 1515-1525Subject Categories
Pediatrics
Public Health, Global Health, Social Medicine and Epidemiology
Obstetrics, Gynecology and Reproductive Medicine
DOI
10.1111/apa.16354
PubMed
35395120