Perinatal outcomes of a large cohort of extremely low gestational age infants (twenty-three to twenty-eight completed weeks of gestation)☆,☆☆,★,★★
Section snippets
Institution
The Grace/Children's Hospital complex serves a population of 3 million persons with approximately 45,000 births per year. The Grace Hospital has between 7000 and 8000 deliveries each year, one third of which are high-risk obstetric referrals. About 700 to 800 infants are admitted annually to the NICU in British Columbia's Children's Hospital, of whom 140 are outborn. The neonatal resuscitation team from the NICU attends all high risk deliveries in Grace Hospital. Infants in the NICU no longer
Study population
After obstetric review of the hospital records of all patients identified to have delivered live-born or stillborn infants at or less than 30 weeks GA in the Grace Hospital, it was found that 1024 infants born to 920 mothers had validated GAs between 23 and 28 weeks, inclusive, and they formed the study group. There were no survivors born before 23 completed weeks of gestation. Fetal ultrasonographic data from the first 24 weeks of gestation were available for 904 (88%) of the study infants. Of
DISCUSSION
These outcome data on infants born at extremely low GAs are based on the largest such population published to date. Exhaustive efforts were made to establish GA as accurately as possible and to overcome the shortcomings of previous studies. Our validation procedure for GA revealed a consistent tendency among clinicians to overestimate GA at these critically short GAs; on review, a correction was required in 34%, the error usually being an overestimate. There may be two reasons for this
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Cited by (141)
Over-reaching with causality language in neurodevelopmental infant research: A methodological literature review
2023, Early Human DevelopmentMaternal and Perinatal Outcomes of Pregnancies Delivered at 23 Weeks' Gestation
2015, Journal of Obstetrics and Gynaecology CanadaCitation Excerpt :The rate of survival was 10.8% (25/232) when antepartum stillbirths were excluded and 12.8% (5/39) in centres that offered fetal heart rate monitoring at 23 weeks’ gestation. Previous studies have noted a wide range of survival rates for all births (including stillbirths) at this gestation, ranging from 0% to 37%.5–7,9–12,14,17–19,36,37 Some studies present survival rates for live births only, ranging from 0% to 53%.5,7,10,11,14,16–18,20,36,37,47
The Effect of Maternal Age on Adverse Birth Outcomes: Does Parity Matter?
2010, Journal of Obstetrics and Gynaecology CanadaNeonatal outcomes of multiple versus single very preterm infants
2023, Minerva PediatricsEffect of biomedical complications on very and extremely preterm children's language
2023, Frontiers in Psychology
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From the Departments of Pediatrics and of Obstetrics and Gynecology, Research Support Services, University of British Columbia, British Columbia's Children's Hospital and Grace Maternity Hospital, Vancouver, British Columbia, Canada.
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Supported by British Columbia Health Research Foundation grant No. 134 (90-92).
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Reprint requests: Emily W. Y. Ling, British Columbia's Children's Hospital, Room 1N1, 4480 Oak St., Vancouver, British Columbia V6H 3V4, Canada.
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0022-3476/94/$3.00 + 0 9/23/58440