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Single‐centre vs. population‐based outcome data of extremely preterm infants at the limits of viability
Author(s) -
Kutz Patrizia,
Horsch Sandra,
Kühn Lisa,
Roll Claudia
Publication year - 2009
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2009.01393.x
Subject(s) - medicine , pediatrics , cohort , gestational age , population , intensive care , cohort study , overall survival , surgery , pregnancy , intensive care medicine , genetics , environmental health , biology
Aim: In response to the disappointing outcome data of the population‐based EPICure study published in 2000, we compared the outcome of infants 22 0/7 to 25 6/7 weeks of gestational age (GA) in a single tertiary care centre 2000–2004 with that of EPICure. Methods: EPICure tools and definitions, including 30 months’ Bayley Scales. Results: Of 83 infants <26 weeks born alive, more were admitted to intensive care – 82% vs. 68% (p < 0.0001) – and more infants survived to discharge (57% vs. 26%, p < 0.0001; 69% vs. 39%, p < 0.01, of those admitted to intensive care). More infants, as a percentage of live births, survived without severe (41%, 34/83 vs. 20%, 233/1185, p < 0.0001) or overall disability (22%, 18/83 vs. 13%, 155/1185, p = 0.03). However, at the border of viability – GA 23 and 24 weeks – the rate of infants surviving without overall disability was not significantly higher (13%, 6/45 vs. 9%, 56/623). Conclusion: In infants <26 weeks of GA, increased rates of survival and survival without disability were observed in a single‐centre inborn cohort born 5–8 years later than the EPICure cohort. This did not translate into increased survival without overall disability in infants of 23–24 weeks of GA.