Risk Factors for Mortality and Neurodevelopmental Impairment
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Researchers aimed to evaluate the risk factors for mortality and neurodevelopmental impairment (NDI) among infants of 22–23 weeks’ gestational age.

This retrospective case-control study included 104 infants delivered at 22–23 week's gestation. Researchers compared 65 and 34 cases of survival to discharge and postnatal in-hospital death (5 excluded), respectively, and 26 and 35 cases with and without NDI, respectively, using maternal, prenatal, and postnatal records. A high rate of survivor's follow-up (61/65) was achieved in this study.

Results:
--The survival rate was 75.0% and 62.0% among infants born at 22 and 23 week's gestation, respectively.

--Infants who died weighed less (525.5 vs. 578 g) and their intrauterine growth retardation (IUGR) rate was higher (14.7 vs. 1.5%).

--Mortality was associated with an increased incidence of bradycardia on fetal heart rate monitoring (11.8 vs. 1.5%), periventricular hemorrhagic infarction (PVHI; 32.4 vs. 6.2%), necrotizing enterocolitis (NEC, surgery or drain tube; 14.7 vs. 0.0%), and tension pneumothorax (29.4 vs. 6.2%).

--There were significant differences in the proportion of PVHI (15.4 vs. 0%) between infants with and without NDI.

Finally, IUGR, bradycardia, PVHI, NEC, and stress pneumothorax were linked to neonatal mortality in babies born at 22–23 weeks gestation. PVHI was correlated with NDI at 36–42 months of chronological age.

Source: https://www.karger.com/Article/Abstract/514161
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