Abstract
Objective This study aimed to compare inborn infants aged 22 and 23 gestational weeks at our
hospital to assess for differences in survival and long-term prognosis.
Study Design We retrospectively analyzed 22- and 23-gestational-weeks-old infants born in our
hospital between January 2011 and December 2018. The prognosis of inborn infants in
Japan was also calculated using the Neonatal Research Network of Japan (NRNJ) data
during the same period.
Results The survival rates at our institution's neonatal intensive care unit discharge, including
stillbirth, were 72 and 89% at 22 and 23 gestational weeks, respectively. The mortality
rate and neurodevelopmental impairment (NDI) rate at 3 years of age, including stillbirth,
were 58 and 32% at 22 and 23 weeks, respectively. Cerebral palsy, mental developmental
retardation, visual impairment, and hearing impairment defined NDI. The prognosis
at our hospital was better than the average calculated using NRNJ data. Survival rates
varied among facilities, and some facilities had survival rates similar to that of
our hospital.
Conclusion The prognosis of 22-gestational-week-old inborn infants was inferior to that of 23
gestational weeks in our institution but was better than previously reported. If aggressive
treatment is provided, survival without sequelae can be fully expected even for 22-gestational-week-old
infants.
Key Points
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We examined babies of gestation ages 22 and 23 weeks.
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We examined the survival and neurological prognoses.
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We compared our facility with that in entire Japan.
Keywords
extremely low birth weight - infant - mortality rate - neurodevelopmental outcome
- survival rate
