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Am J Perinatol 2015; 32(07): 627-632
DOI: 10.1055/s-0034-1390350
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Influence of Perinatal Factors in Short- and Long-Term Outcomes of Infants Born at 23 Weeks of Gestation

Hamzah R. Miltaha
1   Division of Neonatal Medicine, Department of Pediatrics, Loyola University Medical Center, Maywood, Illinois
,
Lisa M. Fahey
2   Department of Pediatrics, New York Presbyterian-Weill Cornell Medical Center, New York, New York
,
Christine H. Sajous
1   Division of Neonatal Medicine, Department of Pediatrics, Loyola University Medical Center, Maywood, Illinois
,
John C. Morrison
3   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, Mississippi
,
Jonathan K. Muraskas
1   Division of Neonatal Medicine, Department of Pediatrics, Loyola University Medical Center, Maywood, Illinois
› Author Affiliations
Further Information

Publication History

30 May 2014

25 July 2014

Publication Date:
08 December 2014 (online)

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Abstract

Objective Investigate the influence of perinatal factors on short- and long-term outcomes for infants born at 23 weeks of gestation.

Study Design This is a retrospective study over a 25-year period (1987–2011) of 87 successfully resuscitated infants at 23 weeks of gestation. We investigated the effects of poor prenatal care, race, gender, chorioamnionitis, antenatal corticosteroids, delivery route/location, low 5-minute Apgar score, birth weight, and multiple births on short- and long-term outcomes.

Results The mortality rate was 43% (37/87). A total of 88% (44/50) of the survivors were followed at 2 years corrected age with 66% (29/44) diagnosed with a moderate-to-severe neurological impairment. Outborn and multiple birth infants had significantly higher mortality (p-value 0.042 and 0.006, respectively). Lack of exposure to antenatal steroids and lower birth weight significantly increased the disability score (p-value 0.042 and 0.003, respectively).

Conclusion Multiple perinatal factors significantly influence outcomes at the threshold of viability.

Keywords

neonatal outcome - periviable birth - risk factors - survival
 

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