Neurological outcomes and associated perinatal factors in infants born between 22 and 25 weeks with active care

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY Journal of Perinatology Pub Date : 2024-09-18 DOI:10.1038/s41372-024-02093-0

Yu Ariyoshi, Takayuki Iriyama, Takahiro Seyama, Seisuke Sayama, Eriko Yano, Kensuke Suzuki, Taiki Samejima, Mari Ichinose, Masatake Toshimitsu, Kenbun Sone, Atsushi Ito, Yoshihiko Shitara, Keiichi Kumasawa, Kohei Kashima, Satsuki Kakiuchi, Yasushi Hirota, Naoto Takahashi, Yutaka Osuga

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Abstract

Objectives

To elucidate the outcomes of periviable infants receiving active care (AC) and explore perinatal factors associated with neurodevelopmental outcomes.

Methods

This is a single-center retrospective study on infants born at 22–25 weeks of gestation, all of whom received AC. A developmental quotient (DQ) ≥ 85 at corrected 18 months was judged as normal.

Results

Fifty-seven infants were included in the study. The survival rates at discharge were 83%, 86%, 93%, and 93% at 22, 23, 24, and 25 gestational weeks, respectively. The overall percentage of normal DQ was 26/47 (55%). Acidemia in the arterial blood gas measured within 6 h after birth was identified as a factor significantly associated with subnormal DQ.

Conclusions

Not only high survival rates, but also favorable neurodevelopmental outcomes may be achieved by AC in periviable infants. Moreover, impaired neurodevelopmental outcomes may be associated with early postnatal acidemia following initial resuscitation.

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接受积极护理的 22 至 25 周出生婴儿的神经系统预后和相关围产期因素

目的阐明接受积极护理（AC）的围产期婴儿的预后，并探讨与神经发育预后相关的围产期因素。方法这是一项单中心回顾性研究，研究对象是妊娠 22-25 周出生的婴儿，所有这些婴儿都接受了 AC。结果57名婴儿被纳入研究。22、23、24 和 25 孕周婴儿出院时的存活率分别为 83%、86%、93% 和 93%。DQ正常的总比例为26/47（55%）。在出生后 6 小时内测量的动脉血气中的酸血症被确定为与 DQ 不正常显著相关的因素。此外，神经发育受损可能与最初复苏后的产后早期酸血症有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.