Morbidity and mortality of preterm infants less than 26 weeks of gestational age

• Type: Article in International Scientific Journal
• Date: 2019

Authors

da Cunha Duraes, MI (Author) Other; Filipa Flor-de-Lima (Author) FMUP; Rocha, G (Author) Other; Henrique Soares (Author) FMUP; Guimarães H (Author) FMUP

Journal

Title: Minerva Pediatrica

Vol. 71

Pages: 12-20

ISSN: 0026-4946

Publisher: EDIZIONI MINERVA MEDICA

Indexing

ISI Web of Knowledge - 5 Citations

Scopus - 4 Citations

Other information

Authenticus ID: P-00Q-1E9

DOI: 10.23736/s0026-4946.16.04609-0

Abstract (EN): BACKGROUND: Extreme preterm infants have a high risk of morbidity and mortality. Newborns delivered between 23(+0) and 25(+6) weeks. are considered to be in the "gray zone" and have uncertain prognosis. For these children medical decision-making becomes complex and controversial. The present study intends to evaluate the neonatal morbidity and mortality of preterm infants born between 23 weeks and 25(+6) weeks of gestational age. METHODS: A retrospective study was conducted including all inborn preterm infants, with a gestational age between 23(+0) and 25(+6) weeks, admitted to a level IIIC NICU, between January 1st, 1996 and December 31st, 2014. RESULTS: A total of 72 preterm neonates were included, 18.1% had a full cycle of antenatal stemids. The most frequent major morbidities were RDS (95.4%), patent ductus arteriosus (81.3%), sepsis (55.7%. being 19.7% early sepsis. and 36.1% late sepsis), intraventricular hemorrhage (34.4%). retinopathy of prematurity (21.9%) and necrotizing enterocolitis (10.9%). Fifty-four (75%) children died. The only factor adjusted to age associated with high mortality founded was hypotension (OR= 4.99, P<0.019). Morbidity at discharge was: severe bronchopulmonary dysplasia (77.8%), retinopathy of prematurity (72.2%), intraventricular hemorrhage (16.7%). cystic periventricular leukomalacia (11.1%), and sequalae of necrotizing enterocolitis (5.6%). CONCLUSIONS: The survival rate was 25% and a high morbidity at discharge was observed, which leave us with the huge responsibility to improve this result in a near future. Extreme prematurity is still a very controversial and complex issue and particular challenge for neonatologists. The use of antenatal steroid in the more immature preterm infants should be encouraged.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 9