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

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2024年9月18日

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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

摘要

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.