Changes in long-term survival and neurodevelopmental disability in infants born extremely preterm in the post-surfactant era

Extremely preterm birth before 28 weeks’ gestation accounts for less than 1% of births in high-income countries but is associated with high rates of perinatal and infant mortality, and of neurodevelopmental disability in surviving children. Survival rates have increased over time, both overall, and...

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Bibliographic Details
Published in:Seminars in perinatology 2021-12, Vol.45 (8), p.151479-151479, Article 151479
Main Authors: Boland, Rosemarie A., Cheong, Jeanie L.Y., Doyle, Lex W.
Format: Article
Language:English
Subjects:
Child
Child, Preschool
Female
Gestational Age
Humans
Infant
Infant, Extremely Premature
Infant, Newborn
Infant, Premature, Diseases
Pregnancy
Premature Birth
Surface-Active Agents
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Summary:Extremely preterm birth before 28 weeks’ gestation accounts for less than 1% of births in high-income countries but is associated with high rates of perinatal and infant mortality, and of neurodevelopmental disability in surviving children. Survival rates have increased over time, both overall, and within each week of gestational age since the introduction of exogenous surfactant into clinical care in the early 1990s. However, rates of major neurodevelopmental disability in survivors, whether they be in early childhood or at school-age, have not clearly improved in parallel with the increases in survival. An important strategy to improve survival free of major neurodevelopmental disability is to birth extremely preterm infants in a tertiary perinatal center, where specialist obstetric care for the mother and ongoing intensive care for the infant can both be provided without the potential morbidities associated with postnatal transfer.
ISSN:0146-0005
1558-075X
DOI:10.1016/j.semperi.2021.151479