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Medial Publications about Survival of 22 week neonates 

Links to medical studies, reports and treatments for babies born at 22 weeks of gestation and survival.

Author: Norman, Mikael; Hallberg, Boubou
Publication: JAMA
Publisher: American Medical Association
Date: Mar 26, 2019

 In this comparison of 2 birth cohorts in Sweden that included 2205 births at 22-26 weeks’ gestational age, 1-year survival among those born alive in 2004-2007 was 70% compared with 77% for those born alive in 2014-2016 and the difference was statistically significant.

"Systematic survival among infants at 22 weeks’ gestational age has not been restricted to Swedish hospitals. For example, the Japanese Neonatal Network (including tertiary centers only) reported a survival rate of 36% among live-born infants at 22 weeks’ gestational age during 2003-2005.31 Researchers at the University of Iowa Hospitals and Clinics reported a survival rate of 33% among infants born without any major congenital anomalies at 22 weeks’ gestational age during 2000-2009,32 and the University of Cologne (in Germany) reported a survival rate of 67% to hospital discharge among infants born at 22-23 weeks’ gestational age receiving active care (instead of only comfort care) during 2010-2014.33 At 24 US hospitals, the survival rate was 23% among infants born at 22 weeks’ gestational age if active care was offered.1 A study of US tertiary centers reported a survival rate of 28% at 22 weeks’ gestation when infants were resuscitated, which increased to 38% in the subgroup that also received antenatal corticosteroids.34" 

Backes, C.H., Söderström, F., Ågren, J. et al. .Journal of Perinatology volume 39, pages39–47(2019) doi:10.1038/s41372-018-0248-y Published: 23 October 2018

One center (Uppsala, Sweden; UUCH) provided proactive care to all mother–infant dyads (comprehensive center); the other center (Nationwide Children’s Hospital, USA; NCH) initiated or withheld treatment based on physician and family preferences (selective center). Differences in outcomes between the two centers were evaluated.

Result

Among 112 live-born infants at 22 weeks of gestation, those treated at UUCH had in-hospital survival rates higher than those at NCH (21/40, 53% vs. 6/72, 8%; P < 0.01).

Click here to read a Canadian Neonatologist blog post of this study 

May 7, 2015
N Engl J Med 2015; 372:1801-1811
DOI: 10.1056/NEJMoa1410689

 Overall rates of survival and survival without severe impairment ranged from 5.1% (IQR, 0 to 10.6) and 3.4% (IQR, 0 to 6.9), respectively, among children born at 22 weeks of gestation...  (please note these rates are listed as ones with out server impairment like ROP, BPD etc. Click here for more about these definitions used in studies)  

Raju, T., Mercer, B., Burchfield, D. et al.

 Journal of Perinatology volume 34, pages333–342(2014)

When counseling parents, it is appropriate to present the data regarding the rate of survival and long-term disabilities separately, as the parents’ perspectives and the importance they give these may be different. Physicians should recognize that the parents’ views on what is a ‘severe’ disability may be different from those of the researchers or clinicians, who traditionally report the combination of death and severe disability together. Coping with a child’s behavior problem, considered a ‘minor’ disability in the published literature, may be difficult to handle for some families, while other families may be able to adapt more readily to disabilities typically considered to be major (for example, cerebral palsy).

Abstract
Our aim was to evaluate the literature on survival and major disability rate in preterm infants born at 22- 25 weeks of gestational age (GA).

We compared survival and neurodevelopmental outcomes among infants born at 22 to 24 weeks of gestation, as assessed at 18 to 22 months of corrected age, across three consecutive birth-year epochs (2000–2003 [epoch 1], 2004–2007 [epoch 2], and 2008–2011 [epoch 3]).

PEDIATRICS Volume 138 , number 1 , July 2016 :e 20154434

WHAT’S KNOWN ON THIS SUBJECT: Extremely preterm infants (22–28 weeks’ gestation) are at high risk of death and morbidity. In recent years, more infants born at 22 to 24 weeks’ gestation are being resuscitated instead of receiving comfort care only.
WHAT THIS STUDY ADDS: In our population-based study, extremely preterm infants remain at risk for death and major morbidity, with 22- to 25-week gestation infants being at highest risk. We report rates of resuscitation and timing of death for 22- to 28-week gestation infants.