Survival improved for very preterm infants

Thursday, August 3, 2006

NEW YORK (Reuters Health) - For infants born between 22 and 24 weeks of gestation, immediate life support increases survival without increasing the risk of neonatal ailments, German researchers report.
The overall survival rate for these infants is 67 percent, compared with rates ranging from 10 to 50 percent in the 1990s, they report in the American Journal of Obstetrics and Gynecology.
Dr. Susanne Herbert-Jonat of Ludwig Maximilian University of Munich and colleagues note that in Germany, life support is generally provided immediately to infants who have completed 24 weeks of gestation.
However, because the chances of more premature infants surviving without severe handicaps have been slim, guidelines recommend that life support be provided to neonates born at 22 or 23 weeks gestation only if requested by the parents after counseling.
To evaluate the benefit or otherwise of life support, the researchers examined data for 336 infants born between 22 and 24 weeks gestation at three centers over a 5-year period.
In total, 133 (40 percent) of the babies died before or immediately after birth and no life support was provided. The remaining 203 received active life support. Of this group, 82 had a gestational age of 22 to 23 weeks and 121 had a gestational age of 24 weeks.
The rates of brain damage, severe retinal damage and chronic lung disease were similar in the two age groups.
As noted, the overall survival was 67 percent in the younger group, compared with 82 percent in the older group.
Herbert-Jonat and colleagues say that the data "provide new information for the ongoing discussion on whether life support should be offered to infants born at less than 25 weeks' gestation."
SOURCE: American Journal of Obstetrics and Gynecology, July 2006.

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