Document Detail

Outcomes of children of extremely low birthweight and gestational age in the 1990s.
MedLine Citation:
PMID:  10859704     Owner:  NLM     Status:  MEDLINE    
Advances in perinatal care have improved the chances for survival of extremely low birthweight (<800 grams) and gestational age (<26 weeks) infants. A review of the world literature reveals that among regional populations, survival at 23 weeks' gestation ranges from 2 to 35%, at 24 weeks' gestation 17 to 62% and at 25 weeks' gestation 35 to 72%. These wide variations may be accounted for by differences in population descriptors, in the criteria used for starting or withdrawing treatment, in the reported duration of survival and differences in care. Major neonatal morbidity increases with decreasing gestational age and birthweight. At 23 weeks' gestation, chronic lung disease occurs in 57 to 86% of survivors, at 24 weeks in 33 to 89% and at 25 weeks' gestation in 16 to 71% of survivors. The rates of severe cerebral ultrasound abnormality range from 10 to 83% at 23 weeks' gestation, 9 to 64% at 24 weeks and 7 to 22% at 25 weeks' gestation Of 77 survivors at 23 weeks' gestation, 26 (34%) have severe disability (defined as subnormal cognitive function, cerebral palsy, blindness and/or deafness). At 24 weeks' gestation, the rates of severe neurodevelopmental disability range from 22 to 45%, and at 25 weeks' gestation 12 to 35%. When compared with children born prior to the 1990s, the rates of neurodevelopmental disability have, in general, remained unchanged. We conclude that, with current methods of care, the limits of viability have been reached. The continuing toll of major neonatal morbidity and neurodevelopmental handicap are of serious concern.
M Hack; A A Fanaroff
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Seminars in neonatology : SN     Volume:  5     ISSN:  1084-2756     ISO Abbreviation:  Semin Neonatol     Publication Date:  2000 May 
Date Detail:
Created Date:  2000-10-16     Completed Date:  2000-10-16     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9606001     Medline TA:  Semin Neonatol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  89-106     Citation Subset:  IM    
Copyright Information:
Copyright 2000 Harcourt Publishers Ltd.
Department of Pediatrics, Case Western Reserve University School of Medicine, University Hospitals of Cleveland, OH 44106-6010, SA.
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MeSH Terms
Gestational Age
Infant Mortality / trends*
Infant, Newborn
Infant, Premature*
Infant, Very Low Birth Weight*
Outcome Assessment (Health Care)*
Perinatal Care / standards*
World Health

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