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Am J Perinatol 2024; 41(05): 660-668
DOI: 10.1055/a-1779-4032
Original Article

Prognosis of 22- and 23-Gestational-Week-Old Infants at Our Facility: A Retrospective Cohort Study

Toshimitsu Yanagisawa 
1   Division of Neonatology, Nagano Children's Hospital, Azumino, Nagano, Japan
,
Tomohiko Nakamura
1   Division of Neonatology, Nagano Children's Hospital, Azumino, Nagano, Japan
2   Division of Neonatology, Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
,
Masayo Kokubo
1   Division of Neonatology, Nagano Children's Hospital, Azumino, Nagano, Japan
3   Department of Healthcare Epidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
› Author Affiliations Funding None.
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Abstract

Objective This study aimed to compare inborn infants aged 22 and 23 gestational weeks at our hospital to assess for differences in survival and long-term prognosis.

Study Design We retrospectively analyzed 22- and 23-gestational-weeks-old infants born in our hospital between January 2011 and December 2018. The prognosis of inborn infants in Japan was also calculated using the Neonatal Research Network of Japan (NRNJ) data during the same period.

Results The survival rates at our institution's neonatal intensive care unit discharge, including stillbirth, were 72 and 89% at 22 and 23 gestational weeks, respectively. The mortality rate and neurodevelopmental impairment (NDI) rate at 3 years of age, including stillbirth, were 58 and 32% at 22 and 23 weeks, respectively. Cerebral palsy, mental developmental retardation, visual impairment, and hearing impairment defined NDI. The prognosis at our hospital was better than the average calculated using NRNJ data. Survival rates varied among facilities, and some facilities had survival rates similar to that of our hospital.

Conclusion The prognosis of 22-gestational-week-old inborn infants was inferior to that of 23 gestational weeks in our institution but was better than previously reported. If aggressive treatment is provided, survival without sequelae can be fully expected even for 22-gestational-week-old infants.

Key Points

  • We examined babies of gestation ages 22 and 23 weeks.

  • We examined the survival and neurological prognoses.

  • We compared our facility with that in entire Japan.

Keywords

extremely low birth weight - infant - mortality rate - neurodevelopmental outcome - survival rate

Authors' Contribution

T.Y. and T.N. conceptualized and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript. M.K. revised the manuscript. All authors approved the final manuscript and agree to be accountable for all aspects of the work.


Supplementary Material



Publication History

Received: 13 October 2021

Accepted: 07 February 2022

Accepted Manuscript online:
22 February 2022

Article published online:
11 March 2022

© 2022. Thieme. All rights reserved.

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