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Am J Perinatol 2016; 33(09): 910-917
DOI: 10.1055/s-0036-1581131
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Online Calculator to Improve Counseling of Short-Term Neonatal Morbidity and Mortality Outcomes at Extremely Low Gestational Age (23–28 Weeks)

Carol P. King
1   Department of Obstetrics and Gynecology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
,
Orlando da Silva
2   Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
,
Guido Filler
2   Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
3   Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
4   Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
,
Laudelino M. Lopes
1   Department of Obstetrics and Gynecology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
› Author Affiliations
Further Information

Publication History

27 August 2015

23 February 2016

Publication Date:
08 April 2016 (online)

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Abstract

Objective Extremely low gestational age (ELGA) infants are at high risk of perinatal and neonatal morbidity and mortality. Accurate and relevant data are essential for developing a health care plan and providing realistic estimates of infants' outcomes.

Study Design Retrospective analysis of all infants delivered between 230/7 and 286/7 weeks' gestation over 11 years at a single center. Using logistic regression analysis, gestational age (GA)-specific mortality and morbidity rates, and the effects of gender, antenatal corticosteroids, multiple gestation, and birth weight (BW) were determined.

Results Of the 766 study infants, 644 (84.1%) were admitted to the neonatal intensive care unit, of which 502 (75.8%) survived to discharge. GA, antenatal corticosteroids, and BW were significant predictors of survival (GA: odds ratio [OR] = 1.83, 95% confidence interval [CI] = 1.64–2.04; corticosteroids: OR = 7.62, 95% CI = 5.19–11.18; BW: OR = 1.56, 95% CI = 1.44–1.69). Increasing BW correlated with a decreasing mortality rate.

Conclusion This study provides recent outcome data of ELGA infants delivered at a tertiary level center. The results have been translated into an online counseling tool (http://murmuring-brook-6600.herokuapp.com/ELGA.html).

Keywords

extremely low gestational age - survival - morbidity - counseling
 

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