Abstract
To provide comprehensive, contemporary information on the actuarial survival of infants born at 22-25weeks of gestation in Canada. In a retrospective cohort study, we included data from preterm infants of 22-25weeks of gestation admitted to neonatal intensive care units participating in the Canadian Neonatal Network between 2010 and 2017. Infants with major congenital anomalies were excluded. We calculated gestational age using invitro fertilization date, antenatal ultrasound dating, last menstrual period, obstetrical estimate, or neonatal estimate (in that order). Infants were followed until either discharge or death. Each day of gestational age was considered a category except for births at 22weeks, where the first 4days were grouped into one category and the last 3days were grouped intoanother category. For each day of life, an actuarial survival rate was obtained by calculating how many infants survived to discharge out of those who had survived up to that day. Of 4335 included infants, 85, 679, 1504, and 2067 were born at 22, 23, 24, and 25weeks of gestation, respectively. Survival increased from 32% at 22weeks to 83% at 254-6/7weeks. Graphs of actuarial survival developed for the first 6weeks after birth in male and female children indicated a steep increase in survival during the first 7-10days postnatally. Survival increased steadily with postnatal survival and was dependent on gestational age in days and sex of the child.
Published Version
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