G113(P) Survival in infants born at less than 24 weeks gestation – a population based study

Abstract

Background The management of infants born at less than 24 weeks gestation ( Methods Cases (live-born infants at 22–23w) were identified using a well-validated population based database (Regional Maternity Survey Office, Northern Region, UK) for the 5-year epoch 2008–2012. We included cases still alive at 6 h of age, in order to identify a group where the intention to provide active management appears likely. Survivors were identified from unit databases of the 4 tertiary level neonatal units, and individual case notes reviewed. Results During the study period 55 infants (56% male) born at 22–23w (n = 2 at 22w) were alive at 6 h (birth prevalence ˜4:10,000). Of these 24/55 infants (44%) were alive at 12 months age (50% male); 18/24 survivors received at least one dose of steroids. Median survival of non-survivors was 2.65 days (excludes one case known to have died at >2 years age). 7/31 non-survivors had a laparotomy, 3 had retinopathy of prematurity (ROP) treatment, 3 had PDA ligation, and only 2/31 ever achieved full feeds. Amongst survivors, 20/24 required some form of invasive surgery/intervention (4 laparotomy, 2 other surgery, 15 laser ROP, 2 Avastin for ROP, and 14 PDA ligation.) There was no significant difference in birthweight between survivors and non-survivors. Initial analysis did not identify early postnatal factors that enabled clear identification of infants who subsequently died. Conclusion Survival at