Survivors of Extreme Prematurity — Outcome at 8 Years of Age

Summary: Of 149 infants liveborn in a large maternity hospital in 1980 to 1982 and delivered between 24 and 29 completed weeks of gestation inclusive, 91 (61%) survived; 88 (97%) survivors were assessed at 8 years' corrected age; 77% of children were not disabled; disability was mild in 13%, moderate in 2% and severe in 4% of children. Although survival decreased with decreasing gestation, disability in survivors did not increase. An earlier assessment of the same children at approximately 2 years of age had been unduly pessimistic particularly for those born ≤26 weeks' gestation. The only other reports in the literature on outcome by gestation have all assessed the children in early childhood, and estimates of severe disability rates from these studies will probably also be too pessimistic. Since the rate of severe disabilities in infants of borderline viability is not much higher than in more mature infants the obstetrician should mainly consider survival chances for the fetus, and not be overly concerned with long‐term neurological outcome, when making clinical decisions.

[1]  L. Doyle,et al.  Changing two-year outcome of infants weighing 500 to 999 grams at birth: a hospital study. , 1991, The Journal of pediatrics.

[2]  W. Giles,et al.  The Short‐term Outcome of Infants of Multiple Pregnancies Delivered Before 28 Weeks' Gestation , 1991, The Australian & New Zealand journal of obstetrics & gynaecology.

[3]  W. Giles,et al.  The Short‐term Outcome of Singleton Infants Delivered Before 28 Weeks' Gestation , 1991, The Australian & New Zealand journal of obstetrics & gynaecology.

[4]  A. Orgill,et al.  Neurodevelopmental Outcome, Growth And Health Of Extremely Low‐Birthweight Survivors: How Soon Can We Tell? , 1990, Developmental medicine and child neurology.

[5]  E. Zimmer,et al.  Survival and long-term outcome of infants delivered at 24 to 28 weeks' gestation, by method of delivery and fetal presentation. , 1989, Journal of perinatology : official journal of the California Perinatal Association.

[6]  E. Hey,et al.  Pregnancy outcome at 24-31 weeks' gestation: neonatal survivors. , 1989, Archives of disease in childhood.

[7]  N. Marlow,et al.  Neurodevelopmental outcome in babies weighing less than 2001 g at birth. , 1987, British medical journal.

[8]  A. Orgill,et al.  Prognosis for infants born at 23 to 28 weeks' gestation. , 1986, British medical journal.

[9]  J. Milligan,et al.  Perinatal intensive care: where and how to draw the line. , 1984, American journal of obstetrics and gynecology.

[10]  M. Ryan,et al.  Live-born infants of 24 to 28 weeks' gestation: survival and sequelae at two years of age. , 1985, Ciba Foundation symposium.