Survival, morbidity, and resource use of infants of 25 weeks' gestational age or less.
OBJECTIVE
The objective of this study was to examine survival, morbidity, and resource use in a large cohort of extremely preterm infants.


METHODS
We examined all (n = 754) neonatal intensive care unit admissions born at < or =25 weeks' gestation and inborn deliveries (n = 949) between 22 and 25 weeks' gestation at 17 Canadian neonatal intensive care units.


RESULTS
The overall survival rate was 63%, with a range from 14% at 22 weeks' gestation to 76% at 25 weeks' gestation. There was a high incidence of chronic lung disease (33%-51%), > or =grade 3 intraventricular hemorrhage (0%-16%), necrotizing enterocolitis (0%-14%), > or =stage 3 retinopathy of prematurity (27%-55%), nosocomial infection (25%-39%), and multiple gestation (18%-46%). Extremely preterm infants comprise 4% of neonatal intensive care unit admissions but account for 22% of deaths, 20%-60% of major morbidities, 11% of patient days, and 10%-35% of major procedures. Outborn infants had a higher incidence of chronic lung disease, severe retinopathy of prematurity, and intraventricular hemorrhage.


CONCLUSIONS
Extremely preterm infants have a high incidence of mortality and morbidity and consume disproportionate amounts of neonatal intensive care unit resources.
Chan
K
K
Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
Ohlsson
A
A
Synnes
A
A
Lee
D S
DS
Chien
L Y
LY
Lee
S K
SK
D002170:Canada / Q000453:epidemiology; D002543:Cerebral Hemorrhage / Q000453:epidemiology; D002908:Chronic Disease; D003428:Cross Infection / Q000453:epidemiology; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D015931:Intensive Care, Neonatal; D008171:Lung Diseases / Q000453:epidemiology; D008297:Male; D009017:Morbidity; D011247:Pregnancy; D011272:Pregnancy, Multiple; D012178:Retinopathy of Prematurity / Q000453:epidemiology; D015996:Survival Rate