Single-centre vs. population-based outcome data of extremely preterm infants at the limits of viability.
OBJECTIVE
In response to the disappointing outcome data of the population-based EPICure study published in 2000, we compared the outcome of infants 22 0/7 to 25 6/7 weeks of gestational age (GA) in a single tertiary care centre 2000-2004 with that of EPICure.


METHODS
EPICure tools and definitions, including 30 months' Bayley Scales.


RESULTS
Of 83 infants <26 weeks born alive, more were admitted to intensive care--82% vs. 68% (p < 0.0001)--and more infants survived to discharge (57% vs. 26%, p < 0.0001; 69% vs. 39%, p < 0.01, of those admitted to intensive care). More infants, as a percentage of live births, survived without severe (41%, 34/83 vs. 20%, 233/1185, p < 0.0001) or overall disability (22%, 18/83 vs. 13%, 155/1185, p = 0.03). However, at the border of viability--GA 23 and 24 weeks--the rate of infants surviving without overall disability was not significantly higher (13%, 6/45 vs. 9%, 56/623).


CONCLUSIONS
In infants <26 weeks of GA, increased rates of survival and survival without disability were observed in a single-centre inborn cohort born 5-8 years later than the EPICure cohort. This did not translate into increased survival without overall disability in infants of 23-24 weeks of GA.
Kutz
Patrizia
P
Department of Neonatology and Paediatric Intensive Care, Vest Children's Hospital, University Witten-Herdecke, Datteln, Germany.
Horsch
Sandra
S
Kühn
Lisa
L
Roll
Claudia
C
D000367:Age Factors; D016009:Chi-Square Distribution; D015331:Cohort Studies; D002658:Developmental Disabilities / Q000453:epidemiology*; D005328:Fetal Viability; D005858:Germany / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000401:mortality*; D007363:Intensive Care Units, Neonatal; D015931:Intensive Care, Neonatal / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D012720:Severity of Illness Index; D015996:Survival Rate